Why is painful sex more common for people with vaginas?

According to Dr. Laurie Mintz, 30% of women report having pain at their last instance of penetrative sex.

Overall, research suggests that women are more likely to experience pain during sex than men.

But sex isn't supposed to hurt! Yes, even first-time sex should be painless. Just because it's common doesn't mean it's normal.

 

So, why do we experience discomfort?

Well, anatomically speaking, people with vaginas have a complex reproductive system that has many different sources for pain and discomfort (i.e. the vagina, cervix, uterus, ovaries). People with vaginas can be prone to things like vaginal dryness, vaginismus, and endometriosis, which can all contribute to pain during sex.

Here are some common reasons for pain during sex:

Vaginal dryness:

One of the most common reasons for pain during sex is vaginal dryness. There are a number of reasons for this, including: not enough foreplay, hormonal changes, medical conditions, or arousal non-concordance (when your brain is aroused but you aren’t experiencing vaginal lubrication in response). The good news is: lube can help! It’s good practice to incorporate lube into your sexual experiences regardless, as it helps reduce friction and can enhance overall pleasure. If you’re using condoms, remember to choose either a silicone-based or water-based lube, and avoid oil-based lubes which can cause breakage.

 

Vaginismus

Vaginismus is when the muscles of the vagina involuntarily contract during penetration, making sex painful or impossible. It can be caused by anxiety, trauma, or other psychological factors. Common signs of Vaginismus include: trouble inserting a tampon, struggling with vaginal penetration, and burning or stinging during sex. Treatment for Vaginismus might involve things like: managing your feelings around penetration, relaxation techniques, and pelvic floor exercises.

Endometriosis

Endometriosis is a condition where the tissue that lines the uterus grows outside of it, causing pain and discomfort during sex and other activities. Endo is notoriously underdiagnosed. The exact cause of it is not well understood, but it is thought to be related to hormonal imbalances and genetic factors. It is a chronic condition and is estimated to affect 10% of women of reproductive age. Certain treatment options can help manage the symptoms and improve quality of life, such as: pain relievers, surgery, or other therapies. A supportive healthcare provider should help you develop a treatment plan that suits your needs and preferences.

Pelvic inflammatory disease (PID)

PID is an infection of the female reproductive organs that can cause pain during sex, as well as other symptoms such as fever, abdominal pain, and irregular periods. Symptoms of PID can include abdominal or pelvic pain, fever, abnormal vaginal discharge, painful urination, and painful intercourse. If left untreated, PID can lead to serious complications such as infertility, chronic pain, and ectopic pregnancy. Treatment for PID typically involves a course of antibiotics to eliminate the infection. The specific type of antibiotics and duration of treatment will depend on the severity of the infection and the individual's overall health.

In Conclusion…

It’s important to note that all genders can experience pain during sex. Penis owners might experience pain if they have conditions such as Peyronie's disease, prostate inflammation, or genital infections.

As always, it’s important to consult with a doctor if you’re experiencing continued discomfort.