Pain during sex - what causes it and what women can do

Sex shouldn't hurt, yet a surprisingly number of women experience pain during intercourse. One US study - the 2009 National Survey of Sexual Health and Behavour – found that as many as 30% of women had suffered pain and discomfort the last time they had sex.

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"Many women dismiss the problem as 'all in their head' but sex shouldn't be painful. If you're having problems, it's important to look into the causes as there are lots of solutions available," says Alix Fox, sex and relationships expert for Durex.

What makes sex painful?

"Pain during sex can be caused by all manner of things, from simple friction resulting from dryness if a woman's body isn't producing sufficient amounts of natural lubrication, to vaginismus – a condition where the muscles of the vagina clamp tightly shut when penetration is attempted," says Alix.

"It's even possible for pain to stem from an allergy to semen. The official name for this is Human Seminal Plasma Hypersensitivity, and it can result in an intense burning sensation, along with itching, peeling skin, hives and swelling."

If sex is painful and the problem isn't obvious, see your GP to check that there isn't an underlying issue. A genital infection, like thrush, or a sexually transmitted infection, such as chlamydia, gonorrhoea or genital herpes, can cause discomfort and pain during sex. In some cases you may not experience any other symptoms, so it's important to see your GP or visit your local GUM clinic to be tested. Painful sex can also be a symptom of endometriosis and is associated with irritable bowel syndrome.

"Don't be afraid to talk it over with a health professional. They've seen and heard it all before, so there's no need to be embarrassed," says Alix.

Far-reaching effects
Painful sex doesn't just ruin the moment. The effects of even one session of uncomfortable lovemaking can be far-reaching, according to Alix.

"The fear and trepidation that sex will cause pain again can trigger a woman to both tense up and dry up the next time a sexual encounter begins, and guess what? A tense, dry vagina equals discomfort, so the problem can become a self-fulfilling prophecy, and ladies can get stuck in a horrible loop of sexual pain and worry."

In turn, this can lead to a drop in libido, cause a reduction in intimacy within relationships, and give rise to more general feelings of stress and anxiety.

Make sure you're aroused enough

A lack of sufficient arousal prior to penetration is one of the leading causes of sex being less 'Ooh!' and more 'Ouch!' for women, as Alix explains: "Being turned on prompts the vagina to begin producing moisture. Being in an aroused mental state also makes the muscles of the vagina relax and the vaginal opening widen, making it easier for a penis to enter."

Alix adds: "Different people get excited by different things, but to ensure penetration feels great rather than making you grit your teeth, it's important to spend plenty of time doing whatever gets you in the mood before you even attempt intercourse.

"Some women might find it helpful to dab a little Durex Play O gel on their clitoris to kick things off. It causes a variety of warming, cooling and tingling sensations, and quietly concentrating on exactly how this feels – almost meditating, if you will - can help centre your attention around your genitals and get you 'in the zone'."

Alix is also a fan of erotic board games and card games. "Sure, they may seem silly, but adding a sense of fun to sex can help reduce unhelpful feelings of being under pressure (which can lead to muscular tension, dryness, and pain). Plus going through the process of playing a game together ensures foreplay isn't rushed, and places an emphasis on communication and relaxation. What have you got to lose by giving it a try?"

What causes dryness

During the menopause, falling levels of oestrogen can cause vaginal tissues to become thinner and less elastic, which may potentially make sex dry and uncomfortable. If you find that vaginal dryness is an issue, you're not alone. The problem is believed to affect some 50-80% of women going through the menopause.

Your GP may recommend Hormone Replacement Therapy (HRT). This should prompt the mucous membranes in the vagina to begin producing lubricating fluids again. Alternatively, milder oestrogen treatments are available that can be applied directly to the vaginal area by inserting a pessary, using a cream, or wearing a special vaginal ring that stays in place for a few months at a time.

It's not just the menopause that can cause a problem. Hot showers and baths can dry vaginal secretions, as can some allergy medications and hormonal birth control pills. An allergy to spermicides, latex condoms or soap and shampoo, can also cause soreness.

Reach for some lube

One very simple, easy thing you can do to relieve the issue is to grab a tube of lube, says Alix.

"Lubricant is something I universally recommend, as it makes so many sexual practices slicker, sleeker and more enjoyable. Water-based types like Durex Play Aloe Vera are good all-rounders, especially for sensitive skins, while silicone-based variants like Durex Play Perfect Glide are formulated to be especially long-lasting. You can order them discreetly online or pick up a bottle at many high street stores and supermarkets."

What can you do if it's a tight squeeze?

If you're petite and your partner is particularly well endowed, pain can be caused by the penis hitting the cervix. Using lubrication can help, as can changing sex positions.

Alix explains: "You may want to stick to having sex in positions designed to keep penetration quite shallow, and where the woman is better able to control the depths of his thrusts.

"Girl-on-top is a great option, or try having him sit on an armless chair and then straddle his lap, either face-to-face or turned away from him. Use your thigh muscles to move up and down on his penis, only allowing him to enter you as far as feels comfortable. The motions will still feel amazing for him, plus the view of your breasts or bum will be spectacular.

"You could also try a penis ring, like the new Durex Pleasure Ring," suggests Alix. "It's designed to be worn at the base of the penis, and while its primary purpose is to help keep him hard, it will also slightly reduce his length because it takes up a couple of centimetres of space on the shaft, making him a little less of an intimidating proposition!"