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13 Reasons Why Your Vagina Might Hurt During Sex

Let's talk about when sex hurts and what you can do about it.

Posted on February 24, 2018, at 4:01 p.m. ET

Sex can hurt for many reasons β€” both physiological and psychological β€” but here are some of the more common ones and how to deal with them.

1. An active vaginal infection.

2. Injuries or irritation to the vulva and vagina.

3. Vaginismus, which causes the vaginal muscles to tense up upon penetration.

4. A chronic pain condition like vulvodynia or vestibular vulvitis.

5. Abnormal anatomy.

Marita Patrinos / Via buzzfeed.com

Some people are born with an anatomical defect that either changes the shape of the vagina or makes it so there is little or no opening. You've probably heard of the hymen, a membrane that partially covers the vaginal opening, and the myths about how it "breaks" during intercourse. When someone has an "imperforate hymen," Minkin says, it means that the membrane is abnormally thick or tight, which can make sex very painful or even impossible. "Sometimes there's no opening at all, so these women don't even bleed during their period and the blood can collect in the vagina," Minkin says.

Mayer-Rokitansky-Kuster-Hauser syndrome is a rare sexual development disorder that can cause a person to be born without a vagina or incomplete reproductive organs. In these cases, attempting penetration can be super painful. Treating these disorders may involve surgery, Minkin says, or using vaginal dilators.

6. Conditions like endometriosis, pelvic inflammatory disease, or fibroids can cause deep pain.

7. Vaginal dryness caused by hormones, medication, or stress.

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When sex is painful during penetration, it could mean that you aren't sufficiently lubricated. Moisture is key and without it, penetrative sex can cause friction that leads to micro-tears and irritation. The vulvar tissue is already fragile, but vaginal dryness can cause a lot of pain during penetration. Vaginal dryness could be caused by a change or suppression of hormones, Chavez says, which can happen during pregnancy, menopause, or when someone goes on birth control. Stress can also change the body's chemistry, Chavez says, and result in a loss of moisture.

"Medications, such as antidepressants and antihistamines like Benadryl, can also cause vaginal dryness and affect libido," Minkin says. If you have vaginal dryness, you should talk to your OBGYN to find out what could be causing it and how you can treat the problem.

8. Not enough lube.

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Even if you don't have a problem with vaginal dryness, sometimes the vagina's own lubricant isn't enough to last throughout sex. And that can lead to discomfort, friction, and pain during penetration or deep thrusting. So lube should really be your best friend. You can use it during foreplay and penetration. Minkin suggests trying a good lube that'll actually keep the vagina moist, and trying out a few different kinds to see which one works best.

Some of the experts' vagina-friendly lube picks include Vagisil ProHydrate Internal Moisturizing Gel, Lelo Personal Lubricant, and Überlube. Check out this lube guide for more information and suggestions.

9. Lack of foreplay and stimulation.

Vimeo / Via giphy.com

"It's the equivalent to a male erection β€” the woman needs stimulation and foreplay or else sex is probably going to be uncomfortable or painful," Minkin says. The vagina is self-lubricating, but it takes a little work and dedication to get the liquids flowing. "It takes a woman’s body at least 20 minutes to become fully aroused, which includes engorgement of erectile tissue in the labia, clitoris, and vaginal canal," Chavez says.

The solution? Talk to your partner and ask for more stimulation and foreplay, Minkin says, and don't rush into penetrative sex. "There is no particular form of foreplay needed other than an activity that is pleasurable and stimulating to you," Chavez says. Slowing things down and being more mindful about foreplay and sexual arousal can really help.

10. Certain positions.

Comedy Central / Via giphy.com

In some positions, you might feel perfectly fine and good but other positions can really cause a lot of pain during penetration and deep thrusting. "You should try to find positions that are comfortable and that work with your partner β€” we can't change anatomy but we can find positions that work with your body," Chavez says.

A large penis or dildo (within a reasonable size range) can cause some discomfort and pain, Minkin says, but it's highly unlikely that a penis is "too big" for a vagina or it will injure the cervix. "The vagina can accommodate a baby's head that's 10 centimeters in diameter, and there's no penis as big as that," Minkin says. If you do feel like size is an issue, try loading up on lube and avoiding positions that cause pain.

11. Lack of connection or relationship issues.

12. Psychological factors such as anxiety, fear, or self-esteem issues.

Jenny Chang / Via buzzfeed.com

Fear and anxiety around penetration can create a mental barrier, Chavez says,

which can lead someone to unconsciously tense up their pelvic floor muscles during sex, which causes a physical barrier for penetration-based activity. "Maybe they had a negative sexual experience so they anticipate pain and discomfort, or they have experienced trauma such as sexual abuse, violation of boundaries, sexual assault," Chavez says. As a result, the mind can go into fight-or-flight mode, which can cause the body and pelvic floor muscles to clench up.

Poor self-esteem and body image issues can also decrease arousal or cause someone to become tense or nervous during sex. "There is no one-size-fits-all treatment," Chavez says, so overcoming these psychological barriers will depend on the person and their experiences and needs.

13. Ignoring the pain, which can make things worse. Listen to your body and see a doctor.

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