13 Reasons Why Your Vagina Might Hurt During Sex

Penetrative sex can be uncomfortable, but sometimes it really hurts...like I-am-doubled-over-in-pain hurts. The medical term for this is dyspareunia, which refers to recurring or persistent pain before, during, or after sex, according to the Mayo Clinic. The pain might only occur upon entry, penetration with anything (like a tampon), deep thrusting, or a combination of those — and the level of pain can range from mild to severe.

Pain is a complex and multifaceted issue, so there isn't always one single explanation or treatment. And it can be very frustrating when something that's supposed to be pleasurable causes pain and discomfort instead. So we spoke to two experts to find out what can cause painful sex and and which treatments are out there: Dr. Mary Jane Minkin, clinical professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine; and Dr. Shannon Chavez, a licensed clinical psychologist and certified sex therapist in Los Angeles.

FYI, for the purposes of this article we are focusing on penetrative vaginal sex — so that means sex involving a penis or finger or dildo (or any other toy) going into the vagina.

"The first question we ask is, does she have an active infection of some sort which is causing or exacerbating her pain?" Minkin tells BuzzFeed Health. An outbreak of genital herpes, UTIs, yeast infections, chlamydia, and gonorrhea are all examples of vaginal infections that can make sex painful and uncomfortable, Minkin says. These infections can cause inflammation or irritation of the vulva and vaginal canal, which makes entry and penetration really hurt. Some infections can also affect the cervix and uterus, which may cause deeper pain with thrusting.

In addition to painful sex, you might also have other STI symptoms such as itching, abnormal discharge, or burning. But oftentimes, STIs have no symptoms at all. So the best way to tell if an infection is causing the pain is to visit your OBYGN and to get tested.

The skin of the vulva and vaginal opening is very delicate and sensitive, Minkin says, so it's not uncommon for injuries to happen. These injuries could be caused by an accident, surgery, pelvic trauma, female circumcision, piercings gone wrong, or an incision made to widen the birth canal (episiotomy). They can cause tears and scarring that make sex very painful upon entry, especially if there's a wound that isn't fully healed.

So if you do have an injury on or around your genitals, it's important to take the time to heal properly and wait to have sex until your OBGYN gives you the green light. Additionally, certain skin conditions can cause irritation or lesions on the skin of your vulva that make sex painful. These include eczema, allergic reactions, or a condition called lichen planus. If you are concerned, talk to your OBGYN or dermatologist about pain during sex.

"Vaginismus is a condition in which there's involuntary contraction of the vaginal and pelvic floor muscles, and there can be so much tension that it doesn't even allow for entry," Chavez tells BuzzFeed Health. So in addition to making sex painful, vaginismus can cause the muscles to spasm and clench to the point where you can't insert anything in the vagina, even a tampon. Since the tightening of these muscles is involuntary, it can happen even when a person is aroused and wants to have sex, Chavez says — so the condition can be incredibly frustrating. Many women with vaginismus suffer in silence.

It can be caused by both physical and psychological factors, or a combination of both. "In treatment, we often tackle both sides," Chavez says. So a patient might need to see a therapist to deal with anxiety or stress about intercourse, but also see a pelvic floor therapist to learn how to relax and retrain their muscles.

Read one woman's search for the right treatment in I Got Botox In My Vagina And It Changed My Life.

"The big thing that causes pain upon entry is vulvodynia or vestibular vulvitis, which causes chronic pain in the vulvar region," Minkin says. This can cause a lot of pain during penetration and also any other activity that puts pressure on the vulva, such as bike riding or even just sitting. "We don't know the exact medical cause, but we think it might be an inflammatory response in the nerves around the opening of the vagina and the vulva, which causes hypersensitivity and pain," Minkin says.

There is no cure for vulvodynia, but you can treat the symptoms. If you have vulvodynia, do not feel alone. "It's not uncommon and studies have shown that as many as 9% of women have dealt with this at one point in their life," Minkin says.

"If the pain is deeper in the pelvis, the first thing we consider is endometriosis, because it's fairly common and usually causes pain during sex," Minkin says. Endometriosis occurs when the tissue lining the uterus grows on other organs, and it's a common culprit when it comes to pain during sex. There's no cure, but treatment can include hormone therapy or surgery, Chavez says.

Other conditions that can cause chronic pelvic pain include scarring due to infections, uterine prolapse, pelvic inflammatory disease, fibroids, ovarian cysts, and more. "If the pain is deep in your pelvis, you should go to the doctor because you may need to get the fibroids or cysts removed — vigorous sex could actually pop a cyst, which is extremely painful," Minkin says.

Pain and discomfort during sex can also be caused by a personal issue between two partners, Chavez says. Lack of attraction, relationship issues, and poor communication can all affect a person's mental state and result in a lack of arousal or decreased lubrication. It's important to communicate with your partner and let them know what you do and do not like, Minkin says — and remember, consent is key.

You can also check in with your partner about boundaries to make sure you are both on the same page during sex. Some couples may benefit from seeing a sex therapist, Chavez says, who can do exercises with couples to teach them how to enhance pleasure and avoid things that cause pain.

"Pain is a communication from the body, so I always tell clients to listen to what the pain is telling you — do not ignore it, because it's better to address it sooner than later and avoid further discomfort to the body," Chavez says. So if you have recurring pain during sex, you should see a doctor who can help pinpoint the cause and suggest treatment. Not to mention, you should speak up to your partner and communicate how and when sex hurts, so you can work together to make things more comfortable.

And finally, don't feel alone. "Pain during sex is actually so common, but it's also so isolating because a lot of women feel like everyone else in the world is having great sex so there must be something wrong with them," Chavez says. If you do have pain during sex, know that it's common and you have a lot of options and many different specialists out there who can help.