Painful intercourse

Dear Unfulfilled,

There are a number of physical reasons you might experience pain during intercourse (and fortunately all have solutions):

• Insufficient lubrication: If your natural lubrication is not enough, or timing is off, the friction of sex could be quite painful. In this case, using a water-based lubricant may help.
• Tightness in the vaginal entrance: The first few times a woman has intercourse, an un-stretched hymen may cause pain. Whenever you are tense or preoccupied, the vaginal entrance is not likely to relax, making penetration painful. Even with enough lube, arousal takes time. Slow down and and enjoy the foreplay.
• Painful penetration — vaginismus: This is a strong, involuntary tightening of your vaginal muscles — a spasm of the outer third of your vagina which makes entrance by the penis acutely painful. This can be physically- or psychologically-based. If you have ruled out other possible causes of pain, speak with a health care provider about vaginismus.
• Local infection: It's possible to have an infection even if you don't have any symptoms. The friction from sex can cause an infection to flare up. Luckily, many infections can be treated quickly with a trip to your health care provider.
• Pain deep in the pelvis: This can be caused by tears in the ligaments that support the uterus, infections of the cervix, uterus or tubes, endometriosis, or cysts or tumors on the ovaries. All of these may be medically treatable and would require a visit to your health care provider.

Whatever the cause, you needn't put up with the pain! A gynecological exam that includes a full discussion of your concerns is a good first step to find out what's going on. Contact your women's health care provider or a community-based resource like Planned Parenthood for a referral. In the meantime, keep on doing what you're already doing — finding other ways to give each other pleasure, taking your time, and enjoying each other. Feel good!