Painful intercourse

Dear Alice,

I am a 19 year old woman who had sex for the first time this summer. My boyfriend and I have known each other for a very long time and we have an incredible relationship. Hence, our first time was great except for penetration hurt terribly. I kind of expected that, but when the incredible pain did not stop after we had slept with each other for a couple of times, I got worried. I have been talking to friends, who could not relate to my experiences. They keep telling me to go on. It will eventually stop hurting. For now, my boyfriend and I have resorted to other methods to reach climax and he says he is perfectly satisfied with that. The problem is that I have a feeling I am missing out on an important part of sex. I was wondering if there is such a thing as a physical condition that makes penetration permanently painful. And if there is what can be done about it? I don't think we are making technical mistakes because we are pretty resourceful and sensitive lovers. I hope you can give me some information.

— Unfulfilled

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!

Last updated May 06, 2015
Originally published Oct 01, 1993

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