Why Sex Hurts: Causes of Painful Sex and How to Make It Feel Good

By: Jay Dee, MPH

Why Sex Hurts—and How to Fix It

One of the most common reasons for painful sex is simply not enough natural vaginal lubrication. Your body’s wetness can fluctuate for many reasons—pre-menopause or menopause, hormonal birth control, diabetes, being overweight, dehydration, or certain medications. A lack of lubrication increases friction, which can make penetration uncomfortable or even painful.

The first step? Talk to your OBGYN for personalized guidance. In the meantime, using a high-quality personal lubricant can make sex smoother, reduce irritation, and increase pleasure.

Tight Vaginal Muscles: Vaginismus and Trauma Responses

Sometimes, pain isn’t about lubrication at all—it’s about tension. Vaginismus occurs when the vaginal muscles involuntarily tighten, making penetration difficult or impossible. This is often a trauma response, where the body’s natural reflex is to protect itself. Remember: the vagina is a muscle, and like any muscle, it needs to relax and conform during sex. If you struggle with this, a sex-positive therapist can help you explore triggers, work through trauma, and learn exercises to ease tension and reclaim pleasurable intimacy.

Infections That Cause Pain

Painful sex can also signal common vaginal or urinary infections:

• UTIs (Urinary Tract Infections): Infections in the bladder or urethra can cause burning, stinging, or pain during penetration.

• BV (Bacterial Vaginosis): An imbalance of vaginal bacteria can lead to irritation, inflammation, and discomfort during sex.

• Yeast Infections: Overgrowth of Candida can cause itching, swelling, and painful intercourse.

  
  

If you suspect an infection, see your healthcare provider promptly to relieve pain and protect your reproductive health.

Untreated STIs Can Cause Pain

Another frequently overlooked cause of painful sex is untreated sexually transmitted infections (STIs). Many infections don’t cause obvious symptoms, so it’s easy to assume everything is fine. However, leaving an STI untreated can seriously impact your reproductive health and make sex painful. Regular testing, early treatment, and open communication with your partner are essential steps to protect your body and your pleasure.

If you’re experiencing pain, here are solutions:

Hydration: Drink Up for Vaginal Health

Your body needs water to function—and that includes natural lubrication. A simple rule: aim to drink half your body weight in ounces of water each day. For example, if you weigh 140 lbs, that’s about 70 ounces of water. Hydrating foods like watermelon, cucumbers, and oranges can also help keep your vaginal tissues supple and healthy.

Lubrication: Reduce Friction, Increase Pleasure

A good personal lubricant can make all the difference. Use water-based lubes if you’re using condoms, or silicone-based lubes for condom-less sex for longer-lasting slickness. Lubrication isn’t just about comfort—it’s about enhancing sensation, reducing pain, and allowing your body to relax fully during intimacy.

Medical guidance: Talk to a Sex-Positive Practitioner

Painful sex isn’t something you have to tolerate. Coordinate care with a sex-positive OBGYN, gynecologist, or healthcare provider who makes you feel comfortable discussing your sexual health openly. They can help identify hormonal changes, medical conditions, or medications that may be affecting your comfort, and guide you toward effective solutions.

Therapy: Address Muscle Tension and Trauma

If tight vaginal muscles or trauma are contributing to pain, therapy can be life-changing. A sex-positive therapist can help you explore triggers, learn relaxation techniques, and work through any past trauma that’s affecting your ability to enjoy sex. Vaginal muscles are like any other muscles—they respond to care, relaxation exercises, and intentional practice.

STI Testing: Protect Your Body and Pleasure

Untreated sexually transmitted infections can cause pain and serious health problems. Make it a habit to test at least twice a year for common STIs and HIV, and encourage your partners to do the same. Exchanging results before intimacy ensures both safety and peace of mind, allowing sex to be comfortable and worry-free.

Understanding your body and giving it the care it deserves can help you enjoy comfortable, confident, and empowering sex.

Until Next Time,

The Vagina Liberator