Real talk: For most women, it’s not all pleasure, all the time in between the sheets. Pain after sex happens to a lot of us, despite the fact that it’s not publicly discussed as often as masturbation or foreplay techniques—and it can be really troublesome, both physically and mentally.
Post-sex pain can come in many forms, from period-like cramps to vaginal swelling, itching, or a burning sensation when you pee, says Sherry A. Ross, MD, women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period.
The first step toward fixing the issue, she says, is to identify what’s causing the discomfort in the first place. This isn’t something she recommends trying to figure out on your own—if the pain is consistent, your first move should be a visit to your gyno. You’ll be saving yourself lots of anxiety-filled hours Googling your symptoms away in the name of self-diagnosis.
But to ensure that you have the most productive conversation with your MD as possible, there are a few common causes for postcoital pain that you may want to keep in mind before your appointment. Luckily, most of them are treatable—allowing you to fully enjoy the afterglow of getting busy, minus any uncomfortable distractions.
Keep reading to learn why you might feel pain after sex — and what to do about it.
For new mamas, breastfeeding might explain pain after sex. “If you continue to breastfeed, you are still in postpartum menopause, meaning you have no libido and your vagina is extremely dry,” Dr. Ross says. Estrogen is the key ingredient for a fired-up sex drive, self-lubrication, and blood flow to your nether region. But, when you’re breastfeeding, estrogen levels dip low to promote milk production.
Treatment: Don’t stress: The physical (and emotional) challenges that come along with breastfeeding will improve with time. For now, a little KY Jelly should do the trick, Dr. Ross says.
2. Vaginal Dryness
Vaginal dryness is actually very common, and it can fluctuate due to various factors including your menstrual cycle, what you’re eating, your quality of sleep, and even how hydrated you are. Rushing into sex is also likely to result in a desert-like situation down under. “If you have not had the right amount of foreplay to become sexually aroused and ‘get wet,’ the vagina will be dry, making sex painful,” Dr. Ross says.
3. STI or PID
Sexually transmitted infections, such as chlamydia and gonorrhea, could also be culprits behind your pelvic pain. If untreated, these can progress into pelvic inflammatory disease (or PID), an infection of the female reproductive organs that comes with symptoms like bleeding, heavy discharge, and fever.
Treatment: Go see your doctor, ASAP—PID can lead to infertility. Treatment usually includes antibiotics. And, as a precaution, Dr. Ross recommends also getting STI check-ups in between sexual partners.
Pain after sex is often an issue in menopausal women who are not taking estrogen. Again, this essential hormone is the magic ingredient that creates vaginal moisture. Without it, Dr. Ross says, “it results in a burning sensation inside the vagina, especially with sex.”
Treatment: Dr. Ross recommends estrogen cream or Osphena, a hormone-free oral pill. (Obviously, go see your doctor to find out what will work best for you.) And if you want to go the drug-free route, she suggests the FDA-approved MonaLisa Touch, which is a quick 5-minute treatment that uses laser energy to stimulate the vaginal wall.
5. Penis Size
So yes, apparently there is a such thing as overly big dick energy, which can explain soreness after doing the dirty. “‘Bigger is better’ is not the case for a vagina that can’t tolerate a long or thick penis,” Dr. Ross says.
Treatment: This scenario isn’t necessarily a lost cause—you’ll just need to ease into things with your well-endowed partner. “The vagina does stretch depending on the size of the penis,” Dr. Ross explains. “But, it may take time, patience, KY Jelly, and open communication.”
6. Latex Allergy
Most condoms on the market are made out of latex. And if you’re allergic to this material, knocking boots can cause vaginal swelling, itching, and pain during and up to 36 hours afterwards, Dr. Ross says. Oh, and it’s worth noting that the allergy often develops slowly. So even if you’ve been using latex condoms for years, you can become allergic over time.
Treatment: Dr. Ross recommends switching to polyurethane condoms, which are made of plastic. Fair warning: Because they don’t have the same stretch as latex, they may be more likely to slip off or break, so be extra careful.
7. Ruptured Ovarian Cyst
“If you are ovulating, chances are there is an expected large ovarian cyst waiting to burst and release the egg,” Dr. Ross says. “Aggressive sex, exercise, or a spontaneous rupture can cause this cyst to release its fluid contents along with the egg, causing noticeable pain.”
Treatment: Even though it sounds scary, this is actually a normal physiological phenomenon known as mittelschmerz, Dr. Ross explains. It’s best to consult your doctor and have a pelvic ultrasound to help make the diagnosis.
8. Certain Sex Positions
According to Dr. Ross, it’s totally normal to experience some discomfort after doing it in certain positions. Doggie style, for example, is a bit rougher on your uterus and ovaries than missionary, since it allows for deeper penetration.
Treatment: Take the time to get to know your body and discover what positions are most comfortable and pleasurable for you—and avoid the ones that hurt. (Yes, even if your partner’s into them.)
9. SEXUAL INEXPERIENCE
Contrary to how it’s depicted in the movies, your first few times will probably not be all rainbows and butterflies. In fact, sex will most likely be a bit painful in the beginning, and that’s normal. “It may take time and regular sex before you start to experience pleasure,” Dr. Ross says.
Treatment: “Good communication with your partner and patience is the right recipe for success,” she says. You can also apply some numbing gel to the entrance of the vagina to help relieve the pain—your doctor can advise whether this is the right move for you.
10. Emotional Problems
Your mental and emotional wellbeing can absolutely affect your sex life. “Feeling depressed, anxious, having relationship problems, and fear of intimacy all play a role in getting sexually aroused and can contribute to painful sex,” Dr. Ross says.
If you’re experiencing involuntary spasms inside your vagina or finding it really painful to insert anything up there, then it might be vaginismus. It’s brought about by both emotional and physical triggers, such as fear of pain, traumatic events, an infection, or giving birth.
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