The 10 Most Common Causes of Pain During Sex and What to Do

1. Burning and itching with a strange discharge

Possible causes:

Dreaded yeast infections, with their telltale cottage-cheese-like discharge, are extremely common. However, be aware that a latex allergy can mimic that awful fiery feeling.

Burning and itching with sex, or otherwise, could also be a sign of bacterial vaginosis (BV), the most common cause of a wonky discharge.Hay P. (2017). Bacterial vaginosis. DOI: 10.12688/f1000research.11417.1 BV is often accompanied by a fishy odor.

Sexually transmitted infections (STIs) like chlamydia, gonorrhea, or trichomoniasis may also cause uncomfortable sex and a questionable secretion.

The swelling and pain associated with these infections pretty much takes sex off the table. Plus, if you suspect an STI, you’ll want to get tested, and if necessary, treated, so that you don’t pass bacteria on to a sexual partner.

Potential solutions:

Although you can treat a yeast infection with over-the-counter (OTC) creams, your best bet is to see a doc to get properly diagnosed in case it’s something else.

For a yeast infection, your physician may prescribe you an antifungal medication. For BV or an STI, you may need an antibiotic.

Talk to your OB-GYN if you suspect a latex allergy, which can be life-threatening depending on your level of sensitivity. If you are allergic, switch to polyisoprene or polyurethane condoms.

2. Pain in the pelvis during penetration

Pelvic Inflammatory Disease (PID), an infection of the reproductive organs, will cause this type of pain in addition to discharge. Other symptoms may include irregular bleeding, fever, or painful urination.Das B, et al. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. DOI: 10.2147/IDR.S91260

PID occurs when bacteria gains access to your reproductive organs through the cervix, sometimes as a result of chlamydia or gonorrhea. It can also happen from an infection after IUD insertion, childbirth, or miscarriage.

See a doctor for proper diagnosis. If it is PID, your physician will most likely prescribe antibiotics. If PID is caused by an STI, your partner should see a doctor for treatment as well.Das B, et al. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. DOI: 10.2147/IDR.S91260

3. Pain that goes away when you switch positions

Your partner may have just poked your cervix. It’s most likely an issue of position and angle.

Bumping the cervix isn’t medically harmful, but it can make having sex a whole lot less fun. If you find this happens in a certain position, switch things up, either with your partner or a toy, until you find a position that’s more comfortable.

4. Your vagina feels like sandpaper during penetration

Vaginal dryness is often associated with menopause.Waetjen EL, et al. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause. DOI: 10.1097/GME.0000000000001130 But, if you haven’t joined the meno club yet, you might still feel a dry, tearing sensation during sex for other reasons.

Got seasonal allergies or a cold? Antihistamines and decongestants, which clear up mucous membranes when you have a stuffy or runny nose, could be drying up your you know what. And birth control pills have also been associated with vaginal Castro Coelho F. et al. (2019). The potential of hormonal contraception to influence female sexuality. DOI: 10.1155/2019/9701384

Plus, parching can occur from time to time if you’re not in the mood, you’re distracted, or you’re just not that into your partner.

A lubricant can be a lifesaver. But if dryness is more than just the occasional inconvenience, you may want to see a doctor for treatment.

If your doctor determines medications are the cause, ask about other options that don’t turn your vag into the Sahara. For chronic cases, try long-acting vaginal moisturizers, like Replens, which relieve dryness for days by imitating the body’s natural lubrication.

5. Sharp, localized pain on the outside of the vagina

Take a look at your nether regions in a mirror. Chances are the pain is coming from an ingrown hair. Rubbing up against these bumps during sexual activity sometimes causes more irritation.

Although less common, a Bartholin’s cyst could be to blame. Your Bartholin’s glands secrete vaginal fluid, but if a gland become blocked, a cyst could form.

If you have an ingrown hair or suspect a Bartholin’s cyst, keep the area clean and dry, and don’t try to pop it.

A warm compress may help bring the ingrown hair to a head or encourage fluid to drain from a cyst. If it doesn’t go away on its own in a few days, see your doctor for treatment and to rule out an STI.

6. Deep pelvic throbbing and cramping during sex

Possible cause:

You could have endometriosis, a disorder that causes uterine-lining tissue, called the endometrium, to grow somewhere outside your uterus, like the ovaries, bowel, or pelvis. Uterine fibroids, noncancerous growths of the uterus, are also a possibility.Moshesh M, et al. (2014). Examining the relationship between uterine fibroids and dyspareunia among premenopausal women in the united states. DOI: 10.1111/jsm.12425

In addition to potentially making sex painful, both endometriosis and uterine fibroids may cause heavier, longer, or irregular periods that come with deep, stabbing pain. Pain may also be present when your period is not.

Talk to your OB-GYN about your pain. Uterine fibroids can often be removed. Although there’s no cure for endometriosis, treatments include surgery to remove growths, hysterectomy, hormonal or pain medications, and more.Becker CM, et al. (2017). Reevaluating response and failure of medical treatment of endometriosis: a systematic review. DOI: 10.1016/j.fertnstert.2017.05.004

7. Your vagina clamps shut whenever you attempt penetration

Vaginismus is when your pelvic floor muscles involuntarily spasm.

This condition’s roots can be both physical and mental. It can happen after sexual trauma or in individuals who’ve grown up with a background that frowns upon premarital sex. Vaginismus can also be an anxiety response caused by fear of pain or intimacy.Bhatt JK, et al. (2017). A study of vaginismus in patients presenting with infertility. DOI: 10.18203/2320-1770.ijrcog20175270

Since vaginismus often has a psychological component, your doctor may prescribe psychotherapy. Pelvic floor physical therapy, to help retrain muscles, may also be a consideration.Reissing ED, et al. (2013). Pelvic floor physical therapy for lifelong vaginismus: A retrospective chart review and interview study. DOI: 10.1080/0092623X.2012.697535

8. A stabbing pain on your vulva when touched

Vulvodynia is pain around the opening of the vagina that doesn’t have a known cause and that’s occurred for at least three months. It can make sex, exercise, sitting, or even wearing tight pants painful.Corsini-Munt S, et al. (2017). Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. DOI: 10.2147/JPR.S126259

Since doctors aren’t sure of the cause of vulvodynia, treatment is complex. Your doctor may prescribe a combination of medication, local analgesics, and physical therapy. Sometimes surgery is also a consideration. Corsini-Munt S, et al. (2017). Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. DOI: 10.2147/JPR.S126259

9. You’ve never been able to insert anything into your vagina

Sometimes a hymen can prevent penetration. You may have an imperforate hymen, which is a completely intact membrane that obstructs the vaginal opening.Haw Lee K, et al. (2019). Imperforate hymen: A comprehensive systematic review. DOI: 10.3390/jcm8010056 Or, a septate hymen is broken but still has a band of tissue running through the center, making penetration impossible.Mishori R, et al. (2019). The little tissue that couldn’t — dispelling myths about the Hymen’s role in determining sexual history and assault. DOI: 10.1186/s12978-019-0731-8

If your doctor determines that your hymen is the cause of your pain, a minor surgery (hymenectomy) can remove it.Haw Lee K, et al. (2019). Imperforate hymen: A comprehensive systematic review. DOI: 10.3390/jcm8010056

10. Pelvic pain during sex and an urge to urinate

Interstitial cystitis, or painful bladder syndrome, is a chronic condition that causes painful pressure on the bladder. It can feel like a urinary tract infection (UTI), but it isn’t bacterial.Han E. (2018). Current best practice management of interstitial cystitis/bladder pain syndrome. DOI: 10.1177/1756287218761574

Interstitial cystitis has no known cure, but it may go away after a period of time. Methods for finding relief include dietary changes, medications, and pelvic physical therapy.

Because everyone knows that sex is supposed to feel good, it can feel sort of weird and awful when it doesn’t.

But pain during sex isn’t something to be ashamed of — especially since it’s a complaint that Alyssa Dweck, M.D., gynecologist based on Westchester County, New York, assistant clinical professor of ob-gyn at Mount Sinai School of Medicine, and author of V is for Vagina, hears all the time. “It’s more common than you’d think, and there’s a lot you can do about it,” she says.

Typically, there are two culprits: Vaginal dryness or infection. (Note: Neither have to do with your “small vagina” or his large endowment. Men!)

Here’s why you might be experiencing pain during sex, according to Dr. Dweck — and her advice on what to do about it (besides see your own doc, who’s best suited to diagnosis you).

1. You use hormonal birth control. The hormones reduce fluid secretion so your vagina is naturally drier.


The fix: Lubricant can go a long way. Make a water-based brand like KY or Astroglide your go-to; rely on a longer-lasting silicon formula like Replens Silky Smooth, or Wet Platinum for water play; and try the very effective coconut oil if you use a method besides condoms for birth control and STD protection. (Otherwise, oil-based lubricant will break down the condom and render it useless.)

2. You’re a week away from ovulating. Your vagina’s natural secretions vary throughout your cycle and dip after your period but before your mid-cycle egg drop.

The fix: Use lubricant or wait until you ovulate (about two weeks before your next scheduled period). Mid-cycle, you’ll have more mucus-y discharge, which reduces friction for better-feeling sex.

3. You skimped on foreplay. Taking your time getting to the main event gives your body a chance to lubricate itself so painful dryness isn’t an issue.


The fix: Use lube or patience. Both should work👌.

4. You’re taking antihistamines. The daily allergy meds you take to dry up sinus secretions can dry out your vagina too.

The fix: Ask your doctor about alternative treatments so you can wean off the meds.

5. You did the worst job shaving. Depending on the wound placement on the vulva or labia, and the sex position you’re working with, infected hair follicles and shaving rash can make sex feel preeetty awful.


The fix: Treat the infected area with an antibiotic or hydrocortisone cream, and lay off sex until it’s cleared up.

6. You have a yeast infection. While yeast infections tend to be more itchy than painful, they alter the pH in your vagina, which can inflame vaginal tissue, causing pain upon penetration.

The fix: Abstain from sex until your yeast infection is resolved. (Topical OTC remedies can be a total a godsend.)

7. You have chlamydia. Frequently asymptomatic, this STD can cause scaring and inflammation that makes thrusting uncomfortable.

The fix: Abstain from sex until you can see your doctor to get tested.

8. You’re bloated AF. If you have IBS or colitis, or just wolfed an entire burrito, bloating can make sex feel particularly uncomfortable. Especially if you washed down said burrito with half a pitcher of margarita — sex with a full bladder is The Worst.


The fix: Wait until you digest or – at the very least — pee before penetration.

9. You have a uterine fibroid. This benign, non-cancerous uterine growth is made of muscle tissue. It’s miniscule and most people never even notice it — unless it grow large enough to get jostled around during sex.

The fix: An ultrasound can confirm this diagnosis, which is either left to go away on its own or surgically removed.

10. You have an ovarian cyst. This non-cancerous, fluid-filled growth on the ovary can cause pressure during sex — or acute and sudden pain, if sex causes the cyst to pop or leak. (The fluid is usually clear so you might not even notice.)

The fix: Diagnosed by ultrasound, there are a few treatment options: Relax and do nothing — cysts often go away on their own; have it surgically removed; or take birth control to suppress ovarian function and prevent cysts from growing (this last one is the best option for women with reoccurring cysts).

11. Your sex position isn’t working for you. The tilt of your uterus affects your comfort level during sex: Say yours is pointed backward, you’ll feel pain in missionary position and pleasure on top.

Rachel Bellinsky/Stocksy

The fix: Switch positions — and try girl-on-top, which gives you more control in terms of depth and angle of penetration.

12. You have endometriosis. It’s when the cells that typically line the uterine (and do the whole shed-and-bleed thing every time you get your period) grow elsewhere — like on the fallopian tubes or on the tissue that lines the pelvis. While endometriosis has been linked to fertility issues and pelvic pain plus over-the-top cramping, the bleeding isn’t necessarily dangerous, just uncomfortable, particularly when scarring occurs.

The fix: See a doctor for diagnosis and treatment, which can include going on birth control or (sometimes) surgery.

13. You’re really pregnant. The closer you are to your due date, the heavier your uterus. When you lie directly on your back, the weight can compress a large blood vessel, causing discomfort that some interpret as painful.


The fix: Avoid lying on your back. Women who are further along in their pregnancies tend to be far most comfortable in doggy-style or side-by-side positions.

14. You use spermicide. Lots of women are sensitive to the stuff. If you’re one of them, the irritation can increase your risk of infection and microtears in the vagina. Ouch.

The fix: Use regular condoms to contain sperm instead of kill it.

15. You have vaginismus. This involuntary clenching of the vaginal muscles makes penetration painful if not impossible.

The fix: Sometimes triggered by psychological trauma or fear, treatment often involves therapy, so talk to your doctor.

16. You’re breastfeeding. Lactating and breastfeeding lower estrogen and make vaginal tissues more delicate.


The fix: Use a lubricant during sex and a vaginal moisturizer the rest of the time.

17. You’re going through early menopause. You’ll have low estrogen levels that cause dryness and thin vaginal tissues, making your vagina especially delicate — and susceptible to tears.

The fix: Use lube or talk to your doctor about estrogen pills.

18. You ODed on indoor cycling. Your regular cycling session can put pressure on the nerves and bruising on the vulva, which can to cause general discomfort that reveals itself in the form of pain during sex — particularly if you set your bike up incorrectly.


The fix: Use a padded saddle or wear padded shorts. Then raise your handlebars and/or lower your seat to change your positioning and alleviate the pressure.

19. You have vulvodynia. It’s a rare but miserable syndrome that causes chronic pain throughout the vulvar region — so not just during sex.

The fix: Because this is believed to be a neurological condition, there’s no go-to fix — your doctor might prescribe estrogen, steroid cream, or antidepressants to isolate the offending agent.

20. You have Sjogren’s syndrome. It’s a rare immune system disorder characterized by dry eyes and dry mouth and — yep — dry vagina.

K-Y Brands

The fix: Lube. It’s like magic!

21. The last time you had sex was Hard. Core. Rough, vigorous thrusting can cause microtears in the vagina that lead to scarring and sensitivity.


The fix: Abstain from sex until pain goes away, and make sure you’re properly lubricated the next time you have sex.

When Pain Warrants a Doctor’s Visit

Any time you experience a sudden and acute onset of severe pain unlike anything you’ve felt before, get it checked out — especially if the pain outlasts the sex.

Your doctor can rule out the worst-case scenarios so you can get back in the saddle — and make it a more *~pLeAsUrAble~* ride.

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Elizabeth Narins Senior fitness and health editor Elizabeth Narins is a Brooklyn, NY-based writer and a former senior editor at, where she wrote about fitness, health, and more.

Pain During Intercourse or Penetration

Vaginal penetration that you desire typically doesn’t hurt, especially if you and your partner ensure that you are stimulated enough to be fully aroused.

Yet sometimes discomfort or pain during sexual intercourse or penetration may occur, even when it seems like your body is ready. If penetration is at all painful during sex, find out what the cause is and what can be done about it. A gynecologist can help to determine if there’s an underlying physical cause and advise on treatment.

The following situations and conditions can contribute to or cause pain during intercourse or other forms of penetration.

Sexual Intercourse or Penetration for the First Time

The first few times you have intercourse or experience vaginal penetration, you may feel a small to moderate amount of pain at the entrance to the vagina. There can be some bleeding or no bleeding at all—both are normal.The reasons for the pain are not always clear, but it is typically temporary.

An unstretched hymen (vaginal corona) has typically been blamed for this pain at first penetration, but new understandings of the hymen suggest otherwise.

As Hanne Blank, author of “Virgin: The Untouched History,” comments: “If the hymen is substantial, relatively inflexible, and attached around much of the circumference of the vaginal opening, then yes, it’s fair to say that the hymen is at issue. But not all hymens meet these criteria, and women without substantial hymens can also experience painful penetration. The truth is that research has not told us with any particular specificity why it is that this discomfort happens, or why it happens for some women (regardless of hymen type) and not others.”

Insufficient lubrication

In most women, the wall of the vagina responds to arousal by producing a liquid that moistens the vagina and its entrance, making penetration easier. Sometimes there isn’t enough lubrication — you may need more time for stimulation, or you may be nervous or tense.

Insufficient lubrication can also be caused by lowered levels of estrogen, which can make vaginal tissue more fragile and affect the vaginal walls in such a way that less liquid is produced. This may occur after childbirth (particularly if you’re breastfeeding), or if you’re taking hormone therapy after breast cancer.

Some women experience insufficient lubrication during perimenopause and after and may need to look for signs other than vaginal wetness to signal arousal. Others, regardless of their age, simply produce less lubricant.

Even if you are not experiencing painful penetration, using a lubricant can dramatically increase sexual comfort, pleasure, and stamina—especially if you use condoms.

Local infection

Some vaginal infections—like monilia (yeast) or trichomoniasis—can be present even when you can’t see any signs. The friction of a penis, dildo, or finger moving on the vulva or in the vagina might cause the infection to flare up, resulting in stinging and itchiness. A herpes sore on the external genitals can make friction painful.

Local irritation

Birth control foam, cream or jelly can cause irritation in the vagina. If you think this is the case, try a different brand. If the irritation persists, it may be in reaction to the spermicide Nonoxynol-9. Alternative spermicides are extremely hard to find, so you may want to consider another birth control method.

Though latex allergy is uncommon, some people are sensitive to latex condoms, diaphragms and gloves. Alternatives include polyurethane condoms, including female condoms.

Vaginal deodorant sprays, douches, scented tampons, and all so-called feminine hygiene products can irritate the vagina or vulva, as can body wash, soaps, bubble bath, and laundry detergents and dryer sheets. Try to avoid applying or using products that contain fragrances.

Tightness in the vaginal entrance

In some situations, size matters—if, for example, a male partner has a large penis and your vagina is small. Keep in mind, though, that a woman’s body size is not related to size of her vagina.

Women’s difficulty with penetration is sometimes attributed to vaginismus, believed to be a strong, involuntary tightening of the vaginal muscles, a spasm of the outer third of the vagina.

Researchers have not always been able to identify these muscle spasms, writes Debby Herbenick, author of “Because It Feels Good: A Woman’s Guide to Sexual Pleasure and Satisfaction” and founder of

More recently, vaginismus has been described as “persistent or recurrent difficulties of the woman to allow vaginal entry of a penis, a finger, or any object, despite the woman’s expressed wish to do so” (see Graziottin, 2008). This is an important distinction because it reinforces the point that penetration should be consensual and wanted.

Pain deep in the pelvis

Sometimes the thrust of penetration hurts way inside. This pain can be caused by tears and scarring (known as adhesions) in the ligaments that support the uterus (caused by obstetrical mismanagement during childbirth, an improperly performed abortion, pelvic surgery, rape, or excessively rough penetration during sex); infections of the cervix, uterus, and tubes (such as pelvic inflammatory disease—the result of untreated sexually transmitted infection in many women); endometriosis; cysts or tumors on the ovaries; a vagina that has shortened with age; or a tilted pelvis.

Penetration in these cases is sometimes less painful if you’re on top or lying beside a partner.


Vulvodynia is a catchall term describing chronic vulvar pain that has no identifiable cause.

When the pain occurs around the vaginal opening (the vestibule) upon being touched or pressed, it’s referred to as localized vulvodynia. (Older terms for this condition include vestibulodynia, vulvar vestibulitis, or localized vulvar dysesthesia).

If the symptoms occur in different areas of the vulva, at various times and sometimes even when the vulva is not being touched, it’s referred to as generalized vulvodynia.

Pelvic floor physical therapy, hormonal creams and low-dose tricyclic antidepressants can sometimes help. Some women have reported finding relief with the same treatments prescribed for fibromyalgia, which causes an amplified reaction to pain.

At the age of sixteen, most girls will be surprised they have their menstrual period to worry about. While period cramps are common in women, It’s not the only concern for girls. Having vaginal pain during penetration can be worrying.
As you grow older, falling in love with someone and expressing your feeling through sexual intercourse may become necessary.
Now you get disappointed on the first day with a severe painful penetration, vaginal bleeding, and lower abdominal discomfort.
If you are having intercourse for the first time, you should know it’s painful and may come with spotting for a few days.
After your first sexual intercourse, some women may still get pain for months or years. Though, It could easily be prevented by using the right techniques.
There are other reasons you could have intercourse after losing your virginity. It could occur if you have a urinary tract infection, vaginal infections, anxiety, lack of adequate vaginal lubrication or a forceful penetration.
In older women and women who have given birth, sexual intercourse becomes less painful. Though, the vaginal trauma during childbirth may cause severe painful intercourse.
This article explains the common reasons why you experience pain when your boyfriend enters you, what to do, and when you should worry.
Why does it hurt when my boyfriend enters me? Here’s Why
1. You’ve never had sexual intercourse before
The age of first sexual intercourse varies from women to women; Though one thing is common, PAIN.
The vagina in the early stages of a woman’s life is covered with a crescent-shaped membrane with a small opening that allows blood from menstruation to flow through
During you first intercourse with your boyfriend, you may experience severe pain when he enters you as the hymen ruptures. Pain may be very mild or severe and sometimes could be accompanied by vaginal spotting.
Having pain the first time is not abnormal and should not bother you. In few months you will start enjoying intercourse with you boyfriend.
However, it’s possible you may still get pain later on. Here are some other reason it occurs
2. Your vagina is not wet enough
Sometimes you may not have the urge for intercourse and you are pressured into it; If you are not in the mood or not stimulated before penetration, your vaginal area will hurt during penetration.
Within the sides of the vaginal wall is the Bartholin gland which helps to release watery discharge during pre-intimacy, and intercourse.
However, if you are not ready for sexual intercourse, your body is not stimulated to increase vaginal wetness. This will result in pain.
One easy way to help ease the stress on your vagina is applying a lubricant. This commonly used by women to prevent pain, vaginal tear and improve sexual experience.
3. You have vaginismus
Some women may have difficulty engaging in any form of vaginal penetration. This is called vaginismus and occurs due to spasm of the pubococcygeus muscle.
Pain may occur during sexual intercourse – when your boyfriend tries to enter you, or while inserting a tampon or menstrual cup.
In most women, psychological help with sufficient vaginal lubricant will help prevent pain.
4. You have vaginal infection
If you are not expecting, you could get pregnant if you do not use a condom. That’s not the only risk. Sexually transmitted diseases are mainly transmitted through unprotected sexual intercourse.
Therefore, using a condom or abstaining from intercourse is vital to preventing this kind of infections. If you have an infection down there, you may experience persistent vaginal and abdominal pain during intercourse.
Some common infections that could result in pain are Chlamydia, bacterial vaginosis, complicated yeast infection, trichomoniasis, and gonorrhea.
Should you notice penetration pain weeks after unprotected intercourse, it’s possible you may have an infection.
Some other symptoms of vaginal infections you may experience are
Unpleasant vagina smell
Pain before, during and after intercourse
Foul-smelling vaginal discharge
Green vaginal discharge
Yellow vaginal discharge
Low abdomen tenderness
Itching vagina with sore
These symptoms indicate you may have an infection. However, you may have an infection and still not show any symptoms.
Chlamydia, trichomoniasis and gonorrhea infections may lie dormant for months or years. If you feel pain after an unhealthy sexual practice, it advisable you inform your doctor.
In fact, the World Health Organization and Center For Disease Control (CDC) recommends women less than 25 years to routinely check for infections yearly.
This is important because gonorrhea and chlamydia may spread up to the uterus and fallopian tubes resulting in pelvic inflammatory disease. Long-term vaginal infections may also affect your chances of conceiving in the future or result in ectopic pregnancy.
5. You had a rough intercourse
Emotions and desire may sometimes drive urge for a deep and rough sexual experience. If you are not aroused with a dry vagina, this may result in severe pain.
On the other hand, during deep penetration, the man’s penis may hit your cervix very hard. This could cause inner vaginal pain or low abdominal cramps after intercourse.
Most women will experience an increased desire for sexual intercourse a week after period. This occurs because of body changes during ovulation.
During you ovulation period or fertile window, your cervix is soft and may be difficult to detect. Sexual intercourse during this time will not cause pain.
However, immediately after the end of period or days before your period will start, deep penetration may hit your low-lying cervix with pain.
6. You are emotionally not ready
Not being psychologically ready for intercourse could affect vaginal wetness and result in pain.
The fear of getting pregnant, catching an infection, having a break up with your boyfriend or stress, may affect vaginal wetness or cause pain.
It’s important you are ready to prevent a painful experience.
Why does it hurt when my boyfriend goes deep?
Normally, vaginal intercourse should not be painful. If you are having intercourse for your first time, its okay if you feel some pain.
During sexual intercourse, it’s possible you could get pain when your boyfriend goes deep or hit your cervix from behind.
This occurs because your cervix is low down in your vagina or you have inflammation of the ovary, fallopian tubes or abdomen.
Possible causes of pain are intestinal diseases, ovarian cyst, ovarian cancer, or adhesions from previous surgeries or endometriosis.

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How to feel better now: Abdur-Rahman says your best bet is a warm bath, heating pad, or over-the-counter pain reliever (like Motrin or Ibuprofen). All of these things have anti-inflammatory effects, which can relieve some of the pain. In addition to that, just give it time. It shouldn’t take too long for the pain to subside, and if it doesn’t, talk to your doctor.

How to prevent pain in the future: Foreplay is a great first step. According to Abdur-Rahman, the vagina expands (becoming larger, longer, and wider) during foreplay, which allows for deeper, more comfortable penetration. Foreplay also increases lubrication, which will make penetration a little easier. Adding lube as needed will also help.

From there, you should be thoughtful about your positioning. Abdur-Rahman says any position that puts the vagina owner in control of the penetration is a safe bet. Think: you on top. Avoid positions that maximize penetration—like doggy style or anything where the vagina owner’s legs are in the air. Those positions are more likely to lead to a sore vagina.

Finally, take your time. Be slow and gentle, and communicate with your partner about any discomfort you experience. And if you’re using a dildo, consider sizing down.

3. The sex you had was super rough or fast.

Friction can be great! It often is! But too much friction can definitely make your vagina hurt after sex, mostly likely because there wasn’t enough lubrication.

How to feel better now: If your vulva (or the opening to your vagina) really hurts or is swollen after sex, Abdur-Rahman says you can try putting an ice cube or two in a thick washcloth or in a plastic bag and resting that on the outside of your underwear for 10 to 15 minutes. Don’t put the ice inside your vagina—that will only irritate it more. Again, give it time, and talk to your doctor if you still have a sore vagina after a few days.

How to prevent pain in the future: Take whatever steps you can to ensure adequate lubrication. Foreplay is a great way to give the vagina time to warm up, and lube helps too. It’s also important to take things slow—at least at first. Start gently and slowly, and then transition into rougher, faster sex (assuming that’s what you’re into).

4. You’re sensitive to latex.

Some people are allergic (or sensitive) to latex. If you’re one of these people and you’ve been using latex condoms, you might end up irritating your vagina, Miriam Greene, M.D., ob/gyn at NYU Langone Health, tells SELF.

How to feel better now: Placing an ice pack outside your underwear to soothe your vulva for 10 to 15 minutes is your best bet, as well as giving it time.

How to prevent pain in the future: Talk to your gynecologist to confirm your suspicion that you’re allergic or sensitive to latex (and that there’s not something else going on). If you are, avoid latex condoms in the future. That doesn’t mean giving up on condoms altogether—there are plenty of alternatives, like polyurethane condoms, that you can still use to prevent disease and pregnancy.

Quick note: Though polyurethane condoms are non-latex and help prevent both disease and pregnancy, they have higher slippage and breakage rates than latex condoms, according to the Centers for Disease Control and Prevention (CDC). The female condom is also latex-free, but it’s slightly less effective at preventing pregnancy than latex condoms. You can work with your gynecologist to find something that works for both you and your partner.

5. You have an infection.

If you’re experiencing discomfort that goes beyond slight soreness—like itching, burning, or abnormal discharge—you might have an infection. It could be a yeast infection, bacterial vaginosis, an STI, or something else entirely, and the best course of action is talking to your gynecologist.

‘Sex is painful’: A guide on what to do if you experience pain or bleeding during sex

This may seem like a very basic question but helps if you’re trying to find out what is making things so painful and why. Are you meaning ‘sex’ as in penis in vagina sex or something else? For example is it painful when you masturbate? Or if you receive oral sex? Or have anal sex? When you bleed is this inside or outside your vagina or bum or another part of your genitals?

What’s the pain like and where do you feel it?

It can help to reflect on where you feel pain – does it affect all of your genitals? Or specific areas like your clitoris, labia, urethra, vagina or other genital areas, perineum or bum. Do you experience it more as a pain inside your vagina or bum or something that feels more like tummy ache? How would you describe the pain? Is it constant or does it come and go? Does it happen at any other time or only during/ after sex?

Can you think of anything that may be causing the pain? For example recovering after birth (particularly if you’ve had an episiotomy).

Is it linked to any kind of touch? For example is all your genital area sensitive or do you find it’s particular touch (with finger, sex toy, penis etc) in particular places that produce pain or bleeding?


You don’t want to ignore bleeding during or after sex but again can you pinpoint any possible causes? For example you might be near the start of your period. You might be very dry (more on this later). Your partner may have scratched you with untrimmed nails or been clumsy or rough when touching you. Bleeding isn’t unusual during sex in pregnancy – could you be pregnant? Might you have an STI? Where is the bleeding coming from? What does the blood look like, how long does it go on for, and is it accompanied by pain?

You may find it helps to make a list of all the symptoms you’ve spotted and possible causes – either by reflecting back on when you’ve noticed the problem or by keeping a diary. If you end up seeking medical help or therapy this information can be important. As is noting what do you do when you experience pain?


Pain often seems to be linked to particular positions. While some people find any kind of penetrative sex uncomfortable, in general positions that allow for deeper penetration seem to cause more discomfort.

If you have a partner with a large penis (long or wide) this may cause pain and together you may need to find positions that are the most comfortable for you.

Regardless of what position you’re in penetration that involves fast thrusting (with toys, penis or fingers) or lengthy penetration (of vagina or bum) can cause discomfort or pain.

Are you able to think about more pleasurable and pain free alternatives?

It may be that while all of the above is painful you also enjoy it. If so limiting the amount you do it or varying how long you do it for may resolve things.

‘I’m wet but it still hurts’

Quite often in situations like this you may feel wet but are still doing things that are uncomfortable (see above). Or it may be you’re feeling wet but aren’t all that turned on, or are anxious about things being painful. It could be that while you feel wet it’s still not adequate for the kind of sex you’re enjoying. It could be worth experimenting with lubricants – but not to mask any pain. Some lubricants can also make things worse so if you’re ‘wet’ because you’ve been using a lot of lube but are still in pain, so it may be better to try an alternative or investigate possible allergies.

‘I can’t get wet at all’

When pain is due to dryness this might be down to some of the problems listed above, or factors including breastfeeding, vaginoplasty, menopause, or the side effects of certain medications. It could be due to not feeling turned on, general anxiety about pain or other relationships issues. You could be feeling very excited but not well lubricated, or can get wet but dry quickly. Again a lubricant may be useful here as is exploring what brings you pleasure and spending as much time as possible on this.

‘I do it even though it hurts’

Repeatedly in questions I get about pain and bleeding there’s a sentence or two that indicates the person with the problem is still having sex even though it is painful. If this is the case for you it is worth noting why that is? Quite often it’s because sex may not be painful at the time but only noticeable after. Or that people hope this time it won’t hurt. Alternatively not all encounters result in bleeding or pain – if this is the case with you it can help to consider what is different about the experiences that lead to pain and bleeding and those that do not.

The pressure to have perfect sex and please a partner, or feeling guilty for not providing enough sex can make people feel obliged to have sex even though it isn’t enjoyable. For some women in some cultures, the view that her pleasure is wrong or irrelevant and can lead to her having sex that’s painful because there’s no sense she might enjoy pleasure – or little concern about her feeling pain.

That said, unless it’s part of consensual BDSM you’re enjoying together, most partners don’t want you to experience pain and bleeding. Have you shared that sex is painful and that you bleed? If so, what was the reaction? (If you don’t feel able to raise such sensitive issues resources about communication are provided below).

If you are in a relationship where you are afraid to speak out, or that you are coerced into sex or that your partner is deliberately hurting you or causing you to bleed to abuse you then you may want to seek help from the National Domestic Violence Helpline or Broken Rainbow.

‘I don’t enjoy sex’

Related to the issue of doing it although it hurts is the notion that sex just isn’t enjoyable. Often in this case people say they stop having sex because of pain or bleeding, or that these factors are preventing sex from being pleasurable.

Is it the case that you simply don’t feel sexual desire or interest at all? In which case it might be worth considering if you are asexual. If you think you would like to be sexual but there are barriers, can you list what they may be? Some women with disabilities report issues with pain and dryness leading to a lack of desire. Others may be recovering from past sexual abuse, or have been taught sex is bad or dirty, or have physical or psychological trauma resulting following any form of genital surgery. Those things could be addressed through therapy or clinical care (see below).

What would make it more enjoyable? Write down all the things that spring to mind. Reading books like Guide to Getting It On by Paul Joannides can give you some ideas about what you’d like to try or revisit. While Carol Queen’s Exhibitionism for the Shy may help you feel better able to ask for what you’d like.

It may be when you ask yourself this question you answer it with ‘nothing’ in which case again therapy may benefit you to identify possible causes and actions you might take.

Relationship problems

If your relationship is struggling with a lack of attraction, arguments, jealousy or other barriers it’s not surprising that you may not want to be intimate with a partner. If communication is difficult (even if you generally get on well) then it can also make it tricky or even impossible to tell a partner either what you would enjoy or that they are hurting you. Meg Barker’s Rewriting The Rules and The Couple Connection ‘listening room’ free online service are both good places to start to address underlying relationships issues. If your budget allows relationship therapy may also benefit you.

Confidence and communication

So often people with these worries tell me they feel afraid, alone, inadequate or that they have failed because they feel pain or bleed. This in turn can affect confidence and communication.

You may find courses at your library or adult education centre on communication and assertiveness helpful. Or Gary Wood’s Confidence Karma that includes activities and reflection exercises to help you feel stronger and better able to express your needs and feelings.

I’ve been checked out/ I am fine so what else can be wrong?

Sometimes people take a clear health check (e.g. pelvic exam, smear or scan) as ‘proof’ there’s nothing wrong so continue to have sex even though it is painful or results in bleeding. Just because there is no obvious physical cause doesn’t rule out other issues – many of which are listed above. It is better to focus on those than continuing to have painful sex because the doctor said you were OK.

If you continue to experience pain and bleeding and try the other self-care solutions it is worth having a second medical opinion to ensure there isn’t an underlying problem that was previously missed.

‘I’m afraid to tell anyone’

The flip side of having a checkup but still having sex that’s painful comes from those who’re so scared of a checkup or hearing bad news they won’t seek help at all. It’s worth noting that most of the time painful sex is down to the non-medical issues listed above. And if it is a medical problem it may be something like thrush, cystitis or bacterial vaginosis that can be easily treated. Sexually Transmitted Infections can often cause pain and bleeding, as can some other medical conditions. If you are afraid about having something seriously wrong or a partner finding out about an STI the quicker you see a doctor the quicker it can be treated and support given.

It may be no physical problem exists but your doctor can still refer you to a psychosexual therapist on the NHS (waiting times and availability vary across the UK). For readers in countries where care is harder to access this guide from Hesperian may benefit you.

Remember your doctor will have heard about this concern from many people before and will not judge you or tell others about why you have asked for help.

Transgendered and Intersex people are often neglected in these discussions. It would be wrong to generalise across all Trans* experiences but many of the suggestions raised here may help address pain or bleeding if you are Trans or Intersex. If you are still worried seek healthcare advice or therapy too.

Next steps

Hopefully there is enough information here for you to either help yourself or seek additional support as needed through therapy, sexual health care or your GP. It may suit you better to completely avoid whatever gives you pain while you try and pinpoint the exact causes and your plans to deal with them.

Petra Boynton is a social psychologist and sex researcher working in International Health Care at University College London. Petra studies sex and relationships and is The Telegraph’s agony aunt. Follow her on Twitter @drpetra.

Email your sex and relationships queries to: [email protected]

Petra cannot offer individual responses or answer every single question. Please note that by submitting your question to Petra, you are giving your permission for her to use your question as the basis of her next column, published online at Wonder Women. She may not be able to tell you that she is using your question, but will try to email you the reply if she does. All questions will be kept anonymous and key details, facts and figures may change to protect your identity.

Why Does it Hurt When I Have Sex?

Dyspareunia is the medical term for pain during sex.

Painful intercourse in women can occur for several reasons:

    • You might suffer from endometriosis, a condition in which the lining of the uterus (endometrium) extends outside the uterus, and attaches to and irritates organs in your abdomen. Or adenomyosis where endometrial tissue grows into the muscular wall (myometrium) of the uterus.

    • You may have adhesions (scar tissue) from a previous infection or surgery, which can form between the organs in your abdomen, or between the organs and the abdominal wall. Adhesions may trigger pain by causing organs to move away from their normal location or to become fixed (stuck) in an abnormal position.

    • Inadequate vaginal lubrication causing dryness can contribute to sexual pain. Common reasons for vaginal dryness can include conditions contributing to low estrogen levels (induced, surgical or natural menopause, after childbirth, or during the breastfeeding) or medications that are associated with lack of sexual arousal (antihypertensives, antidepressants, antihistamines, sedatives, and certain hormonal agents).

    • Or you might have uterine fibroids or myomas, which are benign (non-cancerous) growths in the wall of your uterus.

    • And you may even have an ovarian cyst, a fluid-filled sac that grows inside your ovary and that can cause pain.

Other less common causes of pain during intercourse include:

    • trauma or surgery of the genital organs,

    • infections or inflammation of the vulva, vagina, or pelvis

    • vaginusmus (painful spasms of the muscles of the vagina)

    • history of sexual abuse

    • psychological conditions (depression, anxiety, relationship dynamics, stress)

Depending on what is causing your pain, there are several treatments, ranging from prescribing medication to keep endometriosis from growing or to shrink a fibroid — to laparoscopic (minimally invasive) surgery to remove scar tissue or cysts. A frank discussion with your medical provider will help to elucidate the causes and treatment options for dyspareunia.

Learn more –

The American Society for Reproductive Medicine has several resources to help you make the choice that is right for you:

Start with the ASRM Topic Index where you can find information on:

  • Adhesions
  • Endometriosis
  • Fibroids
  • Menopause
  • Sexual Dysfunction

ASRM has Fact Sheets and Booklets written with you in mind such as:

Or find out what your physician is reading:

ASRM Practice Guidelines, including:

  • Endometriosis and infertility
  • “Removal of myomas in asymptomatic patients to improve infertility and/or reduce miscarriage rate”
  • “Treatment of pelvic pain associated with endometriosis”

Painful Intercourse (Sex)

What Medical Treatments Are Available for Painful Intercourse (Sex)?

Treatment of pain during intercourse depends on the cause. Introital pain may be treated when the cause is identified.

  • Atrophy (thinning of the vaginal walls) due to menopause: Entrance (introital) pain caused by vaginal atrophy is common among postmenopausal women who do not take estrogen replacement medication. Blood flow and lubricating capacity respond directly to estrogen replacement. The most rapid reversal of vaginal atrophy occurs when topical estrogen vaginal cream is applied directly to the vagina and its opening. This cream is available by prescription only. Newer non-estrogen products are also now available.
  • Urethritis and urethral syndrome: Irritation of the urethra and lower bladder can be caused by a lack of estrogen. This may result in urinary burning, frequency, and hesitancy. In such cases there may be no evidence of bacterial infection on microscopic examination of the urine. In the absence of any chronic inflammation of the urethra, these symptoms may be caused by these symptoms may be caused by muscle spasms, anxiety, low estrogen levels, or a combination of these factors. The doctor may dilate the urethra or may prescribe low-dose antibiotics. At times, antidepressants and antispasmodic medications to reduce muscle contractions in the bladder may also be prescribed.
  • Inadequate lubrication: Treatment of inadequate lubrication depends on its specific etiology. One option of treatment includes water-soluble lubricants (for use with condoms, as other types of lubricants may damage wall of the prophylactic). If adequate arousal does not take place, more extensive foreplay might be helpful in increasing vaginal moisture.
  • Vaginismus: Painful spasms of muscles at the opening of the vagina may be an involuntary but appropriate response to painful stimuli. These spasms may be due to several factors, including painful intromission, previous painful sexual experiences, prior sexual abuse, or an unresolved conflict regarding sexuality. For a woman with vaginismus, her doctor may recommend behavior therapy, including vaginal relaxation exercises.
  • Vaginal strictures (abnormal narrowing): Doctors commonly see vaginal strictures following pelvic surgery, pelvic irradiation, or menopause. Passive dilation and estrogen are used to treat these strictures. Occasionally, vaginal reconstructive surgery is necessary.
  • Interstitial cystitis: This condition refers to chronic inflammation of the bladder with no known cause. However, painful intercourse is a common symptom. A physician may perform a cystoscopy (a procedure to look inside the bladder) and distend (stretch) the bladder wall in order to attempt treatment of the condition. Other treatments include bladder washings with dimethyl sulfoxide (DMSO), as well as oral medications, e.g. imipramine (Tofranil) or pentosan (Elmiron).
  • Endometriosis: Endometriosis occurs when the lining of the uterus is found in ectopic locations outside the interior of the uterus. Pain during intercourse caused by endometriosis is seen frequently. Relief of this pain often indicates success in treating endometriosis.
  • Vulvovaginitis (inflammation of the vulva and vagina): Whether recurrent or chronic, this problem is common despite the rise in the number of over-the-counter treatments.
    • If not responsive to self-treatment with lubricating gels or initial treatment by a physician, a woman may need a more thorough evaluation to identify the cause.
    • A physician may ask a woman if she is using an antibiotic or antifungal medication or if she douches. If so, these practices should be stopped to help determine whether a specific disease-causing organism is present. Instruction in proper vaginal hygiene may be helpful.
    • Treatment is based on the presence of bacteria or other organisms. Often, no single organism is identified. The doctor may talk to the woman about proper hygiene.
    • If recurring symptoms are shared with a sexual partner, both individuals should be tested for sexually transmitted diseases (STDs).
    • A physician should consider the possibility of intermittent urethral infection with chlamydia, (an STD), as well as the more common urinary tract infection. If either is discovered, they should be treated with the appropriate antibiotics.
  • Pelvic adhesions (tissue that has become stuck together, sometimes developing after surgery): Pain with intercourse caused by pelvic adhesions can be relieved by removing or cutting free the adhesions.
  • Uterine retroversion: In addition to the causes previously discussed, the patient may also have what is called uterine retroversion as a cause of their pain. This term refers to a uterus which is tilted backward in the pelvis, as opposed to the normally forward tilted orientation. This can be congenital or due to childbirth injury to the ligaments supporting the uterus. It may also be due to pelvic adhesions which pull the uterus backward into an abnormal location. This condition frequently requires gynecologic surgery for correction.

With an adequate history, physical examination, and laboratory testing, the doctor should be able to pinpoint the cause of dyspareunia. This will allow for the development of a plan of action that will afford the best possibility of resolution of the pelvic pain syndrome.

Pain during sex isn’t totally uncommon—we’ve all felt the cringe that follows not using enough lube. Around 12 to 16 percent of women report consistently painful sex, says Deborah Coady, M.D., a New York City ob-gyn and author of Healing Painful Sex, and there are many more who experience periodic pain.

If you do have any pain during the action, it’s important to pay attention. First things first: Determine whether the pain is transient (an occasional occurrence) or consistent (a regular problem you’ve had more than two or three times in a row), says Dr. Coady. Next, analyze the situation when the pain occurs: What’s going on in your body in that moment? Are you in an uncomfortable position? What is your emotional comfort like? Do you have any infections? Where are you in your cycle? That will help your ob-gyn figure out for sure what’s going on.

Here are the most common reasons you might feel pain during sex—and when to talk to your doctor.

1. You’re not lubricated enough.

Having sex when you’re not fully lubed up can be seriously uncomfortable. “The tissues are not engorged and lubricated and ready,” says Dr. Coady. Luckily, there’s a pretty easy fix. If you’re not getting naturally aroused, spend more time on foreplay. But even with foreplay, some women need a little extra help (and that’s totally OK). Look for a lube that’s water-based (i.e., formulated without oil) if you’re using condoms.

2. You used a new personal care product.

Another major culprit of transient pain is certain personal care products, says Dr. Coady. These include “creams and douches and contact irritants such as soaps,” she says. These products are often full of chemicals that can be irritating to the super-sensitive skin on your vulva and inside your vagina. If you have any sort of issue, ask for a recommendation from your gyno, and if you have any sort of irritation or, worse, an allergic reaction after trying a new product, stop using it immediately and call your doctor.

3. You have an infection.

Yeast infections and urinary tract infections can make sex really uncomfortable. While these things are generally easy to treat on their own, Dr. Coady says they can be exacerbated (or first made evident) by sex. Your doctor will likely advise you to forgo sex while you’re being treated for the infection. If the pain doesn’t resolve, don’t be afraid to head back to your doctor for a follow-up. “If there’s pain in the bladder and it’s consistent and antibiotics don’t work, that should really be evaluated,” Dr. Coady says.

4. You’re constipated or bloated.

Both of these issues—especially bloat—can cause pelvic pain during sex. But, as Dr. Coady points out, they should be short-lived. If it’s a consistent problem, let your doctor know.

5. You have a condition called vestibulodynia.

In some cases, the pain is more constant than situational, which could be a sign of a chronic issue like vestibulodynia—”an inflammatory disorder or process that occurs in the tissue at the vaginal opening,” says Dr. Coady. Eighty percent of consistent sexual pain in women (premenopause) is caused by vestibulodynia, she adds. The condition causes pain when the sensitive area is provoked in any way, sexual or not—even by a tampon. If you’re having pain at the opening of your vagina on a regular basis, get it checked out to know for sure whether this is the case, and to get treatment.

6. Your pelvic-floor muscles are shortened, overactive, or in spasm.

The muscles in your vagina might tense up due to vestibulodynia, but it can also be a sign of more serious conditions like interstitial cystitis or painful bladder syndrome. These conditions can cause the muscles to become shortened or overactive, Dr. Coady says, because they’re reacting to another issue in your body. Your doctor may refer you to a pelvic floor physical therapist.

7. You have another undiagnosed problem.

Whether there’s an ongoing issue or not, it’s important to “know your anatomy,” Dr. Coady says. “Know how you look and know your baseline of feeling fine,” she says. If you feel something outside of that baseline, always get it checked out. “Never ignore pain,” Dr. Coady says.

More important, don’t let anyone tell you it’s just in your head. “The most important thing is self-advocacy,” Dr. Coady says. “If your doctor says they don’t see anything and it must be in your head, the mistake would be to not change doctors. Anyone who says they can’t help you, or that there’s nothing there, is not the right doctor.”

When and why is pain pleasurable?

Many people think of pain and sex as deeply incompatible. After all, sex is all about pleasure, and pain has nothing to do with that, right? Well, for some individuals, pain and pleasure can sometimes overlap in a sexual context, but how come? Continue reading this Spotlight feature to find out.

Share on PinterestSome people find pain pleasurable during sexual acts, but why?

The relationship between pain and sexual pleasure has lit up the imaginations of many writers and artists, with its undertones of forbidden, mischievous enjoyment.

In 1954, the erotic novel Story of O by Anne Desclos (pen name Pauline Réage) caused a stir in France with its explicit references to bondage and discipline, dominance and submission, sadism and masochism — an array of sexual practices referred to as BDSM, for short.

Recently, the series Fifty Shades of Grey by E. L. James has sold millions of copies worldwide, fuelling the erotic fantasies of its readers.

Still, practices that involve an overlap of pain and pleasure are often shrouded in mystery and mythologized, and people who admit to engaging in rough play in the bedroom often face stigma and unwanted attention.

So what happens when an individual finds pleasure in pain during foreplay or sexual intercourse? Why is pain pleasurable for them, and are there any risks when it comes to engaging in rough play?

In this Spotlight feature, we explain why physical pain can sometimes be a source of pleasure, looking at both physiological and psychological explanations.

Also, we look at possible side effects of rough play and how to cope with them and investigate when the overlap of pain and pleasure is not healthful.

Physical pain as a source of pleasure

First of all, a word of warning: Unless a person is specifically interested in experiencing painful sensations as part of their sexual gratification, sex should not be painful for the people engaging in it.

Share on PinterestPain and pleasure activate the same neural mechanisms in the brain.

People may experience pain during intercourse for various health-related reasons, including conditions such as vaginismus, injuries or infections of the vulva or vagina, and injuries or infections of the penis or testicles.

If you experience unwanted pain or any other discomfort in your genitals during sex, it is best to speak to a healthcare professional about it.

Healthy, mutually consenting adults sometimes seek to experience painful sensations as an “enhancer” of sexual pleasure and arousal. This can be as part of BDSM practices or simply an occasional kink to spice up one’s sex life.

But how can pain ever be pleasurable? According to evolutionary theory, for humans and other mammals, pain functions largely as a warning system, denoting the danger of a physical threat. For instance, getting burned or scalded hurts, and this discourages us from stepping into a fire and getting burned to a crisp or drinking boiling water and damaging our bodies irreversibly.

Yet, physiologically speaking, pain and pleasure have more in common than one might think. Research has shown that sensations of pain and pleasure activate the same neural mechanisms in the brain.

Pleasure and pain are both tied to the interacting dopamine and opioid systems in the brain, which regulate neurotransmitters that are involved in reward- or motivation-driven behaviors, which include eating, drinking, and sex.

In terms of brain regions, both pleasure and pain seem to activate the nucleus accumbens, the pallidum, and the amygdala, which are involved in the brain’s reward system, regulating motivation-driven behaviors.

Thus, the “high” experienced by people who find painful sensations sexually arousing is similar to that experienced by athletes as they push their bodies to the limit.

Possible psychological benefits

There is also a complex psychological side to finding pleasure in sensations of pain. First of all, a person’s experience of pain can be highly dependent on the context in which the painful stimuli occur.

Share on PinterestSome people find that rough play allows them to de-stress and distance themselves from daily worries.

Experiencing pain from a knife cut in the kitchen or pain related to surgery, for instance, is bound to be unpleasant in most, if not all, cases.

However, when a person is experiencing physical pain in a context in which they are also experiencing positive emotions, their sense of pain actually decreases.

So when having sex with a trusted partner, the positive emotions associated with the act could blunt sensations of pain resulting from rough play.

At the same time, voluntarily experienced pain during sex or erotic play can, surprisingly, have positive psychological effects, and the main one is interpersonal bonding.

Two studies — with results collectively published in Archives of Sexual Behavior in 2009 — found that participants who engaged in consensual sadomasochistic acts as part of erotic play experienced a heightened sense of bonding with their partners and an increase in emotional trust. In their study paper, the researchers concluded that:

“Although the physiological reactions of bottoms and tops tended to differ, the psychological reactions converged, with bottoms and tops reporting increases in relationship closeness after their scenes .”

Another reason for engaging in rough play during sex is that of escapism. “Pain,” explain authors of a review published in The Journal of Sex Research, “can focus attention on the present moment and away from abstract, high-level thought.”

“In this way,” the authors continue, “pain may facilitate a temporary reprieve or escape from the burdensome responsibilities of adulthood.”

In fact, a study from 2015 found that many people who practiced BDSM reported that their erotic practices helped them de-stress and escape their daily routine and worries.

The study’s authors, Ali Hébert and Prof. Angela Weaver, write that “Many of the participants stated that one of the motivating factors for engaging in BDSM was that it allowed them to take a break from their everyday life.” To illustrate this point, the two quote one participant who chose to play submissive roles:

”It’s a break free from your real world, you know. It’s like giving yourself a freaking break.”

Potential side effects of play

People can also experience negative psychological effects after engaging in rough play — no matter how experienced they are and how much care they take in setting healthful boundaries for an erotic scene.

Share on PinterestPeople can experience psychological side effects following rough play, so it is important to discuss needs and boundaries in advance.

Among BDSM practitioners, this negative side effect is known as “sub drop,” or simply “drop,” and it refers to experiences of sadness and depression that can set in, either immediately after engaging in rough sexual play or days after the event.

Researchers Richard Sprott, Ph.D., and Anna Randall argue that, while the emotional “crash” that some people experience immediately after rough play could be due to hormonal changes in the moment, drops that occur days later most likely have other explanations.

They argue that feelings of depression days after erotic play correspond to a feeling of loss of the “peak experience” of rough sexual play that grants a person psychological respite in the moment.

Like the high offered by the mix of pleasure and pain in the moment, which may be akin to the highs experienced by performance athletes, the researchers liken the afterplay “low” with that experienced by Olympic sportspeople in the aftermath of the competition, which is also referred to as “post-Olympic depression.”

In order to prevent or cope with feeling down after an intense high during erotic play, it is important for a person and their partner or partners to carefully plan aftercare, both at the physical and psychological level, discussing individual needs and worries in detail.

Whatever a person decides to engage in to spice up their sex life, the key is always consent. All the people participating in a sexual encounter must offer explicit and enthusiastic consent for all parts of that encounter, and they must be able to stop participating if they are no longer interested and willing.

Research suggests that fantasies about unusual or rough sexual play are very common, and some people decide to take the fantasy out of the realm of imagination and make it a reality.

If you decide to stray from “vanilla” sex and try other flavors too, that’s fine, and there’s nothing wrong with you. Just make sure that you stay safe and you only engage in what you enjoy and feel comfortable doing.

Why does sex hurt me?

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