6 Common Culprits of Painful Sex and What To Do About It, According to a Somatic Sexologist


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Source: @cottonbro | Pexels
Source: @cottonbro | Pexels

I don’t know why, but sex for me has gotten better and worse with age. Sure, having an orgasm every single time is a non-negotiable that I’m not afraid to ask for, and I know what I like and what my body responds best to, but I’ve also become more prone to vaginal dryness, post-coital bleeding, and experiencing painful sex.

I know I’m not alone in this sentiment. After all, about 75% of women will experience painful sex intermittently throughout their life. Think about it—that’s ¾ of the female population. And despite society’s blatant disregard for female sexual wellness, our pleasure matters.

Make no mistake: Sex is not supposed to be painful. Which is why I tapped somatic sexologist Kiana Reeves for her expert insight on painful sex. Ahead, Reeves breaks down what exactly painful sex is, the 6 most common culprits of it, and what to do if you’re experiencing it. Keep scrolling to learn more.

Meet the expert
Kiana Reeves
Somatic Sexologist, Pelvic Health Practitioner, Certified Doula, and CCO of Foria
Reeves believes sex is an essential part of wellbeing and has been practicing in the field of sexual wellness and female reproductive health for over 10 years. Her career began in birth work as a full spectrum doula, and her background in pleasure, intimacy and sexuality is informed by her work as a certified somatic sex educator, offering clients hands-on experiences to connect with their bodies and pleasure.


What exactly is painful sex?

First things first: There are different kinds of pain. According to Reeves, some pain can actually feel good, pleasurable, and arousing, depending on your erotic preferences. However, certain types of pain—especially vaginal or pelvic pain—are usually indicative of something deeper. “This type of pain usually has a unique feeling to it, and can feel like burning, tearing, sharp, hot, piercing, or just very uncomfortable,” Reeves explained. She also said that this is the kind of pain you don’t want during a sexual experience, which is why it’s important to talk to your gynecologist and get curious about what’s causing this so you can solve the problem.


Common Culprits of Painful Sex


1. Lack of lubrication and arousal

Lack of lubrication and arousal is one of the most common culprits of painful sex, and more often than not, it comes from rushing into things. “When penetration or too much vigorous sexual stimulation happens before you’re fully aroused, it can cause pain and discomfort,” Reeves told me. “Too much friction can cause micro-tears in the vagina and vulva, which can make sex painful and cause discomfort for days afterwards.”


2. Bacterial or yeast infections

Not only are bacterial and yeast infections annoying and downright painful, Reeves says they can also be responsible for painful sex. This is due to the fact that these types of infections can irritate the tissue in the vulva and vagina, causing immediate pain. And having sex with a bacterial or yeast infection can also make symptoms worse, increase pain, and prolong healing time.


3. Hormonal fluctuations and disorders

Have you ever noticed that things tend to get drier down there during certain times in your cycle? Turns out there’s a reason for this: Hormonal fluctuations can increase vaginal dryness, which can create pain and discomfort during sex. “Hormonal fluctuations can impact the vaginal tissues and natural lubrication, and natural life stages like postpartum and menopause can cause changes in the body and impact your vaginal microbiome,” Reeves explained to me. Likewise, hormonal disorders, like polycystic ovary syndrome (PCOS) or endometriosis, can also make sex painful.


4. Pelvic floor tension

The pelvic floor is one of the biggest unsung heroes in the body. It’s responsible for bladder and bowel movements, supports the reproductive system, and promotes a healthy sex. However, according to Reeves, any increased tension to the pelvic floor—caused by stress, anxiety, vaginismus, or vulvodynia—can make sex unenjoyable, downright painful, or damn-near impossible. This is because your muscles can’t relax or contract when they’re supposed to in order to make sex pleasurable and penetration possible, and both of these things can inhibit your ability to orgasm.


5. Scar tissue

“Scar tissue is another common reason women experience painful sex, and it can come from a number of things,” Reeves told me. She listed childbirth, scarring from pelvic procedures or surgeries, and endometriosis as some of the most typical aggressors of this.


6. Unprocessed emotions

It’s no secret that stress can manifest physically in the body, and unprocessed emotions are no different. “The body is the messenger of the subconscious, and big, unfelt emotions can have a chronic impact on our ability to feel present or fully available for connection and pleasure during sexual experience,” Reeves explained. These unprocessed emotions can stem from a number of things, including a traumatic experience or daily life. In the latter instance, this usually comes from not allowing ourselves to truly access and feel emotions we’re regularly experiencing.



How To Deal With Painful Sex


1. Emphasize foreplay

If a lack of lubrication and arousal is the reason you’re experiencing painful sex, the good news is that it’s an easy fix—all you need to do is emphasize foreplay. Reeves recommends giving yourself an average of 20-40 minutes to do this. Not only will this give you a chance to get fully aroused and properly lubricated, it’ll also prolong the session, which really isn’t a bad thing. She also suggests talking to your sexual partner ahead of time and letting them know what you need in order to be adequately turned on.


2. Keep a pleasure journal

“If you’re experiencing any blocks to pleasure or feeling like it’s hard to connect with your body, the first step is to practice feeling pleasure in your body regularly,” Reeves told me. She said that she encourages everyone she works with to keep a little “pleasure” journal with them all day, so they can write down whenever they notice or experience feelings of pleasure. More often than not, this often comes from the most simple acts, such as eating, showering, or moving the body.

“Engaging in this practice will help you train your attention towards positive and pleasurable experiences,” Reeves explained. Likewise, it’ll also teach you how to give yourself permission to indulge, which can help you fully relax and get into everything when it’s time to play.


3. Always use clean, vagina-friendly lube

It’s taken some time, but we’re finally rewriting the narrative that enlisting the help of any “friends”—like sex toys, lube, etc.—in the bedroom is a bad thing. In fact, Reeves strongly advises getting in the habit of using clean, vaginal-friendly lube any time you engage in any sort of sexual play, solo or with a partner. 

“Using a clean, vagina-friendly lube will prevent you from incurring micro-tears caused by too much friction and not enough lubrication,” she said. Plus, it’ll keep things nice and slippery down there the entire time, which is a win for everyone.

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Use breath, sound, and movement

Reeves is also a huge fan of using breath, sound, and movement to help the body clear and process emotions being held inside. “Breath, sound, and movement are tools that help track sensation in the body and integrate undigested emotional experiences,” she explained. She also said that these tools help the body develop a greater capacity for feeling safe and regulating the nervous system. “If you focus on pleasurable sensations in your body while you’re moving your body, you can help your brain build pathways that are available and open to pleasure.”

To get started, Reeves suggests putting on a playlist you love every night, then finding a spot in your house that has a rug and the space where you can move around freely. Once you’re there, use the impulses your body gives you for breath, sound, and movement. “It’s so enjoyable, and such a good way to train your body into a place of safety, pleasure, and expression,” Reeves told me.


Enlist the help of a professional

“If you’re having chronic and serious pain during sex, it might be due to ongoing inflammation, scar tissue, or hormonal imbalances that a professional can help you with,” Reeves said. While she recommends seeing your gynecologist any time you’re experiencing sexual discomfort, she also suggests looking into ways you can heal your body holistically by working with a good pelvic floor therapist or functional doctor.

That said, if you’re having trouble connecting to your body or are regularly interrupted by thoughts and feelings that don’t allow you to feel pleasure, Reeves suggests enlisting the help of a somatic sex therapist. “They’ll help you work the layers of your subconscious to bring those feelings to completion, so they don’t continue to bring you out of the present moment and interrupt your connection to pleasurable sensations,” she said.