The Sex Hurts, What Do I Do?

Lately I've found it can be painful to have sex. Is this because I'm not turned on, or is there a more serious cause?

 Pain during sex is quite common. In fact, most of us will have at least one experience where our "ooohs" are replaced with "ouch!" For instance, during the middle of your cycle, when you are ovulating and your ovary is swollen and tender, the penis may push against it and cause discomfort, especially when penetration is deep. (You may feel similar discomfort just before or after your period.) Switching to a position where penetration's not as deep — try lying on your sides, face-to-face — should solve the problem.

The most common cause of painful sex, though, is vaginal dryness. When you become aroused, your vagina "sweats" a slippery fluid that makes intercourse easy and pleasurable. When you do not produce enough fluid, you have two dry surfaces (a dry penis and a dry vagina) rubbing against each other — causing friction, heat, and burning. The resulting pain can last for hours, or sometimes days. Dryness most commonly occurs when we do not get enough foreplay, which gives your vagina the time it needs to lubricate and become longer and wider at the top, making insertion and movement of the penis easier. Women often need more time to become aroused after they've been in a relationship for a while. That's because that pizazz you had at the beginning — when just thinking about your partner was enough! — eventually dies down, and it takes more action to turn you on. As you age, too, your vagina may be drier due to a drop in estrogen levels, especially after giving birth and after menopause. Medications like antihistamines and birth control pills can also cause dryness. So devote more time to foreplay — that could mean anything from holding hands to nibbling his ear to dirty talk or blowing your hot breath over each other's bodies. Use your imagination! And try using a water-based lubricant (which won't break down a condom) to relieve dryness and make foreplay even more fun.

Discomfort may also stem from yeast, bacterial, or herpes infections, which can cause swelling and irritation of your vagina and vulva. Vestibulitis, an irritation of the glands that surround the opening of your vagina, can make even touching the opening unbearable; vaginismus, or involuntary spasms of the muscles surrounding your vagina, can make it almost impossible for a penis or even a finger to enter. (The cause of the former condition is unknown; the latter may be triggered by a painful past event, among other things.) Recurrent pain during deep penetration can also mean a medical problem — whether it's an ovarian cyst, endometriosis, fibroids, or a pelvic infection — so see your doctor if you're having it.