For anyone who’s ever experienced pain mid-coitus, the discomfort is more common than you think.
In an article published by The Cut, Jennifer Lang, MD an OB/GYN and gynecologic oncologist, who practices in Los Angeles, discussed the complex sexual problem also known as dyspareunia. “The whole field of pelvic pain and pain in general is a very complex subject and it’s very much a mixture of psychology and physiology,” says Dr. Lang. “This could be a book.”
So what’s the cause? Well, according to Dr. Lang, it could be a number of things, including where you are in your menstrual cycle, having a benign cyst or endometriosis, medications you’re taking, an enjoyment for rough sex, or a history of sexual trauma. But in order to pinpoint an exact cause, you will have to describe the type of pain you’re experiencing, when you’re experiencing it and if anything makes it better or worse (like switching positions) to your doctor.
There’s also the chance that you’re feeling pain because your partner isn’t putting in the work they need to before they get to the whole P in V part. “Erections are pretty instantaneous, but women lubricate over a slower period of time,” she explained. “It’s important to make sure that a woman is in a high arousal state before penetration.”
Another explanation could have to do with a woman’s birth control and natural cycle. From The Cut,
And women’s vaginal mucus can change dramatically during the course of their natural cycle, or depending on what type of birth control they’re using, and that can, uh, certainly affect things. Women not using hormonal birth control will often find that their mucus is very slippery and pliable during the estrogen-dominant first two weeks of their cycle (with day one being their period), and less lubricating during the second half of the month when it’s under the effects of progesterone, she says. If women are using progestin-based birth control like the mini-pill or a hormonal IUD, they might notice that they have thicker, drier mucus or just less of it. And many of the very-low-estrogen birth-control pills can also have vaginal drying as a side effect. (But she points out that only some women using these methods will experience this.)
Luckily there’s a way to solve this pesky problem: lube.
“The worst thing that can happen is you’re experiencing pain during intercourse and you’re too uncomfortable to say, ‘Hold on, we need to get the lube,’” Dr. Lang says. “You need to have a certain confidence in recognizing that sex should never been painful. For non-BDSM-type sex, pain is generally an indicator that there’s something that needs attention.”
If the problem is more serious and you experience the pain outside of having sex, you could have an ovarian cyst. According to Dr. Lang, your doctor would be able to reproduce the pain during a pelvic exam if that were the case.
So what if you get checked out and nothing physical turns up as the issue? Dr. Lang says the problem could be psychological. “The mind-body connection with sexuality is tremendous, particularly with women,” she explained. “Once you’ve essentially ruled out these physiologic things … having a 45-minute session just devoted to exploring [psychological] issues can be more beneficial to a woman than six doctor’s visits with quick prescriptions written for this agent or that agent.”
So what’s the moral of the story here? Skip WebMD and just head to the gyno if you’re having problems.
[H/T: The Cut]