Sex and pleasure are part of a package deal – it feels good, and that’s one of the reasons we keep doing it! But recent research shows 30% of women are experiencing pain during the act. Though the hurt could be a symptom of a serious issue such as endometriosis, more often the cause is less grave.

“Most conditions that cause painful intercourse are very treatable,” says Dr Debby Herbenick, author of Sex Made Easy. Read on to find sex-wrecking culprits and their cures.

1. It feels like his penis is made of sandpaper

Vaginal dryness. “A lack of lubrication is hands down the most common cause of painful sex,” says Dr Herbenick. Certain medication – including the Pill, antidepressants, some allergy and cold meds – can stop your juices from flowing. So ditch the pre-sex soak in a warm bath, which dries out vaginal tissue.

Read more: 4 common reasons why you’re suffering from vaginal dryness

Apply a dollop of water-based lubricant to your girl parts during foreplay. A US study found that women who used lube while doing the deed reported significantly less pain and – bonus! – much higher levels of satisfaction.

Opt for positions that allow you to control the pacing (like woman on top) and stop to reapply if needed. Still in pain? If only certain positions are hurting you, common causes are constipation, muscle spasms, endometriosis, cysts or other organic causes, says WH sex expert Dr Elna Rudolph.

2. Your genitals itch and penetration makes it feel worse

Though various conditions can lead to itchiness, the most common cause is a yeast infection, which may result from taking antibiotics. Research also suggests a link between lots of oral sex and recurrent yeast infections; women who suffer from the condition are three times as likely to be on the receiving end of frequent oral loving. However, this is rare, according to Dr Rudolph. “Likely offenders are scented bubble baths, lubes and harmful activities like douching,” she says.

Read more: How much vaginal discharge is normal?

If you think you have a yeast infection, use an over-the-counter treatment, says Dr Rudolph. “If it’s not better within five days, see your gynae and have her take a vaginal swab,” she says. Keep getting that itch? It’s okay to use an OTC treatment up to five times a year – if you need it more often, have another swab taken.

“You may have a resistant infection, or it may not be a yeast infection at all,” says Dr Rudolph. “Conditions like lichen sclerosus also cause itching, and it’s harmful to treat it as a yeast infection.”

3. It seems as if he’s going to burst through your cervix

No, he’s not too big for you. You’re probably just rushing things. “If you’re sufficiently aroused, ‘ballooning’ of the vagina takes place,” says Dr Rudolph. “The uterus is pulled up into the abdomen and the muscles around the vagina relax, creating space for him.”

Read more: 7 cervical cancer symptoms you should absolutely never ignore

Don’t skimp on the pre-game warm-up. Most women need 20 minutes of foreplay to make sure their parts are ready for action. Simply adding lube isn’t a good short cut. “It might make entry easier, but it won’t change the length or shape of your vagina,” says Dr Herbenick.

Still uncomfortable? “It shouldn’t be painful if a penis hits a healthy cervix,” adds Dr Rudolph. If you still feel there isn’t enough space, see your gynae.

4. Post-baby nooky leaves you achy and raw

New moms, especially those who are breastfeeding, can experience plummeting oestrogen levels that leave the vagina drier than the Sahara and the vaginal walls prone to tearing. Scar tissue on a poorly healed episiotomy can also cause penetration woes.

Read more: The 5 best sex positions for after you have a baby

Take a break from intercourse. Many women aren’t physically ready for three months or longer, says obstetrics gynaecologist Dr Elizabeth Stewart. But don’t cut down on intimacy altogether, says Dr Rudolph. Start by using a finger and then try penetration – with plenty of lube.

5. It feels as if shards of glass are cutting up your outer vagina

Provoked vestibulodynia – a problem thought to involve the pelvic muscles, fascia and nerves.

If it’s mild, your doctor can prescribe Remicaine jelly or Emla cream containing a local anaesthetic, says Dr Rudolph. Once your gynae has ruled out obvious causes like infections, see somebody who specialises in genital pain. “Management will be a combo of medical treatment, physiotherapy and, in some cases, psychological interventions.”

6. Your vagina clamps shut when he tries to enter

Vaginismus. This painful but treatable condition causes the muscles at the entrance to the vagina to spasm at penetration, making intercourse all but impossible.

Read more: Two gynae-approved ways to tell if your vagina is too weak or too tight

Vaginismus is the fear of penetration associated with involuntary muscle spasm, and treatment involves overcoming the fear, learning to control the pelvic floor muscles and stretching them sufficiently to allow penetration, says Dr Rudolph. Stretching exercises begin with tiny objects like ear buds, moving on to a pencil, small tampon and vaginal dilators.

Your doctor might also prescribe sex therapy, psychotherapy and pelvic-floor physiotherapy to break down muscle knots through massage. Botox also works to relax overactive vaginal muscles, but it’s still experimental.

7. You get an itchy, hive-like rash around your vulva after sex

An allergic reaction, probably due to latex condoms or your lube. Choose plain condoms with no flavourants, and water or silicone-based lube. If it’s still a problem, see a doctor.

^{This article was originally published on www.womenshealthsa.co.za}

^{Image credit: iStock} 

Tracy Erb Middleton