Sex and Pain:

From Mitigation to Mastery

by Jackie Velez

Sex and Pain

We here at As You Like It are in the business of pleasure. And as pleasure professionals, we know how difficult it can be when our pursuit of pleasure is interrupted by pain. But experiencing pain during sex is actually much more common than you might think!

It is estimated that around 75% of people with vaginas will experience sexual pain at some point in their lives. But for as prevalent as pain during sex is, there is surprisingly few conversations being had about it. Perhaps that’s why sexual pain can feel so isolating — society as a whole is still unwilling to have those kinds of open, honest conversations about sex.

But we talk about pleasure every day, and we’re happy to have this discussion, too. If you’re experiencing painful sex, we want you to know that you’re not alone. And you deserve to experience pleasure without pain! Pleasure and connection are basic human needs.

And sex shouldn’t hurt (unless you want it to, of course)!

Tackling Endometriosis, Pelvic, & Vaginal Pain

March is Endometriosis Awareness Month, which is what inspired us to have this conversation about sex and pain. For those who don’t already know, endometriosis is a condition where endometrial tissue grows outside of the uterus, and is one of the most common causes of pain during sex. It is estimated that up to 10% of people with vaginas suffer from endometriosis, and it is most frequently defined by pain during vaginal penetration, painful menstruation, and frequent pelvic or abdominal pain. Although an estimated 176 million people worldwide suffer from Endometriosis, diagnosis is rare, and treatment can sometimes take a long time to obtain.

It’s also important to note that while Endometriosis is surprisingly common, there are a plethora of other medical reasons that may cause painful sex. From nerve pain to vulvodynia to hormonal imbalances, sexual pain can be particularly hard to self-diagnose. For many vagina-owners who are experiencing intense or frequent sexual pain, professional medical advice may be necessary. Speak to your gynecologist about your symptoms, or consult a specialist, such as the Pelvic Wellness Center in Eugene.

It is also extremely common to find that sex has become painful after life changes, such as undergoing surgery, childbirth, or menopause. Especially after surgery, childbirth, or other large physical changes, make sure to consult your doctor or your gynocologist before participating in penetrative sex. If ever in doubt or pain, consider asking your doctor or gynecologist for advice.

And if you find that your doctor is doubting you or minimizing your symptoms, it may be time to start searching for a new doctor — one who takes your health seriously.

That being said, it’s important to understand that the pelvic floor and the vaginal canal are muscles, just like any other in our bodies. And like all of our other muscles, these muscles can become sore with overuse, stiff with underuse, or simply change naturally over time as we age. But the good news is that there are actions we can take to strengthen, loosen, and improve the strength and elasticity of those muscles over time.

Pelvic Floor Diagram

The pelvic floor is a hammock-shaped muscle that hangs between the base of our spine and the front of our pelvis. For context, this is the muscle that we tense or clench when we want to stop ourselves from urinating. This is also the muscle that clenches when we experience an orgasm. If you focus, you should be able to tighten and release this muscle, and feel it tense and then loosen with conscious effort. Focus on activating only the pelvic floor only; try not to clench the muscles in your abdomen, thighs, or buttocks. Remember to breathe, and make sure that you fully unclench the pelvic floor before tightening again. This is called a Kegel exercise! Think of it like a little workout for your orgasm muscle!

Experiencing pain during sex can sometimes mean that your pelvic floor is out of shape. If you’re looking for a way to help mitigate sexual pain (or if you just want stronger orgasms), you might consider trying a regime of kegel exercises! Try gently and slowly exercising your pelvic floor for a few minutes a day by consciously clenching and unclenching, and slowly increase your time from there as you feel comfortable. Just make sure not to rush yourself and fully relax your body between every clench — like any other muscle, overusing the pelvic floor can cause tension and stiffness. Like any new workout, it’s best to take it slow and listen to your body. If you find that doing kegel exercises cause you pain or make you feel more stiff, you might consider visiting a gynecologist or pelvic floor specialist for professional advice.

There are also several different tools that you can use to help make the most out of your workout. You may have heard of Kegel Balls before, which are essentially small weights for your vagina. The tension of holding a weighted item causes your vagina to clench, which can be helpful for those who need help identifying their pelvic floor, or who are seeking a more intense workout. Some kegel balls, like the Ami set by Je Joue and the Nova set by Svakom, come in sets. With these sets, you begin with the largest and lightest ball, because it is the easiest to hold in place. As your pelvic floor becomes stronger, your kegels will move down in size but up in weight. Other kegel balls, like Bloom by We-Vibe and the Elvie, are incredibly high-tech, and come with apps that help you track your progress and even turn your pelvic workout into a fun game! No matter what your level of kegel experience, there’s a toy for you.

That being said, it’s important to understand that the pelvic floor and the vaginal canal are muscles, just like any other in our bodies. And like all of our other muscles, these muscles can become sore with overuse, stiff with underuse, or simply change naturally over time as we age. But the good news is that there are actions we can take to strengthen, loosen, and improve the strength and elasticity of those muscles over time.

The pelvic floor is a hammock-shaped muscle that hangs between the base of our spine and the front of our pelvis. For context, this is the muscle that we tense or clench when we want to stop ourselves from urinating. This is also the muscle that clenches when we experience an orgasm. If you focus, you should be able to tighten and release this muscle, and feel it tense and then loosen with conscious effort. Focus on activating only the pelvic floor only; try not to clench the muscles in your abdomen, thighs, or buttocks. Remember to breathe, and make sure that you fully unclench the pelvic floor before tightening again. This is called a Kegel exercise! Think of it like a little workout for your orgasm muscle!

Experiencing pain during sex can sometimes mean that your pelvic floor is out of shape. If you’re looking for a way to help mitigate sexual pain (or if you just want stronger orgasms), you might consider trying a regime of kegel exercises! Try gently and slowly exercising your pelvic floor for a few minutes a day by consciously clenching and unclenching, and slowly increase your time from there as you feel comfortable. Just make sure not to rush yourself and fully relax your body between every clench — like any other muscle, overusing the pelvic floor can cause tension and stiffness. Like any new workout, it’s best to take it slow and listen to your body. If you find that doing kegel exercises cause you pain or make you feel more stiff, you might consider visiting a gynecologist or pelvic floor specialist for professional advice.

For some people, especially people with nerve damage or lack of sensation, it can be difficult to manually identify and exercise the pelvic floor. One way that some pelvic therapists suggest for these people to still exercise their kegels is through electrotherapy. The Sizzling Simon is a penetrative toy that is equipped with e-stim capabilities, which also comes with a pelvic floor therapy mode.

Subtle electric shocks can manually cause the pelvic floor to clench, which allows those with limited sensation or muscle control engage in kegel therapy.

In addition, Sizzling Simon comes equipped with good old fashioned vibration, so it can be used as a vibrating toy or as a wellness device! Because pleasure is one of the best ways to fend off pain.

If you are experiencing pain, but only during penetrative sex, this might be a clue that your pelvic floor has become too tense. In that case, doing kegels will likely only serve to increase pelvic tension. The good news is that there are lots of ways to potentially make penetration more comfortable.

If your goal is to be able to have penetration without pain, it can be very important to loosen the pelvic floor. One of the best ways to do this is with dilator sets. Dilator sets are a series of penetrative toys in gradually increasing sizes designed to help you slowly work up to penetration with larger objects. Most dilator kits start at a piece that is about the size of a finger, then gradually increase to a more average phallic size. The idea behind these kits is to begin getting the vagina used to penetration with the smaller pieces, then gradually moving up in size.

Another popular choice for dilation are the slim glass dildos by Crave. Because of their slender shape and incredibly smooth texture, many find these pieces to be more comfortable than standard dilator sets. You can use these glass dildos as internal massagers by gently rotating and moving them against the walls of the vagina to stimulate blood flow and encourage elasticity. Because glass holds temperature, you can also cool these glass toys down in a glass of cold water before use, making them like a soothing ice pack for your vaginal canal!

If you are going to try dilating, make sure that you find a good body-safe lubricant to go with them! We recommend Aloe Cadabra's original, unscented formula for dilating, kegels, and treating post-menopausal tightness or dryness. Aloe Cadabra is a doctor-recommended, water-based lubricant that is over 95% organic aloe vera with no artificial flavors added, no harsh chemicals. Aloe Cadabra is also 100% edible and safe to use anywhere on the body. Best of all, because aloe has the magical ability to actually rebuild our body’s damaged or destroyed mucosal tissues, Aloe Cadabra actually helps your body to become better at creating its own moisture, in addition to moisturizing and replenishing the tissues upon application. So you can use Aloe Cadabra as a lubricant, or as a daily intimate moisturizer!

Finally, if you want to experience penetration from your partner while still maintaining control of the depth of penetration,  there is a new product on the market designed just for that. Meet OhNut, a soft, squishy buffer designed to be worn at the base of a penis to prevent penetration from going too deep. OhNut comes in two widths, so you can decide what size is right for you. Best of all, OhNut comes with four different stackable rings. That way, you can customize your penetration depth to the point where it is most comfortable for you. You can also use OhNut to help keep a condom safely in place. And the wearer also gets a luxuriously soft, slightly squeezy sensation out of the deal, too! Or, you can put it on your favorite toy to protect your cervix while you're playing solo. So if you like penetration, but need to be careful with the depth, consider giving OhNut a try!

It’s also important to remember that no matter what, you can still experience pleasure and intimacy without penetrative sex. While to some people, penetration is considered “the main event” of sex, the idea that penetration is the most valid form of sex is simply untrue. Anything that brings pleasure can be considered sex! So if penetration is too painful to be enjoyable, it may be best to simply take a break from that particular activity. You can consider it an opportunity to expand your idea of what sex means! Explore with clitoral play, mutual masturbation, oral sex, grinding, kink, or tantra. Launch an expedition to discover what brings you pleasure, and you’re likely to come back with lots of valuable personal pleasure knowledge.

Getting Sexy When You Have Chronic Pain

For some people, pain and pain management is a constant part of their life. Those who live with disabilities or chronic pain conditions will always experience a baseline of pain. But all bodies can take actions to manage pain levels and maximize pleasure in relation to their sex life!

Firstly, it’s important to remember that sex can look different for everyone. There is no “one-size-fits-all” model for sex, and anything that brings you pleasure is a valid way to fuck. Expand your definition of sex to include kissing, touching, and exploring sensation. Experiment to find out what activities, positions, and stimulation your body likes. Figure out how you feel most comfortable, relaxed, and able to tap into your sexual self. It can be difficult to feel sexual when you’re dealing with pain, but it’s important to remember that you deserve to experience pleasure, too.

You will know best how to manage your own pain. For some people, CBD can help to relax the body and relieve sore or tense muscles. Consider beginning your play sessions with a sensual massage. This will help you come back into your body and attune to the pleasurable sensations it can experience. And if you are interested, add a massage oil with CBD in it to help relieve soreness or inflammation. We recommend Hemp-Infused Massage Oil by CocoNu, which is a luxurious and moisturizing coconut oil base with CBD added for extra relaxation.

It can be helpful to minimize your necessary movement during sex. Set up your space before you start getting dirty! We suggest placing all your needed mobility aids, lube, toys, tools, water, and clean towels within arm’s reach. Creating a space where everything you need is readily available to you will not only help you to get into the mood, but also make the things you might need more easily accessible to you.

It’s also critically important to be able to communicate your sexual needs with those who you are being sexual with, as well with the medical and caregiving professionals in your life. Get comfortable talking honestly with doctors and caregivers about how to best tend to your sexual health, and try to find medical and caregiving professionals who you can feel comfortable to talk honestly with and supported by. And of course, if you experience pain during sex and need to, you should speak up about it to your partner so they can help mitigate it! But more on that later.

The good news is that there are are plenty of toys, tools, tips, and tricks that exist specifically to help make your sex life as pain-free as it can possibly be!

One of the most helpful things we can recommend to minimize sexual pain is positioning aids. Liberator has an entire line of luxurious positioning aids, from dense pillows to offer additional support wherever you need it most, to toy mounts that allow you to have a hands-free experience with your favorite vibrator. With Liberator to rely on, you’re really only limited by your imagination!

There are also a variety of positioning aids that can help offer better control of your limbs during sex, minimizing spasms and preventing you from being bent into uncomfortable angles. Using the Positioning Strap by Sportsheets around your abdomen can make movement easier. You can also hold onto the loops to help increase your control and focus, while putting the loops around your legs can minimize body tension and help you stay in the position that you’re comfortable in. Another favorite by Sportsheets is the Door Jam Sex Sling, which has control straps for both the hands and feet and can be used to hold your body upright.

If you want to be the penetrating partner, but have limited mobility around your hips, there are also several different types of harnesses that can allow you to top comfortably. La Palma makes a dildo harness that you wear on your hand, perfect for those with dexterity issues. A thigh harness can be helpful to make some positions more accessible and maximize bodily mobility for some. We love the one by Sportsheets! You can also wrap a thigh harness around a pillow, creating a new, mountable way to play.

It can also be convenient to have a toy that you don’t have to hold or manually move. Kimi by VeDo is a dream toy for those with arthritis or grip problems! It comes with a small wrist-strap, and two small vibrating pads that sit on your fingertips. So you have vibration literally at your fingertips without having to hold onto anything! We-Vibe makes an entire line of toys for all bodies and body parts that can be controlled by a phone app — ideal if it is easier for you to simply put the toy in place and then control it conveniently from your phone.

Finally, remember that some of the earliest sex toys were actually back massagers that some very intelligent people reimagined to be used for sexual pleasure. In fact, one of the most popular vibrators of all time, the Magic Wand, was originally marketed as a massager for sore muscles. And while these kinds of massagers turned out to be amazing at delivering orgasms, remember that there’s no reason you can’t use them to help relieve your pain, too! If you have chronic body pain, consider treating yourself to a massager with a strong, rumbly motor that can serve multiple purposes — pain relief and pleasure. A long handle can be a convenient feature as well, to make sure that you can reach all your sensitive spots. For best vibrator-turned-body-massager, we recommend Doxy Die Cast or Le Wand Original. Those two large, powerful wand-style vibes are ideal for muscle-soothing and tension relief.

For sufferers of chronic pain, sex without pain may be an impossible pipe dream. But no matter what, there will always be ways to manage your pain and maximize your pleasure.

What To Do if You Experience Pain During Sex

In spite of our best efforts, it’s very likely that most of us will experience pain during sex at some point in our lives. So it’s very important that we know what to do when it happens!

First, communicate! It’s very important to find partners that are willing to listen to you, but it is equally important to be able to find your voice and speak up if something is wrong! Remember that your partner/s may be incredibly sensitive and attentive, but even they cannot possibly know how it feels to be in your body. So if something hurts, learn to speak up about it! Only then can you work together to find out how to mitigate the pain.

Some of the most common ways to help mitigate sexual pain are simple adjustments. If the pain is onset suddenly during sex, you can try a new position, a slower speed, or a different angle. Use trial and error to discover what works for you and what doesn’t. And if something just isn’t working, take a break and move onto something else! You can always come back and try that particular act again later.

If the pain appears to be topical, it’s possible that your skin is being irritated by something that’s present. You may be having a reaction to your lubricant or the barriers you’re using. Make sure that the lubricant and barriers that you choose to use are body-safe, free of allergens, and comfortable on your skin. Sometimes, shaving or waxing can irritate the skin as well. Our skin is sensitive, so make sure you treat it gently!

Sometimes, stopping sexual pain can be as simple as adding lubricant! When we have penetrative sex, the friction can cause us to chafe. Adding lube can create a cushion between our skin and the penetrating object, minimizing friction and protecting our sensitive skin from damage. Make sure to be aware of the ingredients in your lubricant! Our bodies are very individual and sensitive, and much of the lubricant on the market today includes ingredients that can actually dehydrate your cells and cause micro-tears. Choose something that is body-safe and soothing, and experiment until you find one that works for you.

If you are having trouble getting enough lubricant where it needs to be, there is a handy little device called a lube shooter that can make all the difference. Similar to a syringe, simply insert the tip into your favorite bottle of lubricant and pull the pump back to draw lube into the shooter. Then, you can easily insert the tip of the shooter either vaginally or anally and push down on the plunger to make sure that all the lubricant ends up inside, right where you need it.

It’s important to remember that pain is our bodies’ way of sending us a message, and sometimes, pain is indicative of a more serious problem. Especially if your pain levels change drastically and rapidly, it is possible that there could be something wrong that requires medical treatment. If you are experiencing a burning pain when urinating, or skin irritation that comes with itching or painful sores, it is wise to be tested for a possible yeast infection or sexually-transmitted infection. When in doubt, it may be best to seek the help and advice of a medical professional that you trust.

Pleasure is as complex and unique to each individual as it is necessary; experiences that make us feel good are essential to living a complete and fulfilled life.

Unfortunately, pain can sometimes encroach on what makes us feel good. Pain is a necessary component to life as a human, and it is important that we listen to pain as the teacher and warning sign that it is. But there is no need to wallow in our pain, or to forego our pleasure because we are experiencing pain. So while we want to  make space for pain and pleasure to coexist, we also want to educate and encourage our dear readers to take all possible steps to experience a sex life with as little unwanted pain as possible. Because sex shouldn’t hurt. And you deserve a sex life that is satisfying, affirming, and filled with pleasure.

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