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For me, a typical Friday night is usually spent hanging out with friends, drinking wine, and eating tons of cheese. As the hours wear on, we discuss our jobs or politics or some celebrity news we’ve seen recently. Until—eventually and inevitably—we start talking about our sex lives. How are things with that girl you’ve been seeing? How do I talk to my boyfriend about this new toy I want to try? And often, How do I navigate painful sex?
Sex isn’t supposed to hurt (unless, of course, you want it to), but three in four women will still experience pain during intercourse at some point in their lives, according to the American College of Obstetricians and Gynecologists (ACOG). For some, this pain might be short-lived—a one- or two-time thing. For others, though, it might be more persistent. And, if you already know you have a chronic issue like dyspareunia, sex positions that aren’t painful can be difficult find.
Regardless of the situation, painful sex isn’t something you (or anyone else) should have to put up with, Anthony Pizarro, M.D., a Louisiana-based gynecologist specializing in pelvic medicine and reconstructive surgery, tells StyleCaster. “Many people think it’s acceptable… but it’s never really OK,” he says. There’s no need to feel ashamed, but there’s also no need to tolerate something painful when you don’t have to.
The Different Kinds of Pain Sex Can Cause
For starters, there’s the good kind of pain. The kind of pain people might seek out in a kinkyish situation. That’s not what we’re talking about here, so keep doing your thing.
Then, there’s temporary pain. If you’ve had particularly rough, fast or dry sex—or sex with a large penis or toy—you might feel sore afterward, Natasha Chinn, M.D., a New Jersey–based gynecologist, tells StyleCaster. You might notice some minor cuts or tears. While these aren’t things you should have to put up with, they are problems you can usually solve on your own. (Try starting slower, having gentler sex, using smaller toys, and finding a lube you love.)
Finally, there’s dyspareunia—acute or chronic pain during sex that’s usually attributable to some psychological or medical cause. According to Pizarro, you might be experiencing dyspareunia if sex has always been painful for you, if sex is becoming more painful for you, if you’re beginning to experience painful sex more frequently than before, or if the pain you’re experiencing during sex is acute.
If you feel like you fall into one of these categories, Pizarro says you should talk to your gynecologist or see a painful sex specialist. Though there might not be anything serious going on, it’s worth working through so you can have the happy, healthy sex life you deserve.
Here’s Why Sex Can Hurt
Like I said before, things like friction-filled penetration, lack of lube and sex with a person/toy that’s seriously well-endowed might leave you feeling a little sore. If you’ve recently given birth, you might need to give your system some time to heal before trying to have sex, Chinn says. And if you’re currently experiencing menopause, you might have lower estrogen levels than usual—meaning your vagina might produce less natural lubricant and tear more easily.
Painful sex is also associated with a bunch of medical conditions, such as endometriosis, uterine fibroids and vulvodynia—just to name a few. Different conditions present different symptoms and demand different treatments, which is one of the reasons Pizarro recommends speaking to your gynecologist. Depending on the condition, you could eradicate (or at least reduce) the pain you’re experiencing during sex.
If none of these physiological reasons seem to fit, there might be a psychological reason you’re experiencing dyspareunia, Pizarro says. According to him, your pain might be a result of a mental health condition or prescribed medication. It might also have to do with insecurity, relationship troubles, stress, guilt or fear, according to ACOG.
Don’t Freak Out if Sex Is Painful—but Do Talk to a Doctor
And in the meantime, there are a few things you can do. For starters, you can use lube to soothe vaginal dryness and an ice pack to dull any pain you’re experiencing. You can also talk to your partner about what hurts and what doesn’t—and work with them to find a position that works for both of you.
According to Pizarro, there’s no one-size-fits-all solution. Because painful sex can have such varied causes, it’s impossible to point to one sex position that will feel good for everyone. “Some positions are more painful for some patients, and others are more painful for others,” Pizarro says. “There’s no formula.” That’s why experimentation is so key. But what if you’re down to experiment but have no idea where to begin?
Here, you’ll find five sex positions to try when you’re experiencing painful sex. Chinn has vetted all of these and walked me through exactly what they’re good for—and why they might reduce some of the pain you’re experiencing.
Remember, this article shouldn’t supplant a doctor’s visit; you should still talk to your gynecologist (or a pelvic pain specialist) to learn more about what’s going on and how you can alleviate your symptoms. But in the meantime, as you’re waiting for that appointment to roll around, you might want to experiment with some of the positions we’ve illustrated and explained, ahead.
1. The Slip and Slide
How to do it: Start by lathering up with lube. I’m talking lube everywhere—on your partner’s thighs, their genitals, and all over your body. Then, climb on top of your partner and start grinding. If your partner has a penis or strap-on, mount it at your leisure.
Why this works: When you’re on top, you can control the angle and depth of penetration. This is especially good for vagina-owners who experience pain on entry, because it allows them to slowly and gently begin penetration—if they want penetration at all.
It’s also great for people who experience cervical pain during intercourse (if you’ve ever felt something like a sore menstrual cramp after particularly deep penetration, you’ll know what I’m talking about), because you can keep the penetration from feeling too deep or harsh.
Finally, it’s good for people who are apt to feel sore after sex (from too much friction or too little lube), because, well, it’s hard not to have enough lube when you’re covered in it.
The only potential downside is that being on top requires you to engage your pelvic floor muscles a lot, which might be uncomfortable if the pain you’re experiencing is related to your pelvis.
2. Modified Missionary
How to do it: Lie down, and ask your partner to climb on top of you—face-to-face, toe-to-toe. Then, take a pillow and place it under your lower back and the top of your butt. Move it around until you feel comfortable, and assume business as usual.
Why this works: Not only will this make your back a little more comfortable, but it will keep your pelvis feeling comfortable, too. Plus, since your pelvis will be elevated, it might be easier for your partner to penetrate you, making it a great option for people who experience pain on entry (and vaginal dryness, assuming you use lube).
Worth noting: Since you’re making penetration easier, it’s possible that you’re making deeper penetration easier, too. This might not be ideal for anyone experiencing cervical pain during intercourse, Chinn says, so be thoughtful about whether or not this one might work for you.
3. The Lotus
How to do it: Tell your partner to cross their legs. Then, sit in their lap and wrap your legs around them. This might take some finagling, but you can handle it. Once you’re settled, wrap your arms around each other and start rocking back and forth. If you want penetration, mount your partner and then rock back and forth. If not, just grind on them and enjoy the fun.
Why this works: The Lotus is especially great for anyone who experiences vaginal dryness or pain from deep penetration, Chinn says. Since you’re rocking back and forth, you’re not creating as much painful friction—and you’re limiting how deep the penetration can get.
The modified, sans-penetration version might be a good option for anyone who experiences pain on entry, as it lets you get close to your partner without dealing with penetration.
4. Good, Old-Fashioned Oral
How to do it: Embrace the fact that sex doesn’t have to mean penetration, and assume your favorite oral position. (We opted for 69, but, you know, that’s just us.)
Why this works: So much of the pain associated with intercourse has to do with penetration, so eliminating it means you can get intimate with your partner without dealing with the pain, discomfort, or dryness you’re used to encountering.
How to do it: Lie on your side, and tell your partner to do the same. Face each other, and find a position that works for penetration.
Why this works: This can be really good for anyone who experiences pain from deep penetration, Chinn says. When you lie on your side, you change the angle of penetration—making it harder for your partner to deeply penetrate you (and harder for your cervix to get irritated).
This might be tougher for someone who experiences pain on entry or vaginal dryness, though. Since the angle makes penetration a little harder, it might exacerbate what you’re already dealing with.
A version of this article was published in 2018.