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3 Reasons Sex May Hurt — A Lot

And how you can fix it.

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illustration of man and woman on bed in their underwear with a red circle around woman's vagina
LA Johnson
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After the birth of my first child, I realized pretty quickly that sex was the very last thing on my mind. Sleepless nights, an infant who wanted to nurse constantly and a postpartum body that I barely recognized did nothing for my libido. Frankly, in those first few weeks, I was fine with putting sex on the backburner. And besides, things still weren’t right “down there,” even though I’d had a C section. Let’s face it: The aftermath of having a baby isn’t the least bit sexy.

But eventually I realized that my sleep deprivation fog was lifting, and I saw my husband as more than the guy who ran out for diapers at midnight and stared at me blankly when I cried uncontrollably from exhaustion. I got my sexy groove back and we decided to make an evening of it, if you will.

Yeah, that evening didn’t go as planned.

Our intended reconnection ended with me in tears and my husband bewildered by what he’d just witnessed.

Put simply: There was nothing that felt good about that first time after having a baby.

In fact, it was downright painful, and I shut that action down immediately.

At first, I told myself that it was the stress and the buildup of “getting back to normal” after our lives had been upended by a baby. And, I told myself that painful sex happened now and again, and things would go back to normal quickly.

Yeah, not so much.

It turns out, when you are stressed that sex is going to hurt, your mind can sometimes psychologically train itself to anticipate pain before sex, and your lady muscles can tense up. Sex is painful and it becomes a vicious cycle: You think it’s going to hurt and it does, and round and round you go. It’s embarrassing and heartbreaking when you want to connect with your partner but your body feels pain during an activity that usually feels amazing.

After several frustrating months, I reached out to my gynecologist for help. When I explained my symptoms, he assured me nothing was “wrong” with me. He told me I likely had a condition called vaginismus, which is a condition where a woman’s vaginal muscles tighten during insertion. Vaginismus is treatable with relaxation exercises practiced with your partner, and with Kegel exercises to strengthen the pelvic floor.

When the doctor told me there was a name for what was going on with my sex life, I nearly cried with relief. Saying, “So, my vagina completely shuts down any time my husband comes near me and I’m so frustrated that I could cry,” isn’t really the acceptable chatter of playdates. Thankfully, I could say anything to my best friend, and we had many discussions about how desperately I wanted to have sex free of pain again.

Painful intercourse can be caused by a variety of reasons and, often, the issue lies within three categories: entry pain, deep pain and emotional issues.

Entry pain
This category is pretty self-explanatory: Your vagina hurts during insertion, much like my situation with vaginismus. Entry pain can be caused because of lack of lubrication, irritation from the trauma of birth or an infection. Entry pain can be linked to something as simple as a bladder infection that is wreaking havoc on your insides. Some medications can cause a woman’s vaginal area to be drier than usual, so talking to your doctor about what’s causing entry pain is always a good idea.

Deep pain
Some women report pain from deep within when they are having intercourse. Sometimes, this means something more serious is brewing. If you are experiencing deep pain with sex, don’t wait, call your doctor to make an appointment. Deep pain can be caused by endometriosis, pelvic inflammatory disease, uterine prolapse, uterine fibroids, and cystitis. Even conditions like irritable bowel syndrome, hemorrhoids and ovarian cysts can alter how sex feels with your partner. And don’t panic: Your doctor will be able to run tests and help you find the medical solution for your situation.

Emotional issues
Again, this is pretty straightforward, ladies: I know you hear me on this one. When you’ve been running like a chicken with your head cut off at your job only to start refereeing homework, carpool and household responsibilities when you get home, it’s pretty hard to switch gears and make bedroom eyes at your partner. Underlying anxiety, depression and other psychological conditions could be contributing to painful sex with your partner, so taking an inventory of your mental health might be helpful. Of course, only a licensed therapist can help you unpack your worries, stresses and anxieties. You are not the first person who has had anxiety ruin a sexy night with your partner, trust me.

Painful sex is downright unpleasant, and it was a trying time for my husband and me when we went through it. Talking to your doctor or midwife can often open up a discussion that will help you pinpoint what’s keeping you from getting your sexy on with your partner. And, don’t be afraid to open up to your girlfriends. Chances are, they have the same issues and are dying to talk about it, too.