We all want sex to feel good—and not just orgasmic, but also pleasant and pain-free. But unfortunately that’s not always the case for some vulva-owners. Dyspareunia, pain that happens during or after sex, can occur for multiple reasons. According to certified sexologist and pleasure coach Tyomi Morgan, experiencing pain during sex can be a result of endometriosis, cysts and fibroids, a tight pelvic floor caused by trauma, or even hormones.
“A number of physiological and mental health conditions can carry the symptom of painful sex along with them, and when sex doesn’t feel pleasurable, the desire to engage just isn’t there,” she says. “When health conditions need to be managed, sexual satisfaction takes a back seat.”
If you’re experiencing pain during sex, Morgan advises seeing a doctor when painful sex becomes persistent and interferes with how you interact with your partner and how you feel about yourself. “Self-diagnosing and self-treating before knowing the underlying cause of the pain is not advised,” she says.
But does sex have to stop altogether? According to Morgan, penetrative sex can be avoided if the pain is chronic, but sex doesn’t have to stop. “Outercourse and oral sex are still viable options to engage with while in the midst of determining the underlying cause of painful sex,” she says. “Kissing, massaging, engaging with fetishes or kinks, mutual masturbation and playing with non-penetrative toys are just a few examples of sexual engagement that doesn’t have to involve penetration.”
Expanding the idea of what sex looks like is extremely helpful in maintaining a pleasurable sex life, Morgan says, which is why she recommends the following positions that may help minimize pain during sex.
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- Spooning position: “Both partners lie on their side with the receiving partner positioned in front of the penetrating partner with their back to them, mimicking spoons laying inside of each other,” Morgan says. “This position is great for cuddles and encourages gentle strokes during penetration.”
- Plank Position: “The receiving partner lays down on their stomach with a pillow underneath their pelvis and their legs slightly parted for easy penetration,” Morgan says. “The penetrating partner straddles their partner’s legs and gently strokes as their partner lays comfortably. The partner on top can use their hands to lift and support their partner’s pelvis to gently press deeper into the vagina.”
- Face-to-Face: “Both partners face each other with the receiving partner on the bottom and the penetrating partner on top,” Morgan says. “The receiving partner’s legs can be lifted, wrapped around their partner’s waist or positioned with the knees bent and feet flat. Eye-gazing and synchronized breathing can help with relaxation and deeper connection.”
- Oral sex: Oral sex doesn’t require penetration, so engaging in mouth sex is a great option for those who find it too painful to have sexual intercourse. There are a number of positions you can try, including everything from missionary oral sex to 69-ing. You might even be open to anal oral play too. You can experiment them all with your partner and discover what works best for you.
When penetration is not an option, Morgan recommends using sex toys with your partner, especially those that stimulate the clitoris. “Whether it’s a suction toy or a buzzy vibe, stimulating the head of the clitoris is like a cheat code for arousal,” she says. “By directly stimulating the clitoris from the outside, engorgement occurs and arousal deepens leading the user closer to an orgasm. Pleasure is the ultimate goal of sex, and using toys on the outside of the vulva can feel extremely pleasurable. These same vibes can be used on nipples as well.” Additionally, she suggests using sex pillows or sex furniture for ease in positioning, which can also help with pain relief.