Painful Vaginal Sex

Pain During Sex Is Challenging

Before we begin this guide, we want to let you know that if you are experiencing pain during sex, we genuinely care about what you are going through. It is not just physically painful; it can impact our feelings of self-worth and be challenging in our relationship(s). Sexual health and wellness is our specialty, and we work with many people who are struggling sexually to help them be better empowered through education and healthy sexual products. We are here for you. You are not alone.

Determining The Cause

There are many reasons that vaginal penetration from a penis, fingers/hand, or a sex toy can be painful. The most common is that the vaginal walls are overly snug, dry, or tense. Various factors can cause slight discomfort to extreme pain and may even cause vaginal tearing and bleeding, which may require medical attention.

Even after having sex for many years or even having had a child, many women can experience pain during sexual penetration. This is especially true for those who have had a cesarean section (c-section), have been sexually inactive, are perimenopausal or menopausal, or have other health-related causes for vaginal pain.

Chronic Vulvar Pain

Chronic vulvar pain can be caused by various health conditions, such as a diagnosis like vulvodynia or vulvar vestibulitis. Health issues like these may be mistaken for symptoms of menopause or psychological problems. Thus, it is vital to consider variable symptoms to determine the correct underlying cause in order to effectively treat it.

Exploring Vulvar Pain With Your Doctor

Talking with a physician in detail about pain during sexual penetration is essential. For example, discuss specific symptoms, when they began, and what was going on in your life when they started. Exploring what was going on in your life when the symptoms began may help you rule out possible diagnoses; because stress can cause physical responses in the body that can manifest as medical conditions such as autoimmune responses.

Also, a physical exam, reviewing medication side effects, allergies, sensitivities, nutritional intake, and lab testing can help get to the bottom of your pain. Understanding the root cause of your pain is necessary for addressing it in the best ways possible. Discussing sex with your physician may feel uncomfortable, embarrassing, and emotional, so we put together a helpful guide to assist you in preparing to talk about these sensitive matters: How to Talk To Your Doctor About Sex.

Vaginal Dryness Pain

Vaginal dryness can be caused by various factors such as hormone changes, loss of libido, cigarette smoking, hormone therapy, chemotherapy, prescription medications, douching, menopause, and more. It can cause mild to severe pain when the vagina is penetrated. Keeping the vagina lubricated during sexual activity as well as daily can be a vital part of keeping your vagina healthy. Please see our helpful guide for more information: Vaginal Dryness Remedies.

Dilators For Vaginal Pain

A dilator set is one of the most effective tools for gently stretching vaginal tissue to ease pain during penetration. A dilator set is two or more dildos ranging in small to large sizes to be inserted while providing mild stretching of the vaginal walls to keep them pliable and welcome penetration.

Reasons Vaginal Dilators Are Used

Several health conditions can be assisted by using a dilator set. Using a dilator can slowly stretch the vaginal tissue to make sexual penetration more comfortable and pleasurable again in many of the health conditions below.

Sexual Inactivity

Without regular vaginal penetration, the vagina can become overly tight, and the vaginal tissue can become thinner. This can cause pain, tearing, and bleeding when penetration is attempted. Dilators can help the vagina become gently accustomed to penetration again by stretching the vaginal tissue and making it more pliable.

Menopause

Menopause is one of the most common causes of vaginal pain because the vagina can become narrow and dry due to decreased estrogen. This can cause genitourinary syndrome of menopause (GSM) which was formerly known as vaginal atrophy. The condition is also common in those who've had their ovaries removed. Dilators can be helpful in keeping the vaginal walls stretched and able to accommodate a penis or dildo. For additional information about this, please see our Perimenopause & Menopause Guide.

Low Estrogen Levels

Most people assume that low estrogen levels happen only in women going through menopause; however, other factors can contribute to low levels. This can often be seen in younger women who partake in excessive exercise, have too little body fat, and struggle with an eating disorder. The low estrogen levels can cause vaginal atrophy (atrophic vaginitis) when the vaginal walls become thinner, and the surrounding tissue shrinks. It also decreases lubrication production and can cause vaginal itching, soreness, pain, and bleeding after sex. Working with your medical professional to balance your hormone levels can be helpful through various medical treatments and lifestyle changes. You can use a dilator to help keep vaginal walls able to be penetrated and comfortable.

Vaginismus

Vaginismus is involuntary muscle contractions that make penetration painful and challenging. It stems from a psychological response that can have various causes, from fear of penetration to physical and sexual trauma responses. It is the leading cause of sexless and unconsummated relationships. The tightening of the pelvic muscles causes the vaginal opening to become painfully tight and, in some cases, impenetrable. In the case of vaginismus, the tightness cannot be controlled as it is an involuntary response. 

Unless, it is the first few times having sex, penetration should not cause pain. If sex is ongoing and remains painful, there is something wrong, and symptoms should be explored to determine what is going on. Even if your partner is well endowed, it should not cause ongoing pain, difficulty with entry, and even bleeding after an initial acclimation period. With vaginismus, it will often be difficult for a man even to enter the vagina without pain, and that pain will continue once he has entered. Sex should be pleasurable, and pain is your body's way of trying to get your attention to address your sexual health.

Vaginismus is a medical condition with various possible causes that may influence its development. However, there is currently not a complete understanding of what specifically causes it. Possible medical causes include urinary tract infections or urination problems, yeast infections, sexually transmitted diseases, endometriosis, genital or pelvic tumors, cysts, cancer, vulvodynia/vestibulodynia, pelvic inflammatory disease, lichen planus, lichen sclerosus, eczema, psoriasis, vaginal prolapse, pelvic scarring, gastrointestinal disorders and more.

While vaginismus is a medical condition, it can be brought on by psychological stressors in some cases. Examples of psychological fears are getting pregnant, getting an STD, intercourse pain, being torn and having tissue damage, not being entirely physically healed following pelvic trauma, or concern that a pelvic medical problem may reoccur.

Women who have pain during sex are not frigid and are experiencing an actual medical condition. Vaginismus will not go away on its own and does require treatment. The sooner, the better, as it will worsen if left untreated. The most important thing to understand is that this is a treatable condition, and many women have it and have overcome it. Changing one's diet, relaxing through mediation, and even getting stimulated sexually will not make vaginismus disappear. While relaxing during sex is always a great idea, but this will not affect the vaginal muscles' strong, involuntary contractions.

If you try and keep having sex without stretching and working through this condition, you will only traumatize the vagina and cause increased psychological resistance to sexual intercourse. It is vital to stop sexual intercourse until you can stretch the vaginal muscles enough to be comfortable. Vaginismus cannot be corrected by surgery as muscle contractions cause it. Some surgeries can correct a firm or thick hymen or other malformation of the vaginal opening, but vaginismus is not one of them. Using a dilator is one of the most popular ways to treat vaginismus as it allows a woman to slowly acclimate herself to penetration and become more comfortable with it.

Dyspareunia

Dyspareunia is a general medical term that describes pelvic or genital pain during penetration. It can be caused by various health conditions such as endometriosis, irritable bowel syndrome, injury from childbirth, uterine fibroids, and vaginitis. In some cases, a dilator may be helpful, while in others, it may not. It depends on the underlying cause of the pain.

Cancer Treatments

Cancer treatments such as radiation, chemotherapy, or surgery can have challenging side effects on vaginal health, including dryness, shortening, narrowing of the vaginal canal, pain, and soreness. Dilators can be quite helpful in the recovery of vaginal atrophy, thinning, scarring, etc. Please see our helpful guide on Sex With Cancer for more information. 

Adhesions From Surgery

Certain sexual positions can exacerbate vaginal pain, especially in the case of adhesions after surgery. An adhesion is when tissues heal together and get stuck. It is not uncommon for women to get an adhesion from surgeries such as a c-section, fibroid removal, hysterectomy, cancer surgery, and more. This can cause the vagina to become angled more severely, making penetration more difficult at certain angles.

One of the more common adhesions can cause the vagina to curve upward in a dramatic c-shape so that when a penis or dildo is inserted, it hits the vaginal wall rather than bending upward. In this situation, putting a pillow under one's behind to raise the pelvis upward can be helpful, as can other sexual positions such as being on all fours (doggie style). Dilators can help make the vaginal canal stretch a bit more to allow for a less tight angle should this occur. Also, sexual pillows that offer firm support can be quite beneficial in supporting various sexual positions.

Vaginal Septum

A vaginal septum occurs when the female reproductive system isn't fully developed. There is a wall of tissue that divides the vagina into two sections. There are two types of vaginal septums, based on where the septum is located. A longitudinal vaginal septum (LVS, double vagina) runs vertically and has two vaginal openings, with one possibly being smaller than the other. A transverse vaginal septum (TVS) runs horizontally with a top and bottom opening. These septums can occur anywhere in the vaginal canal and may partially or fully block off the reproductive system. They are determined by a pelvic exam, MRI scan, or ultrasound. If it is necessary, some women may require minor surgery to remove the extra tissue. Using a dilator can help stretch the opening to allow for pain-free penetration.

Imperforate Hymen

The hymen is a thin membrane in some women that cover the vaginal opening and is in the shape of a ring with an opening in the middle. There can be cases where the hymen is completely closed (imperforate hymen), and minor surgery to remove the excess tissue may be required. Dilators used before sexual penetration can be quite helpful in preventing bleeding and pain as they allow the vaginal tissue to be gently stretched and the hymen to be pushed to the sides more gently. For more information, please see our helpful guide: The Hymen & Virginity Myths.

Vaginoplasty

Vaginoplasty is the surgical construction or reconstruction of the vagina. It is used for various reasons such as cancer surgery, injuries, congenital defects, and for trans women (penile inversion surgery). Using dilations will help keep the vagina open and prevent vaginal stenosis (narrowing and shortening of the vagina).

A newly constructed vagina is highly likely to close up because the body will try and heal itself, which is counterproductive to keeping the vagina open and being able to be sexually penetrated. Physicians will often ask you to bring your dilators into follow-up visits to review how to use them with you. It is not uncommon to use dilators often after this type of surgery for at least three months. Your doctor can advise the need for continued maintenance using dilators once you have healed.

MRKH Syndrome

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is when the vagina and uterus are underdeveloped or may not exist at all. It can make vaginal penetration painful or impossible. MRKH syndrome can be treated either surgically or non-surgically using dilators to slowly create a neo-vagina. Similar to vaginoplasty, dilators help keep the body from trying to re-close the vagina once it is surgically expanded or created.

Vaginal Hypoplasia (Hypoplasia Of The Introitus)

This is when the vagina is underdeveloped or incomplete development of the vagina. Vaginal dilators or surgery is the most common treatment.

Vulvodynia

Vulvar pain (vulvodynia) is chronic discomfort or pain around the opening of the vagina (vulva). There is no identifiable cause, and it lasts for three months or more. Vulvodynia can occur at any age and is not related to menopause. It is often misdiagnosed as vaginal dryness, psychological issues, and other non-related causes. Vulvodynia may be linked to sensory diabetic neuropathy (pain caused by diabetes). Women with vulvar pain should be screened for diabetes to rule out that diagnosis.

Vulvar pain can feel like itching, nerve pain, and burning when touched or stimulated and can be constant or intermittent pain ranging from mild to excruciating. Some research has suggested that allergies, excessive histamine, autoimmune disease, physical trauma, childbirth, surgery, neurological conditions, fibromyalgia, or chronic fatigue syndrome can trigger the onset.

There are two types of vulvodynia, generalized vulvodynia, and vulvar vestibulitis. Generalized vulvodynia is when a woman feels pain in different areas of the vulva at different times. Vulvar pain may be constant or occur on occasion. Pressure against it may worsen the pain, making sitting, riding a bike, and sexual activities painful.

Vulvar vestibulitis is a syndrome where the pain in the entrance (vestibule) inside the vagina. It often is in a patch or band around the vaginal walls and is typically only an inch or two inside the opening. It is often slightly pinker or has a red patch and creates a burning sensation when stretched from the insertion of tampons, sex toys, or penis. It is particularly painful to have sexual penetration with this type of vulvodynia.

Dilators for this condition may help in some cases as they may stretch the vaginal skin enough to allow for less pain during penetration. If related to autoimmune issues, a non-inflammatory diet is highly recommended, which we will review further in this article. 

Vulvar Lichen Sclerosus

Lichen sclerosus is a noncontagious, rare chronic health condition that causes thin, smooth white or blotchy patches of skin that are often found on the genitals. It can cause severe itching, redness, bleeding, tearing of the skin, and pain. It is most commonly diagnosed in girls who have not begun to menstruate or in postmenopausal women.

The cause is unknown, but it is thought that it may be related to autoimmune disorders, genetics, trauma, or infection. Surgery and steroidal medications (usually topical corticosteroid ointments) may be helpful. Because the skin becomes thinner and easier to tear, using a dilator to help stretch the skin may be beneficial.

Vaginal Penetration After Surgery

After vaginal surgery, your doctor may instruct you to use a dilator before sexual penetration, such as having sexual intercourse or using a sex toy to ensure that you slowly stretch vaginal tissue. Using a dilator set may make penetration more comfortable and gradually restore vaginal tissue back into its normal position.

How To Choose A Dilator

Dilator Materials

Dilators should be made with a nonporous material such as pure silicone, metal, glass, or medical grade, nonporous TPE. Most dilators on the market are made with silicone.

• To learn more about the quality of silicone that you want in a dilator, see our educational guide: Silicone Sex Toys: Is Yours Real & Safe? 
  
  
• Explore our dilators made with pure silicone that are body-safe for your peace of mind.

Dilator Shapes

The dilator shape can make a big difference in how it feels once inserted. Most women prefer a tapered end with a slight curve; however, due to different vaginal shapes, some may do better with a more straight shaft. The base of the dilator can also impact how easy it is to use. A handle or ring on the end can make it easier to move with your hand, while a flat base may make it easier to sit on. We have found that most women prefer the ring ends, which allow you to loop your finger through and move it around easily.

How To Use A Dilator

Alone Or With A Partner

Using a dilator should be done during a time when you can relax by yourself. Having a partner help can be distracting and may cause added sexual pressure; however, a partner may be helpful if you have mobility issues or are disabled.

If you are comfortable having a partner there, the important thing is not to have any sexual expectations to ensure relaxation. Many women find that doing stretching exercises in a warm bath or shower helps relax them.

If You Are Prone To UTIs

You may wish to drink fluid before dilator therapy to ensure that you are able to urinate after using it if you are prone to getting urinary tract infections (UTIs). That way, you can urinate after using the dilator, and the urine will help push harmful bacteria out of the urethra should it have gotten inside.

Creating A Relaxing Space

You may wish to create a relaxing mood with soft lighting, scented candles, and soft music to quiet the mind and allow for a healing and mindful experience. This does not have to be a sexual experience, but should you wish to make it one, that can make it easier.

Have A Towel Available

Having a towel near you can be helpful if you need to wipe your hand off from applying lubricant. It can also be beneficial if you are using a dilator for the first time so that you can put the used dilators on the towel as you determine what size you will be using. You may have to go through a couple of them to get to the correct size to start using one, and it is convenient to have a towel to place the dilators on so that you do not have to get up during the process. You may also want to lay on a waterproof throw to keep excess lubricant or vaginal discharge from getting on bedding. 

Lubrication

You will want to have ample lubricant available to use. We recommend a pH-balanced, moisturizing lubricant that has the proper osmolality levels for the vagina. If you use a dilator in water, such as in the shower or bath, you may want to use an oil-based lubricant (such as organic coconut oil) as water-based lubricants will wash away. Discuss using oil lubricants with your physician to determine if they are the best choice for your specific health needs. To learn more about this, please see our Ultimate Personal Lubricant Guide, and to purchase such lubricants, please explore our Moisturizing Lubricants Selection.

Monitor Your Breathing

Relaxing is essential when using a dilator, and deep breathing is vital to allowing your body to relax. Take in deep breaths and let them out slowly. Become mindful of any tension in your body and allow it to release as you slowly let out your breaths. When you insert the dilator, stay aware of your breathing. If you begin to become tense, your breathing will become more rapid. This is a sign that you are not relaxing. Moving gradually and breathing in and out slowly will help you stay relaxed. This is important because vaginal muscles can involuntarily tense up. By staying relaxed, you will keep the vaginal muscles relaxed, making inserting a dilator much easier.

Relax Your Pelvic Floor Muscles

Keeping your pelvic floor muscles (Kegel muscles) relaxed is tremendously helpful when inserting a dilator, making it much more comfortable. Before you insert a dilator, you may want to contract and relax your Kegel muscles to ensure that you are better aware of them being relaxed when you insert the dilator. 

To learn more about the importance of Kegel muscles and how to keep them strong and healthy, please see our guides:

• How To Do Kegel Exercises
  
  
• How To Use Kegel Weights

Comfortable Positioning

Getting into a comfortable position will significantly assist you in inserting a dilator. You can use pillows or sex pillows to help elevate your back or legs to better access your vagina. Typically, you will want to lay back with your legs spread open so they are at least shoulder-width apart.

Sexual Stimulation Benefits

Because the vagina is responsive to sexual stimulation, it may be helpful to sexually stimulate yourself before using a dilator. The clitoris is the best place to stimulate as it will increase blood flow to the vaginal walls and help with generating natural lubrication. When the vagina is not sexually aroused, it is about two to four inches long; however, once it is aroused, it can stretch up to four to eight inches, making inserting a dilator much easier. Using a clitoral vibrator to reach arousal or orgasm before inserting a dilator can be very helpful.

For more helpful information, please see our guides: 

• How To Use A Vibrator
  
  
• Air Pulse Sex Toys
  
  
• Female Masturbation Tips

Time To Use The Dilator

• If you have a curved dilator, insert it with the curved end pointing upward toward your navel. The curved and tapered end will help guide it inside as it has the natural curvature of how the vagina is shaped inside.
  
  
• Begin by selecting the smallest dilator to see how that feels. A dilator should feel snug inside but not cause pain.
  
  
• When inserting, use gentle pressure and slowly insert the tip of your dilator into the vaginal opening.
  
  
• Stop if you begin to feel pain, muscle tension, or discomfort. Never force a dilator inside the vagina. Do some Kegel exercises and try with a smaller dilator.
  
  
• Once you have inserted the right-sized dilator, it typically should be used for about 10-15 minutes.
  
  
• Before moving the dilator, you can contract your Kegel muscles around it. This will cause your vaginal canal to become more narrow around it. Then relax them, and you can try slowly moving the dilator in and out and pressing around in a spiraling motion. The more relaxed you are, the easier it will be to insert the dilator.
  
  
• Remember to keep breathing, relaxing breaths throughout to stay in a tranquil state of mind.
  
  
• Don't be concerned if you cannot insert the dilator completely; it can take weeks of stretching before completely inserting it, depending on the underlying cause of your vaginal pain or tightness.

What If I Can't Insert A Dilator?

If you can't insert a dilator or have too much discomfort doing so, you will need to consult with your healthcare provider to discuss ways to make this easier for yourself. There are different reasons this may occur.

It is often necessary to address how you insert a dilator if vaginal tissue is curved or shaped differently. For example, some women who have had a c-section, fibroid removed, or cancer surgery can have adhesions (tissue that healed and stuck together). This can pull the vagina up into a different position than what is typical. If this is the case, it may simply mean that inserting a dilator may have to be done in a different position or direction.

Bleeding After Using A Dilator

It is not uncommon to have a small amount of bleeding after using a vaginal dilator. You may wish to have a panty liner available for this reason. If you have a lot of bleeding which fills a sanitary napkin (pad), or if the bleeding continues for more than 24 hours, you should contact your healthcare provider for further instruction.

Washing Your Vaginal Dilator

Because a proper vaginal dilator should be made with a nonporous material, you can wash them in hot, soapy water for at least thirty seconds and then dry them with a clean towel. Ensure to store them in a cool, dry place so that bacteria, mold, and fungi do not grow on them in between uses. See our guide How To Clean Sex Toys and How To Store Sex Toys for more information.

Increase Dilator Size Slowly

Just like working out to build muscle takes time, so does stretching vaginal tissue. It can take a couple of weeks or longer before you can move up in dilator size. When you can insert a dilator inside your vagina without any discomfort, you can begin using the next size up. The goal is to insert the largest size dilator without any pain or discomfort and be able to move it around easily.

Vaginal Dilator Therapy Frequency

A reasonable goal for dilator therapy is about three to four times per week. You should give yourself at least a full day in between using them to let your vaginal tissue heal, relax and rest. If you need more than a day, take a couple of days off and let your vagina be fully ready for your next therapy session. Doing dilator therapy frequently or intensely can cause pain, irritation, and possible tissue damage.

Try to stay diligent and consistent in doing dilator therapy to continue to see the stretching benefits. If you stop for a while or have pain, you may have to go back down in size, but don't be disheartened as it takes time to succeed. You can't expect to lose weight or be muscular overnight, and this takes the same kind of time and effort to ensure your sexual health and wellbeing.

You are worth the time and effort to do this and feel better. We know this can be challenging, but please know that you are not alone; we work with many women who have to use dilators, so please feel free to ask us questions as we are here for you.

Other Reasons For Painful Sex

Various other health conditions may lead a woman to have painful sex, such as:

Vaginal Cysts

There are a few different types of cysts that can form in the vagina: inclusions cysts, Bartholin's gland cysts, Gartner's duct cysts, Gartner's duct cysts, and Müllerian cysts. These cysts usually develop when a gland or duct becomes clogged; however, the cause depends on the type. Some may be caused by vaginal trauma, STD, or cancer.

Most cysts don't cause symptoms, although they can be painful when infected and cause pain during sexual penetration, inserting a tampon, or sitting. Cysts don't usually need to be treated as they will often go away on their own. Your health care provider may want to do a biopsy if they suspect cancer.

If you are having pain from a cyst, you may want to sit in a warm bath (sitz bath) a few days a day to help the cysts drain or become reabsorbed in the body. In some cases, antibiotics can be prescribed, or your health care provider can drain them. If a cyst keeps returning, you can have it surgically removed.

Retroverted Uterus

A retroverted uterus is when the uterus is tipped backward toward the rectum rather than toward the abdomen and can cause pain during sex. Underlying causes are typically endometriosis, pelvic inflammatory disease (PID), fibroids, and previous pregnancies. Treatments include physical therapy, pessary treatments, and surgery.

Cervicitis

Cervicitis is the irritation or an infection of the cervix and is often caused by STDs. Symptoms may include discharge, pelvic pain, bleeding, and urinary problems. Treatment will depend on the STD that caused the irritation.

Candidiasis (Yeast Infections)

The fungus candida Albicans is responsible for vaginal yeast infections. Please see our helpful and educational guide: Natural Yeast Infections Remedies, for more information.

Pelvic Inflammatory Disease (PID)

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs caused primarily by an STD. Bacteria can spread through the vagina, uterus, fallopian tubes, or ovaries. Symptoms can cause pain during sex, and treatment is based on the STD that caused it.

Uterine Prolapse

Uterine prolapse is when the pelvic floor muscles weaken, and the uterus drops down into the vagina. Surgery is typically required, and sometimes a minimally invasive (laparoscopic) vaginal surgery can be performed. For more information about vaginal prolapse, please see our guide: Vaginal Prolapse Help.

Chlamydia

Chlamydia is the most common STD that can cause painful sex and permanent damage to the reproductive system. It can be treated with antibiotics.

Endometriosis

Endometriosis is a medical condition where tissue similar to the lining of the uterus grows outside of the uterus, and when this tissue grows on or around the reproductive organs, it can cause inflammation, scarring, and nerve irritation that leads to painful sex.

In, February 2023, scientists in Japan have found high levels of a protein called IL-8 in endometriosis tissue. This led to the creation of an antibody, AM Y109, which stops IL-8 and has shown potential in reducing the spread of endometriosis lesions and improving inflammation in the body.

Trichomoniasis

Trichomoniasis (trich) is another common STD. Because it is an infection, it can make sex feel painful. It is treated with antibiotics.

Urinary Tract Infections

A urinary tract infection (UTI) is when bacteria travels through the urethra (where urine comes out) and starts an infection that can travel to your bladder and kidneys. Please see our related guide: Natural Remedies for UTIs.

Ectopic Pregnancy

An ectopic pregnancy is when a fertilized egg implants itself outside the uterus, typically in the fallopian tube. It can cause pain during sex and is life-threatening to the mother. Medication or surgery to terminate the pregnancy are the only treatment options.

Keep A Pain Diary

Tracking your pain experiences, menstrual cycle, moods, thoughts, activities, nutrition, and medicines can be helpful in better understanding any patterns that are associated with painful sex. You can share it with your doctor to assist in looking for any patterns with the pain.

Sexual Products That May Help

If you are having pain from a penis or dildo hitting your cervix during sexual penetration, you may want to use a bumper (buffer) to keep the penis or dildo from going in too far. You can use multiple bumpers to shorten the insertable length of any penis or dildo, keeping it away from your cervix and reducing potential pain. See our selection of body-safe bumpers.

Strengthening pelvic floor muscles using Kegel weights and exercisers may be an excellent way to address pain. However, this would be something to review with your physician to ensure that it is not counterintuitive to your health needs. See our body-safe Kegel Exercisers.

Vibrators can be helpful for vaginal health as they provide stimulation that can increase blood circulation. Discuss if this is right for your medical condition with your physician, and to learn more about vibrators, please see our educational guide: How To Use A Vibrator. Also, see our body-safe vibrators.

Clitoral suction vibrators (air pulse sex toys) efficiently provide clitoral stimulation while increasing blood circulation to the clitoris. It may be beneficial for helping to increase sexual response and a valuable tool before using a dilator for vaginal stretching. As always, discuss this with your physician before using it regarding your specific health needs. See our body-safe Clitoral Suction Vibrators.

When vaginal pain is reduced from certain sexual positions and angles, sex pillows can be quite beneficial as they offer the perfect angle for those positions to be implemented. In addition, they are comfortable and soft with a firm inner core which provides the ideal amount of support. Explore our sex pillows for the right shape for you.

Sex Toy Cleaners

Most non-porous sex toys such as silicone do not need sex toy cleaners to disinfect them correctly, but when there are health issues involved, some people want to use them to take extra measures to ensure that their sex toys are completely clean after use. We carry the best sex toy cleaners available and provide helpful guides on How To Clean Your Sex Toys and How To Store Your Sex Toys for additional education.

Vaginal Pain Prescriptions

Prescriptions that a physician may offer are estrogen cream or lidocaine ointment to be used topically or oral medications such as antidepressants, seizure medicines, and nerve blocks.

Mental Health Therapy

If you have experienced trauma, sexual assault, rape, or abuse, you may wish to receive counseling. To explore therapy options, please see our guides: Types of Therapy and Sex Therapy & Counseling.

Vulva & Vaginal Therapy

Stretching pelvic muscles through pelvic floor physical therapy, visceral gynecologic manipulation (abdominal massage therapy), and acupuncture are other alternative treatments.

Pelvic Floor Physical Therapy

Ask your doctor about pelvic floor physical therapy, where patients learn to contract and relax pelvic floor muscles. This is where you can learn how to stretch tight pelvic muscles, do breathing exercises for relaxation, strengthen weak vaginal muscles and boost your flexibility.

Visceral Manipulation (Abdominal Massage)

You can also ask about visceral manipulation (VM), an abdominal massage therapy performed by a physical therapist who uses massage, yoga, breathing, massage balls, and other massage tools to enhance the mobility, tone, and movement of the viscera (internal organs). It was developed by a French osteopath and physical therapist named Jean-Pierre Barral. Your physical therapist can use these techniques to address chronic pelvic pain, endometriosis, dysmenorrhea, fibroids, cysts, incontinence, symptoms of menopause, anxiety, depressional, sexual trauma, and PTSD.

Acupuncture For Vulva Pain

Acupuncture is an alternative medicine therapy that can be used in addition to Western medicine to treat vulva and vaginal pain. Studies have shown improvement for vulvodynia, vestibulitis, and vestibulodynia. For more information, please see our Sex & Acupuncture Guide.

Use Hypoallergenic Products

One area that may cause vaginal irritation and pain is what you put your vulva into contact with, such as tampons, pads, deodorants, laundry detergent, soap, etc. Make sure that if you are experiencing irritation, you switch to hypoallergenic products, use pH-balanced lubricants and wear materials that allow your vulva to breathe, such as cotton.

Nutrition & A Healthy Vulva

One of the most overlooked aspects of good vaginal health is nutrition. Your nutritional intake influences your sexual functioning. If you are experiencing vaginal dryness, autoimmune issues, or other health conditions, you may want to increase your intake of certain foods and supplements.

It may be in your best interest to have a complete blood analysis done to determine your hormone levels, micronutrient levels, and even an anemia/iron panel to determine what nutrients you are deficient in and if there is anything that you are eating, such as inflammatory foods are contributing to vaginal discomfort and pain. This is particularly important if you have health conditions such as autoimmune issues.

Do not underestimate the power of what you eat when it comes to your sexual functioning. For example, one of the most common vitamin deficiencies in pre-menopausal women is iron deficiency. This can cause vaginal pain, heavier periods, increased cramping as well as loss of sex drive, sexual arousal, and lubrication. Be warned, however, that if you are not deficient, taking an iron supplement can cause serious health problems as well. Again, it is good to have your blood work done to review any nutritional issues that may be causing problems.

What Is The Healthiest Diet For Sexual Health?

Everyone has different health needs, so if you have a specific health condition, such as kidney disease or have had your gallbladder removed you should take that into consideration. It is always a good idea to run by any diet that you try with your physician so that they can address any specific health concerns for you based on your nutritional needs. Below are some examples of what many people take to enhance vaginal health.

Increase Water Intake

Sometimes, vaginal dryness is simply a part of being dehydrated.

Nuts, Seeds, Vegetable Oils & Vitamin E

Oils such as these help increase vaginal secretions allowing for more ease in creating natural lubrication. Examples of food loaded with healthy oils are raw pumpkin seeds, flaxseed, almonds, pecans, wheat germ oil, sunflower seeds, and safflower oil. Nuts and seeds are best eaten when they are raw after being soaked in water for several hours and then dried in a dehydrator to activate the complete nutrients of the seeds.

Wild Yams

These have healthy DHEA, which metabolizes into testosterone and estrogen, and can help regulate sexual libido. They are also an excellent source of healthy fiber, which can remove excess estrogen from the body. Too much estrogen (estrogen dominance) can also cause a loss of sex drive. Some women use wild yam creams for vaginal dryness. See our related educational guide: The Truth About Wild Yam Lube.

Black Cohosh

Native Americans have long been using Black Cohosh to treat gynecological issues in women. It is known for reducing the frequency and severity of irregular periods, hot flashes, headaches, night sweats, heart palpitations, and vaginal dryness.

Kudzu

Researchers have found that taking this herb in a capsule form helped to alleviate vaginal dryness when taken over 24 weeks.

Sea Buckthorn

This is rich in vitamins E, A, and C, minerals, beta-carotene, fatty acids, and amino acids; it is used for vaginal dryness as it helps to protect the mucus membranes.

Our Nutritional Guide

We have also put together a comprehensive approach to nutrition which offers insights into the best foods to eat for health in general: Nutrition Guide for Good Sex & Health.

In Closing

Determining what is causing painful sex and addressing it can be frustrating, unnerving, and challenging. Please keep in mind that according to the American College of Obstetricians and Gynecologists, it is quite common with as many as 75% of women experiencing pain during sex at some point in their lives. Thus, you are certainly in good company if it is happening to you.

We care very much and are quite passionate about helping with sexual health issues. If you need additional resources or help selecting products, please let us know, as we are happy to assist you.