Dear Dr. Vanessa: Some Sex Positions Hurt Sometimes

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood ® Federation of America, will be answering your questions here. To ask her your own question, click here.

I find that certain sexual positions (e.g. doggie style or me on top) feel really good some days, and really uncomfortable (even painful) other days. Does this have something to do with where I am in my menstrual cycle?

Certain changes that happen over the course of your menstrual cycle could cause discomfort during sex that comes and goes. Hormonal shifts affect vaginal secretions and may affect vaginal elasticity. If your vagina is drier than usual or less elastic than usual, sex may be uncomfortable. Using a lubricant may help.

Another normal change that happens during the menstrual cycle is the development and release of an egg. Some women experience tenderness or pain around the time when a mature egg is released from the ovary. Sex during that time may make this pain worse for some women.

Over the course of the menstrual cycle, a woman’s reproductive organs also shift slightly. During ovulation, the cervix – which is the bottom part of the uterus that sits at the top of the vagina – moves slightly higher in the body. It’s possible that the discomfort you feel comes because the penis is hitting the cervix during the times of the month when it is sitting slightly lower in the vagina.

The sexual positions that sometimes bother you are the ones that usually result in deeper penetration of the penis than other positions. Whenever you feel discomfort, be sure to tell your partner so you can try a different position or stop having intercourse and enjoy some other kind of sex play.

It’s also a good idea to keep track of when you find sex to be uncomfortable. If you compare it to when you have your period, you might find a link between the painful sex and your menstrual cycle. I really encourage you to talk with your doctor, nurse, or other health care provider to get help figuring out what exactly may be causing your discomfort – and how best to avoid it.

Keep in mind that it’s not normal if sex is frequently painful. It could be a sign of a health problem like endometriosis, infection, yeast overgrowth, allergic reaction, or a uterus that is tilted back in the pelvis instead of straight up. It is interesting to note that some women try weed for endometriosis pain relief as cannabinoids are proven to have analgesic and anti-inflammatory benefits.

Anyone who finds sex to be painful a lot of the time should check with a doctor or nurse. If you have symptoms of endometriosis, that is, pain during sex and intercourse, heavy and/infertility, talk to your doctor without hesitation.

Best wishes for your good sexual health,

Vanessa
Planned Parenthood

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood ® Federation of America.