Dr. Kate, Sex Is Suddenly a Tight Squeeze — and It Hurts!

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in Boston who lectures nationally on women’s health issues and conducts research on reproductive health.  She regularly (and generously!) answers your medical questions here on EMandLO.com. To ask her your own, click here.

Dr. Kate,

I have been having sex for about four years and for the past month I have been having a problem. Sex hurts — it’s become so tight that it is painful when he enters. Is there any reason that this change would have occurred? I try to get over it but eventually it starts feeling like rug burn, even though I am well lubricated.

— Tight Squeeze

Dear TS,

Pain during intercourse is one of the most common complaints I hear, from both patients and readers. And the most common culprit is dryness—your natural or bottled lubricant wearing off, not enough foreplay, or a side effect of medication like anti-histamines. But if you feel that you’re wet enough, but feel burning or pain anyway, then it’s possible that you’ve developed a condition called vulvodynia.

The word basically means “painful vulva.” It’s a condition up to 16 percent of women have, but we still don’t understand very well what causes it. Women often describe it as a burning, stinging, itching, irritating or raw feeling on their vulva and labia, and say it sometimes hurts even when they’re just sitting or walking around.

If this sounds like you, get a referral to a vulvar-pain specialist (your doctor can find one at nva.org) or talk to your ob-gyn. Topical creams and oral medications (including antidepressants) have helped dozens of my patients.

The other possibility here is an STI like genital herpes. Take a mirror and look for pimple-like bumps that look like clear blisters on a red base. If you see anything suspicious, don’t google herpes pictures (it will just freak you out); head to your gynecologist.

In fact, as always, if you’re experiencing pain (enough that it causes you to write us here), then it’s a good idea to make an appointment to see your gynecologist asap.

Dr. Kate

Are you experiencing pain down there? Read:
Dr. Kate’s Sexual Dysfunction Series

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