Tuesday, 23 Jul 2019

Why You Get So Sore After Sex Sometimes

Yesterday, you thought your morning romp was of the hurts-so-good variety. But today, it just plain hurts. What gives?

Changes in partner, position, and products—as well as those related to aging—can lead to some post-coital soreness, says Isa Herrera, a physical therapist in New York City who specializes in integrative pelvic floor therapies for women.

But it’s still important to figure out the cause—and find a solution STAT. Because, as Herrera says, “you should never give up on sex.” Amen.

Here’s how to determine what may be ailing you, and how to fix it or prevent it next time.

1. You skipped the foreplay (or lube).

Most people know that vaginal dryness can make for uncomfortable intercourse, but it’s worth repeating since it remains the **most common** cause of post-sex discomfort, says Alyssa Dweck, MD, an assistant clinical professor of gynecology at the Icahn School of Medicine at Mount Sinai in New York City. Usually, dryness simply means you were a wee bit impatient.

What to do about it: Sufficient arousal (extend that foreplay!) can help prevent the pain. You’ll have more moisture down there, and your vagina becomes more elastic as your excitement grows. Also, don’t be afraid to use lube.

2. Your session was especially long or frisky.

Common sense alert: “Of course you’re going to be sore if you’re very vigorous,” says Leah Millheiser, MD, director of the female sexual medicine program in Stanford University School of Medicine’s department of obstetrics and gynecology. Especially if you’re not well-lubed, those passionate sex sessions can cause little tears in your vaginal tissue, which—hello!—is delicate.

What to do about it: Rest up. Dweck recommends taking a warm bath with unscented Epsom salts and, if necessary, using a hydrocortisone cream around the vaginal opening for relief. Next time, be sure to pause for lube when you need to. “Listen to your body and know when you need to take a break,” says Dr. Millheiser.

3. Your birth control is to blame.

Low-dose combination birth control pills (like Yasmin, Levora, Estrostep and Ortho-Tri-Cyclen-Lo) are implicated in a lot of sore vagina cases. “This is related to the suppression of your own natural estrogen and testosterone, and replacing that with the levels in birth control, which are lower,” says Dr. Millheiser. This can make some women’s vaginal tissue thinner and drier—almost like they’re post-menopausal—making them more vulnerable to irritation and pain.

What to do about it: Short-term, Dr. Dweck suggests natural personal lubricants, like Restore by Good Clean Love. Long-term, talk to your doc about changing your birth control prescription.

4. Your pelvic floor muscles are tight.

Go-getter, active young women are often tight—and not just in their hamstrings. They’re also tight in their pelvic floor muscles, Herrera finds. “If they’re running, doing SoulCycle, and they’re sitting in poor posture at work… the muscles can’t let go during sexual activity,” she says. Cue pain. There’s a good chance this applies to you if you have other issues, like feeling like you have to go to the bathroom all the time or you can’t fully relieve yourself, she says.

What to do about it: Pelvic floor physical therapists can guide you through various exercises—often as straightforward as deep breathing—that can help you relax your pelvic floor muscles. Think of them like reverse kegels. In the meantime, try switching up your sexual position so you’re more in control. It’s possible your partner could be hitting a trigger point, or essentially a knot in the wall of the vagina.

5. Your skin is reacting to products.

If your pain occurs only after using certain hygiene products (like scented cleansers), condoms, or spermicides (such as nonoxynol-9), it’s pretty safe to say your soreness is related to product-induced skin irritation, Dr. Dweck says. Certain condoms (especially if you’re allergic to latex), a new shower soap, or underwear washed with a scented dryer sheet can trigger reactions in some women, too.

What to do about it: Ditch the irritating products (duh!) and search for the most natural, scent-free alternatives you can. Dr. Millheiser even advises against lubes advertising a
“tingling” sensation, which to some women can feel more like burning (hard pass).

6. You have a medical condition.

Bacterial vaginosis, yeast infections, chlamydia, gonorrhea, herpes—all are infections that can make sex (and its aftermath) uncomfortable, Dr. Millheiser says. So, if you have any sort of unusual discharge or lesion down there, take your concern to the pros. Same goes for an ache that’s deep in your pelvis, which could signify a cyst, a fibroid, or endometriosis, Dr. Dweck says.

What to do about it: See your gyno. Infections are totally treatable, and cysts and fibroids can be removed (if necessary). Plus, conditions like endometriosis can be effectively managed—if they’re diagnosed correctly. “In general, pain lasting longer than 24 hours with after-sex bleeding, unusual discharge, or odor calls for a gyno visit,” Dr. Dweck says.

Whatever the cause of your pain, you don’t need to settle for feeling sore after sex. There are tons of tools and resources at your disposal, so you owe it to yourself (and your sex life) to take the time and find one that works.

Additional reporting by Alyssa Dweck, MD.

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