Hopefully your experiences have helped you realize that sex can be a fun and important part of a healthy relationship. But when sex becomes uncomfortable, unfortunately I find that my patients tend to ‘grin and bear’ the pain in order to maintain intimacy with their (male or female) partner. A lot of things can interfere with our comfort during sex-- stress, just having a baby, lack of foreplay and menopausal changes.
Vaginas are pretty cool. They have glands that help keep things well lubricated, and the more you have sex, the better these glands function. The vagina is its own environment (called a microbiome) with good bacteria and its own pH. The hormone estrogen also helps the cells of the vagina stay flexible, limber and happy. If your estrogen decreases for some reason (menopause, post pregnancy with breastfeeding, sometimes using certain types of birth control) your vagina may really notice and feel more dry, itchy, irritated or thin. The great thing is the vagina is pretty resilient, and it actually stays healthier if it has more activity (so more sex will keep the cells happier).
But what can you do if sex becomes uncomfortable?
First, let’s talk about sex. When things get uncomfortable it is really important to have an honest conversation with your partner. Think about what you need in your sex life and how to ask for that. Sometimes you need to take a break for a little while. Sometimes you need to use things in the bedroom (like lubricant or toys) that may be new to your partner. Sometimes you want to ask for them to help you by trying something different or refraining from something that is making things more painful. This kind of conversation can come up naturally, but sometimes needs to be planned with care. You know your partner and yourself better than I do, so you decide if this is something you need discuss with clothes on or clothes off, at the dinner table or over text. If the thing you want is very different than when your partner has gotten used to, they may need some time to mull it over. Remember, you may have been thinking about this for a while and are ready to move forward, but it’s probably news to them and they may need time to absorb it.
How do I make things better?
The first step to help with comfort during vaginal sex is to be sure the vagina is well lubricated. I cannot say enough here about receiving the right amount of foreplay. Some women become aroused quite quickly, while others may require lots and lots of foreplay to get lubricated. If you don’t get as much as you need, sex is bound to be less comfortable. It is worth having a talk with your partner about this and letting them know what you want, like and need. If you are not sure what you want, like or need—experiment! Try masturbating or using toys. She-bop is a woman-owned sex toy store with locations in North and Southeast Portland that is open, friendly and not creepy. Stop by and explore!*
Sometimes, if there is too much lubrication, sensation is decreased because there is a barrier that is too thick between you and your partner. If you make too much lube naturally you may need to wipe some away with a cloth during intercourse. If you are using lube from a bottle and you are too slippery, try using a little less the next time. You may need to experiment with the kind of lube you use also.
There are three basic types of lubricant available. There is water based (like KY jelly or astroglide), oil based (like coconut oil, olive oil or Vaseline) and silicone based (like Uberlube or Swiss Navy lube). Let’s break down the basics of each one and you can decide which one might be helpful for you.
Water based lubes make things feel wet. They are easy to find and buy at most stores. Most of them are hypoallergenic, but some contain glycerin which can cause yeast infections for some women, so read the label. After a while, water based lubes can become sticky or tacky and drag on the skin. Add a few drops of water (so keep a cup by the bed) or saliva to wet them again. If you are sensitive, it is good to avoid any lubricant with flavors, smells or ones that are “warming.” If you are not sensitive, these things can add some new experiences in the bedroom, which can be a fun way to shake things up.
Oil based lubricants are also easy to obtain. These stay slippery on their own for longer, but because they tend to be thicker may stain sheets or clothing and be harder to wash off. If you are using condoms, DO NOT USE OIL BASED LUBES, as they can make the condom break. If you use coconut oil or olive oil they can double as a great vaginal moisturizer as they absorb somewhat into the skin. Just like lotion for your legs, you can help your vagina’s overall moisture by applying a little coconut or olive oil.
Silicone based lubricant can be found in sex toy stores or online, mostly. I have seen a few out at the regular drug store, but they tend to be “warming” and I prefer hypoallergenic. It is best to find a medical grade silicone lube. You can search on Amazon or buy directly from a sex toy store website. Do not use silicone based lube with a silicone sex toy, as it will make the toy break down from a chemical reaction.Be prepared for a little bit of sticker shock with these lubricants. A tiny bottle can seem REALLY expensive after paying only a few dollars for your run of the mill water based lube. But do remember a little goes a long way and it only takes a few drops of these lubes to stay slippery for hours and hours. (Fun fact: this is the lube the marathon runners use to keep skin from chafing as they run. Some women I know also use it on their inner thighs to keep their legs from rubbing together when wearing a skirt.)
It is important to remember that most women have more sensation on the vulva (all the “private parts” that are not the internal vagina) so if putting something in the vagina is no longer comfortable you may opt to concentrate on the outside. Sometimes, no matter how much lube you use, there is still discomfort and at that point you should talk to your provider. He or she may recommend vaginal estrogen or testing for yeast and other infections.
*I have absolutely no vested interest in any of the products or stores mentioned in this post.
Jacqui Quetal, FNP, MN is a nurse practitioner at the Peterkort Office of Northwest Gynecology Center. She helps adolescents and women of all ages achieve their wellness goals, maintain reproductive health and manage the changes associated with menopause. Read more Jacqui >