Feeling Too Tight?
When penetration is painful
There are many things that can cause sex to be painful, especially penetrative sex. People with vulvas, including trans masc and trans femmes, and anyone with an anus who experiences insertion can all have trouble relaxing or have other issues that lead to pain. Everything from a tender cervix to post-surgery scar tissue can cause discomfort during intercourse; for some, even with no obvious bodily differences like those, vaginal insertion of a finger or more will feel too wide or large for them and may hurt.
Vaginismus is a condition in which the muscles in the vaginal canal feel "too tight" for almost any size or type of insertable item, from a penis to a toy to a tampon. It's something that can occur at any stage of life but is commonly seen with folks who have experienced sexual harm (including suffering from an intense dose of fear or shame), those who've gone through cancer treatments like radiation and chemotherapy (especially for genital cancers), and those going through and past menopause. In the case of menopausal people—and in some cases others too—hormonal changes mean the vaginal walls become thinner and more prone to irritation or damage, as well as less lubricated than they’ve been in the past. Some take hormone replacement in cases like this, but you definitely want to have a good lubricant on hand as well.
There are lots of great physical therapists and folks who specialize in pelvic treatment—we always recommend visiting a trained PT specialist first before trying to treat on your own. If your PT or gyno suggests you try dilating, we have just what you need!
Dilators are tools that resemble smooth dildos. They are usually sold in sets, with gradually increasing sizes to help provide a gentle, more comfortable penetration during and after regular use. Many find that regular use of dilation, and massaging a lubricant or vaginal moisturizer into the walls of the vagina can help restore some natural elasticity and moisture to the area. Some dilators will be shaped like plugs that can be held in the body for a period of time, while others will be longer so that you can insert and move them manually.
Dilation is especially important for trans women who have had bottom surgery; the neovagina must have dilation as it begins to heal from surgery because it may not retain its size and function without it. We’re especially glad to be able to offer good-quality dilation sets for our trans customers!
Years before such sets were available in our stores, many of our customers would buy slimline vibes and dildos to dilate with, which also works, but you can't always find that specific size you might need. It’s that Goldilocks moment where "this one's too big" and "this one's too small”! Dilator sets will typically solve that by giving you several sizes to choose from—you can find your “Ah, just right!” and go up from there. That said, using a vibrator as your dilation tool, if you find the right one, is a great idea. Vibration encourages blood flow, so this can be helpful for keeping the vaginal tissues healthy. If you're dilating anally, be sure to only use products with a base, like these.
Whenever dilating, you should be sure to have a nice lubricant handy. Remember, the area is more tender so don't be shy with how much lube you may need, and you can always apply more during play too. This is also a place where a nice CBD lubes, oils, or bath soaks can aid in helping relax the muscles with their natural anti-inflammatory properties. Relaxation matters for all penetration and in particular, it can be the difference between comfort and pain during anal sex. Add some deep breathing to your CBD routine!
Anal Insertion can definitely be pleasurable—but can also cause significant pain if not done with knowledge and care. Learn the basics of relaxation, lubrication, and communication—and much more on anal play here.
Here are a few more things to keep in mind if sex sometimes hurts:
Arousal and orgasm are pain-relieving experiences—they change our body chemistry in the direction of pleasure and some of the elements that affect pain with penetration (like tension and fear) can melt away with high arousal. If penetration happens without arousal, or not enough, it is often painful! Be sure to include arousal activities (aka foreplay) into your sexual experiences to get the benefit of this powerful—and pleasurable—strategy.
Communication and trust are key! For some, certain positions and angles hurt while others do not; to make sure you have as pain-free and enjoyable an experience as possible, you must be able to communicate in the moment, ask for what you need, and trust your partner to hear you and respond accordingly. (If too-deep thrusting is part of the problem, check out the wonderful OhNut—specially deigned by a pelvic pain sufferer to alleviate the problem of cervical pain.)
And remember: Penetration is an option—not the definition of sex. If insertive play hurts right now you likely have options to get it diagnosed and hopefully alleviated. But having pain now does not mean you can’t engage in erotic play that keeps you fully connected to your sexuality and your ability to feel good. This can be part of solo and partnered sex. Find your favorite non-penetrative arousal activities and these can enrich your sex life for as long as you experience sexual desire!
Sex is an important part of many of our lives, and when it's uncomfortable it can make us feel like giving up. But that's why so many physical therapists are committed to helping folks find the best steps to make sex comfortable again—and so are we. You're not alone, and your sex life is worth it!
