Ask the Doctors: Pain With Intercourse- What Can I Do?

I have constant pain during intercourse at this time in my life, although it wasn’t always that way. I am experiencing yeast infections almost constantly — this has lasted pretty much the whole duration of my relationship with my current boyfriend. I went to see an allergist who diagnosed me with a possible yeast allergy. So far the special diet hasn’t helped me with the infections or pain, though.

Intercourse is uncomfortable all the time, so much so that I am getting turned off in general. I can orgasm through oral sex, and that doesn’t hurt, but any penetration — owwww. Can you help?
–Love Hurts

Thanks for writing, and I hope I can offer some help. Firstly: Last year my colleague Charlie Glickman wrote a post answering another woman with a perhaps-similar question.  I’ll add some of my own thoughts below.

You’ll notice that one of the potential issues with vulvodynia (vulvar pain) is yeast, so it might be the case that your allergist is onto something — yeast can cause vaginal pain with intercourse, too. However, please be aware that unless s/he is testing you for these yeast infections, it is possible the vaginal symptoms are not from yeast but from bacterial vaginosis or another pathogen. If you haven’t had a doctor do a vaginal culture when you have symptoms, it may be that you are treating for the wrong thing. Here’s a Planned Parenthood page that goes into some of the other possible culprits.  It is possible that your boyfriend is ping-ponging an infection back and forth to you. If it is yeast, also please be aware that antibiotics and oral contraceptives can increase some women’s susceptibility to yeast infections, and so can douching.

Please note that the idea that Candida (yeast) overgrowth is responsible for various health symptoms, and can be cured with diet and supplements, is controversial. Not all doctors are comfortable with this idea. I would say it’s well worth trying a low-yeast diet, but please keep a diary of symptoms your allergist believes to be associated with the Candida, so you can watch for any patterns that might be relevant and so you can determine for yourself whether symptoms lessen in conjunction with the diet. In this diary it’s also a good idea to note anything else that might be relevant to your vaginal pain with intercourse, including how much time “foreplay” lasts, whether you are having any other health problems, anything. Keeping this sort of diary can actually be incredibly helpful, and if you can keep to it, the answer to your symptoms might reveal itself based on the notes you keep.

Different kinds of vaginal, vulvar, and pelvic pain will cause different sorts of pain, and you haven’t told me what yours is like: burning upon being entered? Pain when the penis reaches your cervix? There are a variety of possibilities when you say “pain,” and a good clinician will ask you some questions to make sure s/he knows what you’re actually experiencing.

Also, it is pretty common for a woman to have pain with penetration because her partner is too large and she is inadequately aroused (or from a vaginal infection, or any of the several possible sources of primary pan);  and then begin to dread sex (I believe you may be getting to this point, so it’s high time you try to find some help with the problem); and the dread helps ensure you won’t be able to get aroused enough to overcome the discomfort, and sometimes will result in a tensing of the vaginal muscles that gives you a whole secondary source of pain–a response called vaginismus. Thus a specific problem can become chronic even if your infection resolves or what-have-you.

I am encouraged, though, that you have explored enough sexually to realize that you can achieve pleasure outside of intercourse, because part of the process of re-learning a pain-free sexuality is to be open to other kinds of intimate activities that do cause pleasure. One more thing: Have you communicated with your partner about this? It would be a very good idea to do so for two reasons: one, if it is a ping-pong infection, he will need to be treated too; and two, his understanding can make a real difference in dealing with this, especially so you can prioritize together what kind of sex to have.

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Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at

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