Ask the Doctors: Painful Penetration

I have a friend (and yes it really is my friend) who had a boyfriend for 3 years. Throughout the 3 years, they never really had sex because it hurt her way too much. She says any kind of penetration is extremely painful for her and not enjoyable. She recently broke up with her boyfriend and kind of regrets not sorting out her “sex” problem. I suggested getting a toy because it seems like shes very uncomfortable and awkward with herself which i think could be part of the problem. She said she’d be scared to try one so im looking for something that will help her get over her fears and not scare her but obviously it has to work. Do you have any suggestions?

The first thing that I can suggest is that your friend might want to get checked out by a medical professional. There are a lot of reasons why vaginal penetration can be painful, and given how long this has been happening for her, that’s probably a good place to start. I would recommend that, rather than using a toy.

One possibility is that she’s experiencing vulvodynia (chronic vulvar pain). The National Vulvodynia Association website has a lot of great info and they have a list of the more common causes:

  • An injury to, or irritation of, the nerves that transmit pain and other sensations from the vulva
  • An increase in nerve fiber density in the vulvar vestibule
  • Elevated levels of inflammatory substances in the vulvar tissue
  • An abnormal response of different types of vulvar cells to environmental factors such as infection or trauma
  • Altered hormone receptor expression in the vulvar tissue
  • Genetic susceptibility to chronic vestibular inflammation
  • Genetic susceptibility to chronic widespread pain
  • Genetic factors associated with an inability to combat vulvovaginal infection
  • A localized hypersensitivity to Candida (yeast) or other vulvovaginal organism
  • Pelvic floor muscle weakness or spasm

Other possibilities include vaginismus (spasming vaginal muscles),  endometriosis, certain skin conditions, sexual or physical trauma, and strong negative feelings  or fears about sex. Sexwithoutpain.com also has some really good info about these concerns.

If it turns out that the issue is caused by pelvic floor weakness or muscle spasms, the Pelvic Pain Rehabilitation Center could be a useful resource. If your friend is in San Francisco, we’re hosting a workshop on March 1 with Liz McBride, one of their physical therapists. If she’s not local, they might be able to help her find someone in her area.

On the other hand, sexual trauma or fears around sex could also be a factor. If so, a therapist with expertise around sexuality might be helpful. The American Association of Sexuality Educators, Counselors, and Therapists has a directory and anyone listed in it has gone through an extensive certification process.

With all of these possible causes, there’s really no way for you or me to know what route will be best for her. I think it’s important for her to find out what’s causing this, rather than trying to fix it with one of our products because if there is a medical issue, our toys won’t do much for it. Similarly, if the underlying cause is an emotional concern or trauma, a vibrator won’t be much help on its own.

Having said that, for some conditions, the appropriate treatment includes using a series of dilators of gradually increasing sizes to help the vagina become accustomed to penetration. In general, you’ll want something smooth since bumps or curves could be too much. While many of our vibrators or dildos could work, it can get expensive to purchase 4 or 6 different ones, so check out our Vibrating Dilator Set. The 4 different cylinders lock into place sort of like nesting dolls, so it’s easy to switch from one size to another. And it’s made from hard plastic, which is easy to clean.

Whatever your friend decides to do, I’m glad that you’re there to support her. I wish her all the best.


We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at education@goodvibes.com! For product-related questions, please email or call our customer service staff at customerservice@goodvibes.com.
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Dr. Charlie Glickman

Charlie Glickman is the Education Program Manager at Good Vibrations. He also writes, blogs, teaches workshops and university courses, presents at conferences, and trains sexuality educators. He’s certified by the American Association of Sexuality Educators, Counselors, and Therapists, and loves geeking out about sex, relationships, sex-positivity, love and shame, communities of erotic affiliation, and sexual practices and techniques of all varieties. Follow him online, on Twitter at @charlieglickman, or on Facebook.

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