They say sex is like pizza: Even when it’s bad, it’s still pretty good. But findings from a new study suggest that’s not the case for many women. One in 13 women reported experiencing painful sex in the past. A smaller subset—one in 53—said sex is “often or always” painful for them.

Researchers surveyed about 7,000 sexually active British women and found that the intercourse issues are most common among women in their late 50s and early 60s, but women between the ages of 16 and 24 aren’t far behind.

The study didn’t break down the causes, though there are a number of medical conditions, such as vaginismus, endometriosis, and fibroids, that can make sex painful. Many women have eased their pain by experimenting with different lubes, and some women with vaginismus have had success with Botox injections in their vagina. It’s case by case, so if this is something you’ve experienced, it’s a good idea to consult a doctor.

Kristin Mitchell, one of the lead researchers of this study, said the underlying problems aren’t always physical. Anxiety about sex can lead to painful experiences too. The best way to treat this? Better education.

“Often, sex education is about STIs and pregnancy, but it should also prepare people to think about what makes sex enjoyable and how to communicate what they like and dislike in a trusting and respectful relationship,” Mitchell told the BBC.

At the end of the day, painful sex is a sign that something is amiss, either in your relationship or in your body. If this is something you’re struggling with, never be embarrassed about asking for help.