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“Burning Love” may be a good song to get you in the mood, but if you get a burning feeling — or pain of any kind — during sex, that mood will take a nosedive.

To help you figure out what might be happening “down there,” we compiled a list of the 10 most common reasons sex (the penis-vagina kind) could be uncomfortable or even excruciating — and how to handle them.

Be sure to talk with your doctor about what’s going on. Educating yourself and reaching out for help are two of the most important steps toward taking sex from ouch to ooooooh.

Painful sex has a medical term, dyspareunia, and while it often occurs during intercourse, it may also happen before or after a romp.Sorenson J, et al. (2018). Evaluation and treatment of female sexual pain: A clinical review. DOI: 10.7759/cureus.2379

If you experience pain during intercourse, you’re certainly not alone. In the United States, 10 to 20 percent of people with vaginas report experiencing discomfort during the deed. But likely a lot of instances go unmentioned.

The type and severity of the pain is a bit different for everyone. Plus, a variety of reasons could be causing it. Find your symptoms, and take a look at the possible culprits and what to do.

1. Burning and itching with a strange discharge

Possible causes:

Dreaded yeast infections, with their telltale cottage-cheese-like discharge, are extremely common. However, be aware that a latex allergy can mimic that awful fiery feeling.

Burning and itching with sex, or otherwise, could also be a sign of bacterial vaginosis (BV), the most common cause of a wonky discharge.Hay P. (2017). Bacterial vaginosis. DOI: 10.12688/f1000research.11417.1 BV is often accompanied by a fishy odor.

Sexually transmitted infections (STIs) like chlamydia, gonorrhea, or trichomoniasis may also cause uncomfortable sex and a questionable secretion.

The swelling and pain associated with these infections pretty much takes sex off the table. Plus, if you suspect an STI, you’ll want to get tested, and if necessary, treated, so that you don’t pass bacteria on to a sexual partner.

Although not an STI, a yeast infection can be passed through intercourse and oral sex.Vaginal yeast infections. (2019). https://www.womenshealth.gov/a-z-topics/vaginal-yeast-infections And some studies show that BV-associated bacteria can also be swapped.Hay P. (2017). Bacterial vaginosis. DOI: 10.12688/f1000research.11417.1

Potential solutions:

Although you can treat a yeast infection with over-the-counter (OTC) creams, your best bet is to see a doc to get properly diagnosed in case it’s something else.

For a yeast infection, your physician may prescribe you an antifungal medication. For BV or an STI, you may need an antibiotic.

Talk to your OB-GYN if you suspect a latex allergy, which can be life-threatening depending on your level of sensitivity. If you are allergic, switch to polyisoprene or polyurethane condoms.

2. Pain in the pelvis during penetration

Possible causes:

Pelvic Inflammatory Disease (PID), an infection of the reproductive organs, will cause this type of pain in addition to discharge. Other symptoms may include irregular bleeding, fever, or painful urination.Das B, et al. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. DOI: 10.2147/IDR.S91260

PID occurs when bacteria gains access to your reproductive organs through the cervix, sometimes as a result of chlamydia or gonorrhea. It can also happen from an infection after IUD insertion, childbirth, or miscarriage.

Potential solutions:

See a doctor for proper diagnosis. If it is PID, your physician will most likely prescribe antibiotics. If PID is caused by an STI, your partner should see a doctor for treatment as well.Das B, et al. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. DOI: 10.2147/IDR.S91260

3. Pain that goes away when you switch positions

Possible causes:

Your partner may have just poked your cervix. It’s most likely an issue of position and angle.

Potential solutions:

Bumping the cervix isn’t medically harmful, but it can make having sex a whole lot less fun. If you find this happens in a certain position, switch things up, either with your partner or a toy, until you find a position that’s more comfortable.

4. Your vagina feels like sandpaper during penetration

Possible causes:

Vaginal dryness is often associated with menopause.Waetjen EL, et al. (2018). Factors associated with developing vaginal dryness symptoms in women transitioning through menopause. DOI: 10.1097/GME.0000000000001130 But, if you haven’t joined the meno club yet, you might still feel a dry, tearing sensation during sex for other reasons.

Got seasonal allergies or a cold? Antihistamines and decongestants, which clear up mucous membranes when you have a stuffy or runny nose, could be drying up your you know what. And birth control pills have also been associated with vaginal dryness.de Castro Coelho F. et al. (2019). The potential of hormonal contraception to influence female sexuality. DOI: 10.1155/2019/9701384

Plus, parching can occur from time to time if you’re not in the mood, you’re distracted, or you’re just not that into your partner.

Potential solutions:

A lubricant can be a lifesaver. But if dryness is more than just the occasional inconvenience, you may want to see a doctor for treatment.

If your doctor determines medications are the cause, ask about other options that don’t turn your vag into the Sahara. For chronic cases, try long-acting vaginal moisturizers, like Replens, which relieve dryness for days by imitating the body’s natural lubrication.

5. Sharp, localized pain on the outside of the vagina

Possible causes:

Take a look at your nether regions in a mirror. Chances are the pain is coming from an ingrown hair. Rubbing up against these bumps during sexual activity sometimes causes more irritation.

Although less common, a Bartholin’s cyst could be to blame. Your Bartholin’s glands secrete vaginal fluid, but if a gland become blocked, a cyst could form.

Potential solutions:

If you have an ingrown hair or suspect a Bartholin’s cyst, keep the area clean and dry, and don’t try to pop it.

A warm compress may help bring the ingrown hair to a head or encourage fluid to drain from a cyst. If it doesn’t go away on its own in a few days, see your doctor for treatment and to rule out an STI.

6. Deep pelvic throbbing and cramping during sex

Possible cause:

You could have endometriosis, a disorder that causes uterine-lining tissue, called the endometrium, to grow somewhere outside your uterus, like the ovaries, bowel, or pelvis. Uterine fibroids, noncancerous growths of the uterus, are also a possibility.Moshesh M, et al. (2014). Examining the relationship between uterine fibroids and dyspareunia among premenopausal women in the united states. DOI: 10.1111/jsm.12425

In addition to potentially making sex painful, both endometriosis and uterine fibroids may cause heavier, longer, or irregular periods that come with deep, stabbing pain. Pain may also be present when your period is not.

Potential solutions:

Talk to your OB-GYN about your pain. Uterine fibroids can often be removed. Although there’s no cure for endometriosis, treatments include surgery to remove growths, hysterectomy, hormonal or pain medications, and more.Becker CM, et al. (2017). Reevaluating response and failure of medical treatment of endometriosis: a systematic review. DOI: 10.1016/j.fertnstert.2017.05.004

7. Your vagina clamps shut whenever you attempt penetration

Possible cause:

Vaginismus is when your pelvic floor muscles involuntarily spasm.

This condition’s roots can be both physical and mental. It can happen after sexual trauma or in individuals who’ve grown up with a background that frowns upon premarital sex. Vaginismus can also be an anxiety response caused by fear of pain or intimacy.Bhatt JK, et al. (2017). A study of vaginismus in patients presenting with infertility. DOI: 10.18203/2320-1770.ijrcog20175270

Potential solutions:

Since vaginismus often has a psychological component, your doctor may prescribe psychotherapy. Pelvic floor physical therapy, to help retrain muscles, may also be a consideration.Reissing ED, et al. (2013). Pelvic floor physical therapy for lifelong vaginismus: A retrospective chart review and interview study. DOI: 10.1080/0092623X.2012.697535

8. A stabbing pain on your vulva when touched

Possible cause:

Vulvodynia is pain around the opening of the vagina that doesn’t have a known cause and that’s occurred for at least three months. It can make sex, exercise, sitting, or even wearing tight pants painful.Corsini-Munt S, et al. (2017). Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. DOI: 10.2147/JPR.S126259

Potential solutions:

Since doctors aren’t sure of the cause of vulvodynia, treatment is complex. Your doctor may prescribe a combination of medication, local analgesics, and physical therapy. Sometimes surgery is also a consideration. Corsini-Munt S, et al. (2017). Vulvodynia: a consideration of clinical and methodological research challenges and recommended solutions. DOI: 10.2147/JPR.S126259

9. You’ve never been able to insert anything into your vagina

Possible cause:

Sometimes a hymen can prevent penetration. You may have an imperforate hymen, which is a completely intact membrane that obstructs the vaginal opening.Haw Lee K, et al. (2019). Imperforate hymen: A comprehensive systematic review. DOI: 10.3390/jcm8010056 Or, a septate hymen is broken but still has a band of tissue running through the center, making penetration impossible.Mishori R, et al. (2019). The little tissue that couldn’t — dispelling myths about the Hymen’s role in determining sexual history and assault. DOI: 10.1186/s12978-019-0731-8

Potential solutions:

If your doctor determines that your hymen is the cause of your pain, a minor surgery (hymenectomy) can remove it.Haw Lee K, et al. (2019). Imperforate hymen: A comprehensive systematic review. DOI: 10.3390/jcm8010056

10. Pelvic pain during sex and an urge to urinate

Possible cause:

Interstitial cystitis, or painful bladder syndrome, is a chronic condition that causes painful pressure on the bladder. It can feel like a urinary tract infection (UTI), but it isn’t bacterial.Han E. (2018). Current best practice management of interstitial cystitis/bladder pain syndrome. DOI: 10.1177/1756287218761574

Potential solutions:

Interstitial cystitis has no known cure, but it may go away after a period of time. Methods for finding relief include dietary changes, medications, and pelvic physical therapy.

Whether you’re experiencing new symptoms or something that has been going on for a while, it’s best to get to the bottom of it and find a solution.

If pain is preventing you from pleasure or from having sex when you want to, talk to a trusted OB-GYN who can help you troubleshoot. Your health and well-being are worth it, and pain-free sex might be just around the corner.