When sex hurts

For Caroline Miller*, sex was painful and traumatic. Not because of violence or assault, but because of endometriosis. From her first sexual experience to her complete hysterectomy at 23, sex to Caroline felt like “stabbing knives” in her vagina. Everyone had to be lying about this “great” experience, she thought. And even after having major surgery, her body and mind expected the pain and tried to convince her it was still there when she had sex with her husband. 

For Sarah Landry*, sex felt great and her orgasms came pretty easily. Until they didn’t. For 17 years, everything worked like clockwork when it was time to get busy. But after the end of a long-term relationship, she took some time away from p in v sex to be celibate for six months. When Sarah was ready to have sex with a new lover, she found that any attempt at penetration was incredibly painful and her orgasm was next to impossible to achieve even without penetration. 

For these two women, one of our most basic bodily functions as humans just... hurt. They agreed to tell us their stories. 

When sex hurts from day one

Caroline’s first symptom of endometriosis emerged at the age of 15. After 12 laparoscopic procedures to remove the uterine tissue that was growing on her bladder and bowels (so much so her uterus was attached to her back), her body was also filled with surgical scar tissue. In between those surgeries, Caroline’s gynecologist suggested an early pregnancy was likely the only way that she might be able to carry a child. So, at 21, she and her husband decided to try for a baby. Caroline became pregnant and delivered a healthy daughter at age 22. 

““We’re probably more sexually active than other couples, but we make it a priority. I also had to learn to instigate sex because that was something I never did. Why would you when it hurts? But things change in any relationship and as we age, so you have to get creative with finding your sexiness and feeling sexy as time passes.” ”

— Caroline Miller 

“My gyno was one of the top infertility doctors in the state. She told me at an office visit that I probably just wasn’t meant to have those organs anymore. So, having the hysterectomy after my daughter wasn’t a battle. My grandmother also looked out for me. She’d had gastrointestinal issues her whole life that probably were related to undiagnosed uterine problems,” explained Caroline.

Thankfully, Caroline’s husband had also been supportive since they started dating in high school. He was the first person she had sex with and encouraged Caroline to seek out a doctor that would listen to her and believe what she was going through. “I always made sure he was satisfied, but it was important to him that pain wasn’t something I connected to something that was so much a part of our intimacy in marriage.”

“Having the hysterectomy was the absolute right thing to do. Ten years later, I know that. But it was difficult for me mentally and physically to learn that sex no longer hurt. Because I never learned sex was supposed to pleasurable or how to be sexy in my early twenties, even after the surgery, things didn’t improve for months,” she says. “I would tense up from the anxiety of anticipated and remembered pain. I had to learn to enjoy sex.”

When sex hurts suddenly

“Right before I turned 40, I began to feel some changes in my body. I could still get aroused, but we needed lube for things to feel normal. It took a lot more manual stimulation for me to have an orgasm. We began to have sex less — probably partly because things were going from great between us to so-so to ‘box to the left”. We were breaking up for a while. I’m not sure if I can say that not having sex was the cause or effect. We both really liked sex,” said Sarah.

“When I told my friends I was going to be celibate for six months after that break-up, they said it would never last. In fact, it lasted six months and nine days. But when I got to the end of that first third date with a guy I really liked, it felt like he was scraping my vagina with sandpaper as he entered me. It’s hard to even describe the pain. Sharp sandpaper? Rough knives? I was frustrated and embarrassed by my body — and confused. So was he, but he’s a solution-oriented guy,” she laughed.

Sarah’s lover suggested toys, lube, and other play that could help her achieve orgasm without penetration. “He was great. And because he was, I really wanted to get some medical advice on what I could do to fix the problem. We’re sexual beings — it shouldn’t hurt to be with someone we love. Or that we’d just love to sleep with.” 

After six months of trying other things, Sarah started hormone therapy (Caroline has been on it since she was 23) and was referred to pelvic floor physical therapy by her gyno. 

*Not their real names. Some details have also been changed to protect their privacy. 

Editor’s note: This article exclusively refers to heterosexual penis in vagina sexual activity. We are very aware this doesn’t represent how many people have sex. We are actively seeking better representation.