Recently, our research team at the Center for Sexual Health Promotion at Indiana University completed the largest nationally representative survey of the US population in nearly 20 years. Specifically, we surveyed women and men ages 14 to 94 about their sexual lives as part of the National Survey of Sexual Health and Behavior

There were many interesting findings that came from the study and that you may have seen highlighted in the media over the past week, anywhere from the New York Times to The Today Show to the Colbert Report. Over the next few weeks, I'll be sharing my thoughts about some of the most striking findings to come from our research. 

We found, for example, that about 30% of all women ages 18 to 59 reported some difficulty with pain the last time that they had sex. This compares to about 5% of men who reported difficulty with pain. Why does sex hurt for so many women? 

We know that about 10% of women experience chronic genital pain, some of whom may be diagnosed with vulvodynia. Other women, however, experience more mild or fleeting pain that comes and goes with sex. For example, some women find it painful if their partner hits up against their cervix during vaginal intercourse or sex toy play. Others find it painful if they start sex too quickly, without adequate vaginal lubrication or the use of a store-bought lubricant. And sometimes women engage in types of sex that they don't enjoy, or that they know from experience to be painful, if they don't feel like they can say no or if they feel as though they must or "should" please their partner at all costs. 

I wonder, too, how many women think that sex is "supposed" to hurt. After all, young women often get the message that "sex hurts" and so they go into sex expecting some discomfort or pain and not necessarily telling their partner or healthcare provider or even their best friends that it hurts. There's some level of "sucking up the pain" that women go through. Men may take physical hits on the sports field more often than women, but our data suggest that women take more hits in the bedroom than men. 

What I hope comes from this finding is that more scientists pay attention to the issue of women's pain during sex. I also hope that more couples pay attention to this issue in their own lives. Here are some things that may help: 

- Connect with the National Vulvodynia Association if you or your partner or friend experience ongoing pain during sex (www.NVA.org). You can also ask the NVA for a healthcare provider recommendation. 

- Spend more time in foreplay before having sex so as to allow a woman's body sufficient time to build vaginal lubrication. Some people find it helpful to wait until a woman feels very "wet", and interested in sex, to proceed with vaginal penetration or intercourse. Lubrication - whether natural or store-bought - can help to enhance sexual comfort and pleasure. 

- Never force or coerce or "trick" a woman into having sex with you. The best sex is sex that is wanted, not manipulated. 

- Don't feel pressured to engage in sex that you don't want to. Anal sex is particularly painful for many women, but it doesn't have to be. Vaginal sex can feel painful or uncomfortable, too. Seek out quality information about how to have more comfortable, pleasurable sex through better communication, the use of lubricants or lubricated condoms, medical help (www.issvd.org) or sex therapy

- Consider positions that provide more control for women, such as woman-on-top, so that she can readjust her body if discomfort or pain appear. 

- If you or your partner experiences pain during sex, you may find it helpful to meet with a sex therapist who can help you better figure out how to have more pleasurable sex, and who may be able to refer you to a medical specialist to make sure that your physical health is in good order. Find a sex therapist through www.sstarnet.org

- An emerging area of research suggests that vibration may help some women who experience vulvar pain. Ask your healthcare provider if you have questions or consider exploring on your own with a vibrator. 

Debby Herbenick, PhD, MPH is a sexual health researcher at Indiana University, a sexual health educator at The Kinsey Institute, and author of the book Because It Feels Good: A Woman’s Guide to Sexual Pleasure and SatisfactionFollow her on Twitter @mysexprofessor and make friends with her on Facebook. 

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