Everything school never taught you about painful vaginal penetration

Chloe McMullen

This article goes out to those who read the American Girl book “The Care and Keeping Of You” at least 50 times when you were younger but never found the answers about your body that you were looking for.

Your vagina can be confusing, despite the fact that you live with it every day and might have received a quick crash course on female anatomy during high school.

Between myths about “popping the cherry,” sex loosening the vagina and the vagina dentata folk tale (no, your vagina can’t bite), accurate information about your own anatomy and how it differs from others is often lost in the fray.

For many women with vaginas and trans people with frontal openings, any type of penetration can be difficult or even painful—and the thought that your body may not be “normal” is scary.

To combat these fears, the Chronicle spoke with experts about common reasons why a vagina may not work the way we think it should and what to do if you’re concerned about chronically painful penetration.

Your hymen and you:

The hymen is a thin membrane that typically covers one’s urinary and genital organs during fetal and early childhood development. If this wall of flesh does not dissolve in the correct way, it can lead to a hymen that covers the opening to the vagina more than it should.

A hymen can have a hole, or holes in some cases, too small for tampons to fit through—or no hole at all. In these instances, trying to push a finger or anything larger through can cause sharp pain.

Jennifer Litner, sexologist and founder of Embrace Sexual Wellness, an organization that offers sex education programs for teens and parents, as well as psychotherapy for individuals and couples, said hymens are often misunderstood.

“Hymenal tissue is not an indicator of vaginal sex,” Litner said. “History is tied to the concept of virginity—a way to regulate people who have vulvas and their bodies and their sexual activity. It’s not true: You don’t pop a hymen or pop a cherry.”

Litner said if a person’s hymen mostly or completely covers their vaginal opening, they may need to see a specific type of physician or surgeon to create a hole in the membrane.

If a hymen already has an opening, it may also stretch open further naturally during a variety of activities such as biking, sexual intercourse and tampon insertion. This means the hymen itself would loosen, not the entire vagina.

Feeling some type of way:

Litner said there are many other reasons for pelvic floor discomfort. This includes vulvodynia, which is chronic pain in the vulva with burning and itching, and vestibulodynia, characterized as pain or discomfort around the opening of the vagina. Vulvar pain is a common culprit for those having difficulty with penetration.

Andrew Fisher, assistant professor in obstetrics and gynecology at the University of Chicago, said issues of pelvic pain and painful intercourse, also called dyspareunia, are some of the most common complaints for all patients, whether young or old, cisgender or heterosexual or LGBTQ+.

He said many people are not immediately willing to see a specialist because they feel shame or embarrassment in seeking things such as pelvic floor physical therapy or advice on vulvar hygiene.

“The first step is … making sure patients understand that having pain with intercourse or having difficulty with penetration is not normal,” Fisher said.

Issues concerning the pelvic floor may begin at a very young age. Dr. Rebecca Unger, a pediatrician at Northwestern Children’s Practice, said sometimes the two labia minora—two folds of skin surrounding the vaginal opening—may stick together due to inflammation in a labial adhesion.

According to Unger, labial adhesions occur most commonly with babies and toddlers, and if they happen during puberty, the change in hormones often resolves the problem.

On the opposite end of the spectrum, older patients in postmenopause or trans male patients undergoing hormone therapy with low estrogen levels, may feel pain during penetration as the vaginal opening and frontal opening respectively become less elastic.

To better understand your body, Fisher said younger patients do not have to wait until they are 21 to get birth control or a pap smear. They can schedule an appointment to see a gynecologist as early as needed.

“We encourage folks to have a teaching examination done, just so that they can better understand their anatomy and get a sense of what is normal and what’s not normal,” Fisher said. “Once they’re educated on those things, then they’re better able to communicate about their symptoms and health care needs.”

Your vagina and vaginismus:

Although many people share anecdotal stories of experiencing painful penetration, research on the frequency of vaginismus is scarce.

“Vaginismus is a condition where the muscles in the pelvic floor will engage in a muscle spasm, and that spasm can make it painful or difficult or impossible to have vaginal penetration.” Litner said.

Women’s Health cited a study done in 1990 that 5 to 17% of people with vaginas live with vaginismus.

While these numbers are decades old, vaginismus remains a prevalent issue today.

The spasms people with vaginismus experience can range from uncomfortable to very painful, and the condition can be lifelong or acquired. While symptoms can arise when anything enters the vagina, they can also occur just in certain cases—for instance, only with a penis or with a specific person.

Litner advises seeking resources to help manage pelvic pain and said living with vaginismus is “just another thing people will have to manage” that can interfere with their pleasure.

There are options such as pelvic floor therapy that can help those with vaginismus slowly work their muscles to be penetrable again.

Sex and you:

Carlin Ross, president of the Betty A. Dodson Foundation, which focuses on aiding people with self-love and independent orgasms, said through virtual workshops and training sessions, she assists women with gaining sexual agency and overcoming emotional, physical and sexual trauma.

Ross said women in particular should be in control of if, when and how they penetrate. She added that penetration of any kind should always feel good, and nothing should ever just be pushed in when it hurts.

“We’ve been socialized into this passive role where things are done to us,” Ross said. “And then we’ve been conditioned to please. … Pain is a familiar sensation. Pleasure is not.”

For those wanting to learn more about their bodies and sexuality, Ross said she recommends people use online educational resources like Embrace Sexual Wellness’s resources page, Scarleteen and Healthline.

She said they should also give themselves time to touch and explore their body using lube and looking at a diverse range of anatomically correct diagrams.

“Find everything—explore,” Ross said. “Pleasure is there for you and anyone you choose to share it with. Be active. Get what you want. There’s endless resources now that are wonderful.”