Can Your Vagina Be Too Tight—or Is Something Else Causing Your Painful Sex?

It's not uncommon for a person to worry about how their vagina will be "too stretched out" or "will never be the same" after having a baby. But some people also wonder if they have the opposite problem: That they have a vagina that's too tight and unable to accommodate a large or even average-sized penis—leading to discomfort and pain during sex that can make enjoyable intercourse almost impossible.

In general, that's largely a myth. Fact is, your vagina is very stretchable. "Any vagina has the capacity to have elasticity. After all, a baby's head comes through there," said Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University's medical school and the medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago.

Of course, that doesn't mean that the pain you feel during sex isn't real. According to the National Institute on Aging, painful intercourse—aka dyspareunia—is a common health problem for people with vaginas. During their lifetime, 10-28% of people with vaginas will report having painful sex, according to a 2017 study in the journal BJOG.

So rather than assume your vagina is too tight and you can't do anything about it, it's time to address what might be causing you to experience pain instead of pleasure while getting it on. Here are possible four main causes to consider.

Vaginal Dryness

So many things can leave people high and dry during sex, and dryness is a major cause of pain during penetration. But what can cause vaginal dryness?

If you're taking antihistamines to dry out your sinuses due to allergies, like Benadryl, Allegra, or Zyrtec, these allergy meds can also dry you out down below. Talk to your healthcare provider about finding a different medication to help with your allergies that might be less likely to contribute to dryness in your vagina.

According to the US Department of Health & Human Services' Office on Women's Health (OWH), douching can also cause vaginal dryness. Besides causing dryness, douching is generally not recommended, as it changes the healthy balance of bacteria and acidity in the vagina.

You may also experience vaginal dryness after giving birth or while breastfeeding, per the OWH, due to lower levels of estrogen in your body.

Foreplay helps lube up the vagina, so if you and your partner aren't allowing for enough warm-up time before the main event, you may need a little more kissing and touching for things to start flowing down there. If you decide foreplay isn't the issue, use lube. Super-slippery silicone lubricants are best, recommended Dr. Streicher.

Perimenopause and menopause can bring with them vaginal dryness, too. Thanks to normal hormonal changes during these life stages, vaginal tissue can thin out and become parched, making sex extremely uncomfortable. Surprisingly, though, the same problem can crop up in your 20s and 30s due to hormonal birth control, said Dr. Streicher. "While most women taking birth control pills will be fine, a small subset of women will develop thin dry vaginal tissue. Their doctor may tell them that they're young and nothing is wrong with them, but what they experience is excruciatingly painful," explained Dr. Streicher.

If you suspect your pain stems from a hormonal issue, tell your healthcare provider what you're experiencing and have them investigate. Fixing the problem could mean going on a different type of hormonal birth control or relying on a vaginal estrogen cream to rebuild elasticity in vaginal tissue.

Muscular or Physical Issues

In the past, if sex has been painful, your vagina may be conditioned to react by clamping down during penetration. Your brain says, nope, I don't want to feel that again. According to the American College of Obstetrics and Gynecology (ACOG), this is called vaginismus, a reflexive tightening of the muscles at the opening of the vagina.

"A lot of times, it's the fear factor," said Dr. Streicher, and recommended that women take the penis out of the equation completely and practice with a dildo. "That can help you figure out if it's the guy, the size, or you," said Dr. Streicher.

And though rarer, the pain could be the result of a structural problem. According to Dr. Streicher, one woman she treated had been told by her doctor that her husband's penis was too big for her vagina. Turns out, she had an undetected vaginal septum—a wall of tissue inside the vagina— that had to be removed. "She's now fine," said Dr. Streicher. This is why pain during sex that doesn't get better with extra lube or foreplay and can't be connected to medications needs to be evaluated by your healthcare provider.

According to ACOG, certain pelvic conditions can also cause pain during sex. Endometriosis and adenomyosis are similar conditions where pieces of the uterine lining—called endometrial tissue—adhere to other parts of the pelvic cavity or the muscular wall of the uterus. Fibroids are noncancerous growths in the uterus that can contribute to painful sex, as can skin disorders that cause painful cracks or ulcers in the skin around the vulva. Your healthcare provider will help you decide what treatment is best for you.

Sexually Transmitted Infections (STIs)

According to Johns Hopkins Medicine, sexually transmitted infections (STIs), like chlamydia and gonorrhea, can create vaginal irritation, which can be painful during intercourse. And the blisters that come with genital herpes can create pain during penetration. If you think you might have an STI, talk with your healthcare provider about the best course of action. Many times, an antibiotic will be prescribed, clearing the infection up within a couple of weeks.

Vulvodynia

If there seems to be no explanation for the pain, it could be vulvodynia. According to ACOG, vulvodynia is pain around the vulva—the female genitals—that lasts for three months or longer, and is not caused by an infection, skin disorder, or other medical condition. This condition is often described as a burning or stinging sensation, irritated rawness, achiness, throbbing, or soreness. There may also be some swelling. Vulvodynia can be caused by damage to the nerves of the vulva, a genetic disorder, previous infections, inflammation of the vulva, or dysfunction of the pelvic floor muscles.

If you've been diagnosed with vulvodynia, research suggests that certain times of your cycle can cause vaginal pain. For example, in a 2022 study published in the Journal of Women's Health, researchers stated that 50% of the women in their study with vulvodynia reported changes in vulvar pain, depending on where they were at in their menstrual cycle; 60% of these women reported greater pain just before and during their period.

Depending on the cause of the vulvodynia, your healthcare provider may recommend physical therapy. This can include strengthening your pelvic floor muscles and training them to relax, trigger point therapy (a form of soft tissue massage), and modalities like electrical stimulation and ultrasound to help relieve pain. Cognitive behavioral therapy (CBT) is a form of therapy that can help with stress reduction and changing patterns of thinking and behavior, giving you more control over the pain.

Sexual activities should be fun and pleasurable—not painful. While it might feel embarrassing to discuss, be honest with your partner and seek medical care to get to the bottom of what's causing the pain.