There can be many reasons for pain during vaginal intercourse. Conditions like vaginismus and vulvodynia can make penetration hurt even if you're super turned on and just put on plenty of lube. Sexual trauma could be one cause; endometriosis, a condition where the tissue that normally lines the uterus grows outside of it, is another.
Sex, of course, should never be narrowly defined as just penetration. But, if you find yourself wanting to have intercourse, there are some angles and positions that can potentially reduce, or even fully avoid, discomfort. For instance, "Women with endometriosis typically have pain upon deeper thrusting, so positions that limit the depth of penetration are key," says Heather Jeffcoat, a doctor of physical therapy and author of Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve. If this all sounds familiar, here are five positions you can try (and, of course, if you've never seen a gynecologist about this, please do so first!).
"Consider additional erotic activities that don't include penetration," says Jenni Skyler, PhD, a certified sex therapist and sex expert for AdamEve.com. "Penetration can be the side dish for sex while the other activities dominate. Pleasure is the goal, so creatively figuring this out is key." Manual stimulation using your hands on your partner's external parts, like in this laying down position, is a stellar alternative to internal pounding.
The Cowgirl Crouch
"The person with the vagina gets on top and kneels over the person who's prone to control the depth and speed of penetration," says Carol Queen, PhD, Good Vibrations staff sexologist, curator of the Antique Vibrator Museum, and co-author of The Sex and Pleasure Book with Shar Rednour. "Bonus comfort element: Ask your partner to refrain from thrusting up too much. Some partners on the bottom get pretty 'buckin' bronco' about it–that might be great if there were not a pelvic pain condition involved, but when there is, gentler is better."
The Safety Spoon
"Longer penises that strike the cervix can cause pain to flare up. Hard and fast thrusting with those long penises can definitely cause pain as well. (This can also be true of a strap-on dildo)," says Queen. "Spooning allows for cuddly and slow sex; it's also great for a clitoral reach-around." Queen also recommends products like OhNut rings that provide a buffer when a partner's penis is too long for comfort.
The Triangle Tower
"Doggie-style often includes movement that can pull and overstretch endometrial tissue, which frequently results in pain during sex," says Skyler. "Lifting the hips up to the ceiling just slightly can help prevent too much depth."
The Lean On Me
Try standing sex by leaning against a wall or something sturdy with your partner entering you from behind. "Women with endometriosis tend to have a lot of abdominal pain and trigger points in the belly that can activate their pain and cause them after-sex pain," says Isa Herrera, MSPT, CSCS, a licensed pelvic floor physical therapist and author of Ending Female Pain. "Standing sex positions decrease the pressure put on the abdominal area and help to decrease pain."
This article originally appeared on Cosmopolitan.com. Minor edits have been made by the Cosmo.ph editors.