Oral sex is often considered an equalizer when it comes to the orgasm gap between men and women. For those who don’t find cunnilingus pleasurable, however, or worse, find it downright painful, the disappointment and sense of isolation can be just as bad as the bad sex itself. To help understand uncomfortable oral and offer advice on treatment options, Dr. Liz Powell, a psychologist and sex educator, and Dr. Pebble Kranz, a sexual medicine specialist, weigh in on the most common causes.
1. Infection
This might be where your mind goes first, and for good reason. As Dr. Kranz explains, “any inflammation on the vulvar tissue” could cause oral sex to be painful, and she adds that several infections do just that. As many of us know all too well, yeast infections can cause significant irritation, often exacerbated by itching, which could certainly be a culprit. And while gonorrhea and chlamydia are more often associated with pain during vaginal intercourse, if your partner uses any kind of digital penetration when they perform oral sex, those STIs could be a part of the problem as well. Lastly, genital herpes would likely cause painful oral sex, and many women experience discomfort in the area even before they have visible breakouts. Luckily, yeast infections can be treated with over the counter creams or oral medication, gonorrhea and chlamydia can be cured with antibiotics, and suppressive medications like Valtrex can greatly reduce herpes breakouts.
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2. Growing up in a sex-negative culture
Whether you had a particular religious upbringing or a scarring sex ed experience, the way we think about sex affects the way we experience it. “If you're worried that having sex is wrong, that fear and anxiety can often tense up the tissues around your vulva and vagina, creating a lot of pain and discomfort,” Dr. Powell explains. So if you find yourself feeling tense during oral sex in particular and think some psychological discomfort might play a role, don’t hesitate to see a professional. Sex therapists are trained to help you unpack these issues. If you want to work on it at home, too, Powell recommends paying more attention to your external genitalia, like your labia. “Our culture views sex as primarily penetration-focused, or focused directly on the clit, and that's not necessarily the entirety of what has pleasurable sensations for genitals,” she cautions. By taking a step back and experimenting with what feels good on your body, you can start to reclaim positive associations with sex.
3. Past trauma
Sexual assault affects hundreds of thousands of women each year, and its impact is sadly long-lasting. Dr. Powell unpacks some of the ways past trauma can manifest in the present: “It's not always a one-to-one, 'someone did this thing to me, so when that thing is happening to me, I have a trigger about it,’” she notes. Often times a color, smell, or even someone’s vibe can set off the fight-or-flight triggers in your body, which can have a very real impact on pain in the moment. It can cause your muscles to tense up, specifically in the pelvic floor, which could lead to physical discomfort during sex, oral sex included, long after an assault occurred. Reaching out for counseling or therapy is one way to start healing, but learning how to communicate about your past with a current partner is another important skill. Dr. Powell offers a simple script if you don’t know where to start. Try something like, "Hey, I have this history of having been touched in ways I didn't want to. I don't want to go into the specifics of what happened, I just want you to know that when we're having sex, sometimes something might not work for me. I need to know that I can just give you that feedback and we can figure out a way to move forward."
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4. Your partner’s technique
Sometimes it’s really not me, it’s you. Spoiler: the clitoris is exceptionally sensitive. As a result, if your partner is using stimulation that’s too intense too quickly, it’s likely to hurt, Powell notes. If it’s too quick, your body hasn’t had time to lubricate and engorge, and if it’s too intense, well...it’s just too intense. Talking to your partner can be uncomfortable, but not as uncomfortable as bad sex. Thankfully, there are lots of ways to handle this unintended pain. If you’re trying to deliver a critique, Powell suggests asking them directly if they’re down to hear some feedback. Getting their buy-in, as she puts it, will likely make them more receptive. Let’s say it’s their first time performing oral sex, for example, and you’re worried about them being disappointed. Try the old-fashioned compliment sandwich, where you deliver some positive statements mixed with your feedback. And finally, if you yourself aren’t sure what feels good, you and your partner can try an A/B test, where you experiment with touching varying spots and using differing pressures right after the other to see which one felt best. Like an eye exam for your vagina, basically.
As Dr. Kranz puts it, “Pain is never a normal part of a sexual experience unless that pain is what is giving you pleasure,” which pretty much sums it up. If something hurts, reach out for the help you need — the fix could be right in front of you.
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