Love hurts, so the old adage goes, but what about the act of love? While sex certainly causes its share of bumps, bruises and burning, there is a difference between the kind of pain that accompanies a wild night of going at it and a chronic pain you feel every time you do the deed. If you've been suffering between the sheets, read on for some clues as to what might be putting the kink into your sex life (or taking the kink out of it, depending on your tastes).
In general, there are three basic reasons as to why moans of oohhhh become cries of ouch: Physical problems or emotional issues can destroy any libidinous high. (And we'll get to those later.) But the most common culprit for painful sex boils down to something as simple—and easily fixable—as lubricant.


Lube Up

All over American men and women are having needlessly painful intercourse because they are too stingy or shy with the lube. "There's this misconception that if a woman is aroused, she'll be all juicy and won't need a lubricant," says Ramona Slupik, M.D., assistant professor of gynecology at Northwestern University Medical School. "But there's nothing wrong with needing lubricant. It doesn't mean a woman's frigid." Au contraire, vaginal dryness could mean a woman is coming off her period, on the Pill, taking allergy medication, breast-feeding, or in menopause. Besides, even a woman who starts out wet as the river Nile can dry up during the course of events, says Judy Seifer, Ph.D., a sex therapist and creator of the Better Sex videos.

And oh, what harm a little dryness can do. If a woman isn't properly oiled, penetration can cause chafing, bruising, and burning. And it's no picnic for a guy either. "Men will feel a sort of rugburn on their penis," Seifer says.

"If there's not enough moisture, there will be a lot of friction—not a smooth ride." Both Seifer and Dr. Slupik advise men and women to a) get over their lubricant-shame and b) buy a bottle of lube. Dr. Slupik recommends Astroglide ("the Dom Perignon of lubricants," she says), which is safe to use with condoms. Some oil-based lubricants will weaken latex, so if you use condoms, be sure to use a water-based lubricant.

If the lube solves your ouch issues, knock yourself out. But if pain persists, there can still be myriad causes.


Girl Trouble

If a woman experiences constant itching or irritation during penetration and after sex, or feels pain during entry, she may have a yeast infection. These are easily treatable with an over-the-counter remedy such as Monistat. But if during deep penetration the pain that seem to come from down inside her pelvis—and if this pain persists over time and doesn't dissipate changing positions—she should see her doctor for a diagnosis. "Such pain could be caused by many things," Dr. Slupik says. "Ovarian cysts, an enlarged uterus, a sexually transmitted disease, or scarring of the reproductive organs. These may sound serious, but all of these problems are treatable, and the sooner you get to a doctor the better."

The aforementioned deep pelvic pain shouldn't be confused with a kind of aching that some women feel when penetration gets particularly intense or deep. "That's usually just the cervix getting bumped during intercourse," Dr. Slupik says. The best remedy? Switch to a position that doesn't allow such intense penetration (for example, lying side by side). The same goes if a woman's pain occurs because her partner is just too well endowed. (And women shouldn't be shy; what guy would be hurt by hearing: "Honey, your penis is so big, it hurts me sometimes. Can we find a gentler position?")


Boy Trouble

Men are far less likely to experience painful intercourse, says Dr. Slupik, and when they do, their problems are easily identified and treated. "The most common pain for men is a pain upon ejaculation," she says. "This would seem to indicate an infection, possibly a sexually transmitted disease, which can be treated with a simple course of antibiotics." The other common male problem is a pain around the testicles. If the discomfort comes during arousal and subsides after ejaculation, there probably isn't a problem. But if the pain persists any time the testicles have pressure put on them (whether you're riding a bicycle or your partner), this might suggest a problem that warrants a trip to the doctor, advises Dr. Slupik.


Emotional Baggage

If a guy is scared, anxious, or unhappy with his partner, sex won't be painful because it will most likely be nonexistent, says Seifer. That's because he won't be able to achieve or maintain an erection, and the show won't go on until his problems are dealt with. For women, on the other hand, sex can often be painful for no physiological reason. "Sometimes our emotions take better care of us than we do of ourselves," says Seifer. If you've ruled out medical problems and position or lubrication issues, it's now time to examine whether fear, anxiety, or discomfort is hurting your sex life.

The problem could be simple. Are you having hurried sex before the baby wakes up? Having quickies in the closet to get a bit of privacy? Feeling embarrassed to be naked in front of your partner? Doing it with someone who hurts or scares you? All of these things can poison your passion, Seifer says. So get a baby-sitter to take the kids; rent a hotel room; find a sex partner who loves and lavishes your body. If your partner frightens you, talk to him. If you feel too intimidated to do that, you might want to take a closer look at your relationship.

In any event, make sure to do something. Because it takes only a few bouts of hurtful sex to train your mind to equate intercourse with pain, Seifer says. And when that happens, sex goes from being that glorious, fun, intimate experience to something to stress over and dread. But you can unlearn your fear by slowly experimenting, talking, and playing with your lover. Relax, breathe, and don't rush it, and you can transform the pain back into pleasure.