New research published in International Journal of Sexual Health provides evidence that pain during sex is a common experience among college students of both genders. This study suggests that people who strongly believe in traditional gender roles are less likely to communicate this discomfort with their partners. These findings highlight the need for better sexual communication to help people prevent and manage everyday physical discomfort that occurs during intimate moments.
Sex usually involves pleasure, but for many people it is a reality of unwanted physical pain. Most scientific focus on this topic relies on clinical samples examining people with diagnosed medical conditions or severe sexual dysfunction. This approach leaves a gap in understanding the everyday non-medical pain that occasionally occurs during sexual activity.
The authors of the new study wanted to investigate this mild to moderate discomfort in the general population. They designed this study to understand how often college students encounter physical pain during different types of sexual activity. The researchers also tried to find out why people hide their discomfort from their partners.
“One of my student co-authors approached me about wanting to do research. She was very interested in the issue of pain during sex, influenced by the reading I had assigned in class. As we looked at the research literature, we found that non-clinical levels of pain during sex, particularly pain in men, were understudied,” said study author Terry D. Fisher, professor of education at the University of the South and professor emeritus at The Ohio State University.
“Ultimately, we added two more students to the team and developed qualitative and quantitative questions to help us understand the degree of physical discomfort during different types of sexual activity, the response to that pain, and the possible reasons for the pain and response.”
The main focus of this project was to see if beliefs about masculinity and femininity influence how people respond to pain in the bedroom. Past observations suggest that women often accept pain as a normal part of sex. The researchers wondered if men also experience discomfort, but hide it to look manly and tough.
To explore these ideas, researchers recruited 263 college students from a university in the southeastern United States. The sample included 179 cisgender women, 71 cisgender men, and 13 individuals who identified as non-cisgender or did not identify their gender. Data were collected through an anonymous online survey between October 2022 and March 2023.
Participants first estimated how common they believed sexual pain was between men and women. They then reported their personal experiences of feeling pain during three different types of sexual activity. These categories include penile-vaginal sex, anal sex, and non-penetrative acts such as manual stimulation and oral sex.
The survey asked participants if they ever felt pain during these acts, how often it happened, if they told their partner, and if they stopped doing the acts. Participants also answered open-ended questions about why people experience sexual pain and why they endure it without complaining. Finally, students completed a questionnaire measuring their adherence to extreme traditional gender role stereotypes.
Survey responses revealed that participants generally underestimated how often men experience sexual pain. Participants estimated that about half of women and less than a fifth of men experience pain during sex. However, the actual reported incidence of pain was much higher in both groups.
More than 90 percent of women who have had penile-vaginal sex report experiencing pain at some point. Almost 50 percent of men also reported feeling pain during this type of sexual activity. Regarding anal sex, 97.1% of women and 44.4% of men reported experiencing pain.
“I was rather surprised by the number of men who said they had experienced pain during sex,” Fisher told SciPost.
But scientists have discovered that there are significant differences in how men and women deal with this physical discomfort. Women who experienced pain during penile-vaginal intercourse were twice as likely as men to tell their partner about it. These women were also twice as likely to stop having sex altogether.
During anal sex, women were more than three times more likely to communicate pain to their partner. Women were also four times more likely than men to stop having anal sex if it hurt.
A different pattern emerged for non-penetrative sex, with more than half of men and just under half of women reporting experiencing pain. For non-penetrative activities, researchers found no significant differences between men and women in reporting pain or stopping contact.
The qualitative part of the study provided insight into why people experience and endure uncomfortable sex. The researchers identified several recurring themes in the open-ended responses.
Participants often blamed physical issues such as lack of natural lubrication, uncomfortable angles, or aggressive movements. Female respondents frequently noted that women can experience pain due to lack of physical arousal or inappropriate foreplay. When discussing pain in men, some respondents pointed to overexertion and tooth abrasion during oral sex.
When asked why they continue to work despite the pain, respondents often cited embarrassment and a strong sense of obligation to please their partner. Many participants believed that raising their voice would ruin the atmosphere or hurt their partner’s feelings. Some respondents even noted that people may push through their discomfort because they mistakenly believe that sexual pain is normal.
The results also showed a strong association between traditional gender stereotypes and silent suffering. Participants who scored high on traditional gender role questionnaires were less likely to tell their partner about pain during vaginal or anal sex. These people were also less likely to stop painful activities.
The researchers noted that these traditional beliefs affect all genders. Traditionally minded women may feel that their primary role is to satisfy their male partner at the expense of themselves. Men with traditional attitudes tend to worry that admitting pain will make them seem weak and unmanly.
“This study revealed that unwanted pain is part of sexual activity, at least for the college students in our sample,” Fisher explained. “Men who had unpleasant sex were much less likely than women to tell their partners about the pain or stop the painful behavior. For our participants, their reluctance to communicate with their partners about pain was related to their level of belief in traditional gender roles.”
Although this study provides evidence regarding the social dynamics of sexual pain, there are some limitations that should be considered. The sample consisted primarily of young adults from a single university, who did not report their sexual orientation or relationship status. A broader sample including older adults from different backgrounds is likely to yield different patterns.
Scientists also point out that there may be misconceptions about the link between gender roles and communication. The study found a correlation between traditional gender beliefs and reluctance to speak up about pain. However, this statistical relationship does not prove that traditional beliefs are a direct cause of people’s silence.
In the future, the researchers plan to create a new standardized questionnaire based on the themes gleaned from the open-ended responses. Using this tool, scientists will be able to measure the exact reasons for the sexual pain people experience and be able to mask it on a larger scale. By expanding this research, scientists hope to improve sex education and promote healthier communication between partners.
“I was pleasantly surprised by the detailed responses to the open-ended questions that many participants provided,” Fisher said. “Our most novel contribution is that we investigated pain during three different types of sex: penile-vaginal sex, anal sex, and non-penetrative sex. Another difference in our study is that we asked about previously experienced pain, while previous studies used a more limited time period for retrospective reporting.”
The study, “Suffering in Silence: Exploring the Relationship between Distressing Sexual Experiences and Gender Roles Among U.S. College Students,” was authored by Terry D. Fisher, Mary Bullard, Sydney Eyster, and Camila Kaltoff.
