A surprising number of men suffer pain during sex but are less likely than women to speak up

New research published in the International Journal of Sexual Health provides evidence that pain during sexual activity is a common experience for college students of all genders. The study suggests that individuals who strongly believe in traditional gender roles are less likely to communicate with their partners about this discomfort. These findings highlight the need for better sexual communication to help people prevent and manage everyday physical discomfort during intimate moments.

While sexual activity is usually associated with pleasure, unwanted physical pain is a reality for many people. Most scientific focus on this topic relies on clinical samples, looking at people with diagnosed medical conditions or severe sexual dysfunctions. This approach leaves a gap in understanding everyday, non-medical pain that occurs occasionally during sexual encounters.

The authors of the new study wanted to explore this mild to moderate discomfort among a general population. They designed the study to understand how often college students encounter physical pain during different types of sexual activities. The researchers also sought to discover why people might hide their discomfort from their partners.

“One of my student co-authors approached me about wanting to do some research, and because of a reading I had assigned in my class, she was very interested in the issue of pain during sexual activity. Our examination of the research literature revealed that non-clinical levels of pain during sexuality hadn’t been studied all that much, especially not in men,” said study author Terri D. Fisher, a teaching professor at The University of the South and professor emeritus at The Ohio State University.

“We eventually added two more students to the team and developed both qualitative and quantitative questions to help us gain an understanding of the extent of physical discomfort during various types of sexual activities, the reactions to that pain, and possible reasons for the pain and the reactions.”

A major focus of the project was to see if beliefs about masculinity and femininity influence how people react to pain in the bedroom. Past observations suggest that women often accept pain as a normal part of sex. The researchers suspected that men might also experience discomfort but hide it to appear masculine and tough.

To explore these ideas, the 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 specify a gender. Data was collected through an anonymous online survey between October 2022 and March 2023.

Participants first guessed how common they believed sexual pain to be among men and women. They then reported their personal experiences with pain during three distinct types of sexual activity. These categories included penile-vaginal intercourse, anal intercourse, and non-penetrative acts like manual stimulation or oral sex.

The survey asked whether participants had ever felt pain during these acts, how often it happened, if they told their partner, and if they stopped the activity. Participants also answered open-ended questions about why people might experience sexual pain and why they might endure it without complaining. Finally, the students completed a questionnaire measuring their adherence to extreme traditional gender role stereotypes.

The survey responses revealed that participants generally underestimated how often men experience sexual pain. Participants guessed that about half of women and less than a fifth of men encounter pain during sex. However, the actual reported incidence of pain was much higher for both groups.

Over 90 percent of the women who had engaged in penile-vaginal intercourse reported experiencing pain at some point. Nearly 50 percent of the men also reported feeling pain during this type of sexual activity. For anal sex, 97.1 percent of women and 44.4 percent of men reported a history of pain.

“We were rather surprised at the number of men who indicated that they had ever experienced pain during sexual activity.” Fisher told PsyPost.

But the scientists found major differences in how men and women handled this physical discomfort. Women who experienced pain during penile-vaginal sex were twice as likely as men to tell their partners about it. These women were also twice as likely to stop the sexual activity altogether.

For anal sex, women were over three times more likely to communicate the pain to their partners. Women were also four times more likely to stop anal sex when it hurt compared to men.

A different pattern emerged regarding non-penetrative sexual acts, where over half of the men and slightly less than half of the women reported experiencing pain. For non-penetrative activities, the researchers found no significant differences between men and women in terms of reporting the pain or stopping the encounter.

The qualitative part of the survey provided insight into why people experience and endure uncomfortable sex. The researchers identified several repeating themes in the open-ended responses.

Participants often blamed physical issues like a lack of natural lubrication, uncomfortable angles, or aggressive movements. Female respondents frequently noted that women might experience pain due to a lack of physical arousal or inadequate foreplay. When discussing male pain, some respondents pointed to overexertion or teeth scraping during oral sex.

When asked why people keep going despite the pain, respondents frequently cited embarrassment or a strong sense of obligation to please their partner. Many participants believed that speaking up would ruin the mood or hurt their partner’s feelings. Some respondents even noted that people might push through the discomfort because they mistakenly believe sexual pain is normal.

The results also showed a strong connection between traditional gender stereotypes and silent suffering. Participants who scored higher on the traditional gender role questionnaire were less likely to tell their partners about pain during vaginal or anal intercourse. These individuals were also less likely to stop the painful activity.

The researchers noted that these traditional beliefs affect all genders. Women holding traditional views might feel their primary role is to satisfy a male partner at their own expense. Men with traditional attitudes tend to worry that admitting to pain makes them look weak or unmanly.

“This study makes clear that unwanted pain is sometimes part of sexual activity, at least for the college students in our sample,” Fisher explained. “Men engaging in uncomfortable sex were far less likely to tell their partners about the pain and to stop the painful activity than women were. For our participants, this reluctance to communicate with their partners about pain was related to the degree of their beliefs in traditional gender roles.”

While the study provides evidence about the social dynamics of sexual pain, there are some limitations to consider. The sample consisted primarily of young adults from a single university, and they did not report their sexual orientation or relationship status. A broader sample containing older adults from different backgrounds might yield different patterns.

The scientists also point out a potential misinterpretation regarding the link between gender roles and communication. The survey found a correlation between traditional gender beliefs and a reluctance to speak up about pain. However, this statistical relationship does not prove that traditional beliefs directly cause a person to stay silent.

In the future, the research team plans to create a new standardized questionnaire based on the themes gathered from the open-ended responses. This tool will allow scientists to measure the exact reasons people experience and hide sexual pain on a much larger scale. By expanding this research, scientists hope to improve sex education and encourage healthier communication between partners.

“We were pleasantly surprised at the detailed responses to the open-ended questions we received from many of the participants,” Fisher said. “The most novel contribution was our examination of pain during three different types of sexual activity: penile-vaginal intercourse, anal intercourse, and non-penetrative sexual activity. Something else that is different about our study is that we asked about pain having ever been experienced, whereas previous studies have used a more limited time frame for the retrospective reports.”

The study, “Suffering in Silence: Examining U.S. College Students’ Painful Sexual Experiences and Their Relationship to Gender Roles,” was authored by Terri D. Fisher, Mary Bullard, Sydney Eyster, and Camilla Kalthoff.