As women, we’re taught to expect the “first time” to hurt. But only the first time. Afterward, sex always feels wonderful and is mutually fulfilling for both partners.

Sadly, this is not accurate. For many women, not only is the first time painful, the second, tenth, and twentieth times are painful.

Painful intercourse is called dyspareunia. The pain is often temporary, but can be indicative of other problems. A few causes of physical discomfort during intercourse are:

Insufficient arousal – Not enough natural or synthetic lubricant could be making sex less than pleasurable. Make plenty of foreplay part of your sexual repertoire and consider adding a water-based lubricant to your lovemaking.

Menopause – Hormone fluctuations can cause, among other symptoms, vaginal dryness. Consult your doctor about possible treatments for the sexual side effects of menopause.

Urinary infection or yeast infection – These infections can cause itching and pain in the vaginal area. Drug stores offer over the counter tests for both ailments. Ultimately, you’ll want to seek treatment from a doctor, and if you believe you have a yeast infection, avoid sexual contact. Yeast infections can be transmitted from person to person.

Vaginismus – This is an over-tightening of the vaginal muscles. Treatment (ranging from psychotherapy to Botox injections) varies depending on the individual.

It’s a shame that something so pleasurable can be excruciating to endure. Though the reasons for painful sex are numerous, treatment is quite accessible. As human beings, as women, it is our right to enjoy sex and have wonderful sex lives. Seek out the sex you deserve.