Sex Positions That Can Help Reduce Pelvic Pain

Sex should never hurt, of course. But painful sex is a common enough issue that it actually has a medical name. Dyspareunia, or painful intercourse, is any persistent or recurrent genital pain that occurs before, during, or after penetrative sex. 

In most cases, pelvic pain during sex is caused by a penis or sex toy hitting the cervix, the canal between the uterus and the vagina, during deep penetration. Hitting the cervix can be pretty uncomfortable on its own, but it can also put pressure on the nearby organs – like the uterus, fallopian tubes, and bladder.

However, other conditions such as pelvic floor dysfunction, vaginismus, endometriosis, or a tilted uterus can also cause pain during sex. If sex-related pelvic pain is a consistent issue, a visit with your healthcare provider may be necessary to determine the cause. 

Sex positions that allow for more shallow or controlled penetration can help you avoid hitting the cervix and putting pressure on other organs in the pelvic region. Here are some go-to sex positions and tips to help reduce pelvic pain during sex if you have a vagina.

The Rider

Getting on top allows you to control the depth and pace of penetration during sex. 

How to do it: First, you straddle your partner. Then, facing each other, you can lean forward onto their chest, or back toward their thighs for leverage.

Why it works: This helps you have more control so you can avoid deep penetration and hitting your cervix.

If you have endometriosis, the scar tissue that may form on the ovaries, cervix, fallopian tubes, and bladder can make it so penetration causes sharp pain in the vagina and pelvis. Opting for shallow penetration may help you avoid hitting the cervix and neighboring organs.

A survey of a group of U.S. women found that about  84% used shallowing to make vaginal penetration more enjoyable. Shallowing is penetration just inside the entrance of the vagina, but not any deeper. 

Spooning

If you prefer some action from behind, spooning can help reduce pelvic pain during sex. 

How to do it: Lying down on your side and facing the same direction, the partner doing the penetration will play “big spoon” while you lay in front as the “little spoon.”

Why it works: You can set the depth of thrusting with your legs, and your butt can help cushion thrusting to avoid deep penetration. Communicating with your partner about the speed and what feels good can also help you set the right penetration depth. 

Spooning is also a  great position to incorporate grinding and touch, too. Pairing penetration with clitoral stimulation, also known as partner pairing, is an ideal way to reach orgasm. Partner pairing was noted as one of the various ways women in a 2021 survey improved pleasure during penetrative sex.

Outercourse

While not technically a sex position, outercourse is a blanket term that can include anything from kissing to mutual masturbation. It's basically any sexual activity that doesn't involve anal or vaginal penetration.

How to do it: For an experience similar to intercourse, try thrusting the penis or sex toy between your breasts, thighs, or butt cheeks. Consider a session of 69, or have your partner treat you to oral sex or clitoral touching, so you can lie back and just enjoy the sensations.

Why it works: Outercourse allows intimacy without penetration. Additionally, if your pelvic pain stems from vaginismus, a condition that causes vaginal muscles to tense up involuntarily at penetration, outercourse may be your best option.

Modified Missionary

Regular missionary can still be pain-free if you and your partner communicate and keep penetration shallow. You can also modify the position to make it more comfortable.

How to do it: The easiest way to modify missionary is to rock instead of thrust. Your partner should kneel over you while you’re lying on your back. During penetration, the base of the penis or toy stays inside your vagina and grinds back and forth, rubbing against your clitoris.

Why it works: Any position that causes pelvic pain during sex can benefit from shallower penetration or grinding as an alternative to deep penetration. A research survey that asked women what makes penetration more enjoyable noted that rocking made sex better for 76% of those surveyed.

Modified Doggy Style

If regular doggy hits all the wrong places, modifying the position can help reduce penetration depth. 

How to do it: Instead of both you and your partner being on your knees to allow penetration from behind, try standing. Standing doggy style gives less room for deep thrusting, thanks to some cushion from the backside.

If you prefer a more traditional doggy, you can lay on your stomach and place a pillow under your hips while keeping your legs fairly closed. This also creates less range of motion for deep penetration and might help achieve shallow thrusting by adjusting the angle of penetration.

Why it works: The pillow modification helps angle the pelvis to prevent deep penetration. Changing the angle and penetration depth can help you avoid pelvic pain, which is often a problem if you have a tilted uterus. Researchers found that angling improved penetration pleasure for 87% of women surveyed.

Other Sex Tips to Reduce Pelvic Pain

Besides switching up your sex positions, there are other ways to ease pain during sex and make the experience more enjoyable for you.

• Use lubrication: If you also experience vaginal dryness in addition to pelvic pain, a lubricant can help make things more slippery. Try a water-based lubricant if you're dealing with irritation or sensitivity. Or opt for a silicone-based lubricant if you need more longevity. Just avoid using oil-based lubricants with condoms, which can cause breakages. If you're using silicone sex toys, stick with water-based ones to avoid damaging the silicone surface.
• Set some sexy time. If your pelvic pain stems from vaginal disorders that make you feel anxious about sex, ditch spontaneity. Try scheduling times for sex so you feel prepared and more in control.
• Communicate with your partner. Sure, you can talk dirty, but telling your partner what feels good or bad during sex will help you figure out what works to avoid pain.
• Take pain relievers. An over-the-counter pain reliever before sex may help relieve pain. If that doesn’t help, your healthcare provider may be able to prescribe medication to help relieve pain or relax your muscles. 
• Pee before sex. Going into sex with a totally empty bladder will help prevent additional pressure on sensitive pelvic areas that may make sex painful.

When to Visit a Healthcare Provider

If you don't know what's causing your pelvic pain during sex, or you suddenly start experiencing pelvic pain, visit a healthcare provider. Pain during sex can indicate a serious infection or health condition, which your doctor can help you identify.

Pelvic pain during sex can also be a sign of sexually transmitted infections (STIs). Chlamydia and gonorrhea cause vaginal inflammation that makes penetrative sex feel painful or burn. See your healthcare provider and schedule STI testing if you experience pain during sex and symptoms like abnormal or smelly discharge and burning when you pee.

Untreated gonorrhea or chlamydia can lead to pelvic inflammatory disease (PID), an infection of the upper female reproductive organs. If you have PID, you'll likely experience pelvic pain during penetrative sex. And if left untreated, PID can cause permanent pelvic pain, scarring, and infertility. There are no tests for PID, but a doctor can diagnose you based on symptoms and examinations.

If you experience the following PID symptoms, especially if you have had chlamydia or gonorrhea, contact your healthcare provider ASAP:

• Lower abdominal pain
• Fever
• Abnormal vaginal discharge with a foul odor
• Pain and/or bleeding during sex
• Burning while you pee
• Bleeding between periods.

A Quick Review

Sex is supposed to feel good, but it's still very common to experience pain during sex. Pelvic pain during sex can make you want to avoid sex and strain your relationship with your partner, but that doesn't mean there aren’t ways to enjoy sex again.

It is possible to help mitigate pelvic pain during sex by trying alternative sex positions to avoid deep penetration. If all types of penetration cause pain, there are alternative sexual activities you can try. Mutual masturbation, oral sex, and outercourse can help you and your partner enjoy intimacy without penetration.

If you don't know the cause of your pelvic pain or experience abnormal discharge, or burning while you pee, talk to your healthcare provider or OB-GYN. They can help you figure out the next steps for treatment.