Sex injuries exist on a pretty wide spectrum. On one end, there’s a pulled muscle from an ambitious new position. On the other end is a rabbit hole of Google results that cannot be unseen. The good news is that most people land firmly on the less catastrophic end of that spectrum.
“Most commonly, people experience a muscle strain from trying a new position or discomfort from penetration without adequate foreplay,” Lauren Bradley, sexologist at Love Therapy Australia, told Body+Soul. Penile fracture, she notes, is significantly rarer than the internet would have you believe, occurring in roughly 1 in 10,000 to 1 in 100,000 penis-owners. More typical injuries include muscle cramps, carpet burn, vaginal or anal tears, and the occasional foreign object situation that requires a very awkward ER visit.
The Foreplay Problem
A significant number of sex injuries, particularly for women, trace back to the same root cause: not enough foreplay.
“Pleasure can turn to pain in an instant if you’re not careful and prime your body for a sexual encounter,” Bradley says. “Most vaginal pain is experienced through insufficient foreplay and penetration when the person isn’t ready.” Without adequate preparation, discomfort, pain, and tearing become likely outcomes, and in more severe cases, medical treatment.
For people with penises, injuries happen when partners fall out of sync and body parts connect at the wrong angle, through prolonged erection, lack of lubrication causing chafing, or overly forceful thrusting. Bradley’s recommendation is 20 to 40 minutes of foreplay minimum for most vagina-owners—enough time for muscles to relax, blood flow to increase, and natural lubrication to do its job.
Allergic reactions also belong in this conversation. Condoms, lubricants, food products used during sex, and oral sex after eating spicy food can all cause itching and burning in places nobody wants to deal with itching and burning.
How to Not End Up in the ER
The advice Bradley gives is practical, not complicated. Warm up before sex, the same way you would before any physical activity that asks something of your body. Communicate with your partner during sex, not just before it. “Listen if they’re asking you to slow down and read their body reactions if they pull away,” she says. “It’s likely a sign that it doesn’t feel good.”
On trying new things: “Don’t jump straight into swinging from the ceiling fan. Warm up with a position you feel comfortable in, and that supports you to reach full arousal.” Affirmative consent for each change of position, she adds, keeps everyone on the same page and reduces the chance that someone ends up hurt.
Finally, if anything unusual happens after sex — unexpected bleeding, sudden intense pain, loss of sensation — see a doctor. The embarrassment of explaining how it happened is considerably less bad than whatever happens if you don’t.
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