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So the best way to tell if an infection is causing the pain is to visit your OBYGN and to get tested. They can cause tears and scarring that make sex very painful upon entry, especially if there's a wound that isn't fully healed. A large penis or dildo within a reasonable size range can cause some discomfort and pain, Minkin says, but it's highly unlikely that a penis is "too big" for a vagina or it will injure the cervix. Fear and anxiety around penetration can create a mental barrier, Chavez says, which can lead someone to unconsciously tense up their pelvic floor muscles during sex, which causes a physical barrier for penetration-based activity. The pain might only occur upon entry, penetration with anything like a tampon , deep thrusting, or a combination of those — and the level of pain can range from mild to severe. The vagina is self-lubricating, but it takes a little work and dedication to get the liquids flowing. So a patient might need to see a therapist to deal with anxiety or stress about intercourse, but also see a pelvic floor therapist to learn how to relax and retrain their muscles.

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