Many people think of pain and sex as deeply incompatible. After all, sex is all about pleasure, and pain has nothing to do with that, right? Well, for some individuals, pain and pleasure can sometimes overlap in a sexual context, but how come? Continue reading this Spotlight feature to find out.

By Maria Cohut

The relationship between pain and sexual pleasure has lit up the imaginations of many writers and artists, with its undertones of forbidden, mischievous enjoyment.

In 1954, the erotic novel Story of O by Anne Desclos (pen name Pauline Réage) caused a stir in France with its explicit references to bondage and discipline, dominance and submission, sadism and masochism — an array of sexual practices referred to as BDSM, for short.

Recently, the series Fifty Shades of Grey by E. L. James has sold millions of copies worldwide, fuelling the erotic fantasies of its readers.

Still, practices that involve an overlap of pain and pleasure are often shrouded in mystery and mythologized, and people who admit to engaging in rough play in the bedroom often face stigma and unwanted attention.

So what happens when an individual finds pleasure in pain during foreplay or sexual intercourse? Why is pain pleasurable for them, and are there any risks when it comes to engaging in rough play?

In this Spotlight feature, we explain why physical pain can sometimes be a source of pleasure, looking at both physiological and psychological explanations.

Also, we look at possible side effects of rough play and how to cope with them and investigate when the overlap of pain and pleasure is not healthful.

Physical pain as a source of pleasure

First of all, a word of warning: Unless a person is specifically interested in experiencing painful sensations as part of their sexual gratification, sex should not be painful for the people engaging in it.

People may experience pain during intercourse for various health-related reasons, including conditions such as vaginismus, injuries or infections of the vulva or vagina, and injuries or infections of the penis or testicles.

If you experience unwanted pain or any other discomfort in your genitals during sex, it is best to speak to a healthcare professional about it.

Healthy, mutually consenting adults sometimes seek to experience painful sensations as an “enhancer” of sexual pleasure and arousal. This can be as part of BDSM practices or simply an occasional kink to spice up one’s sex life.

But how can pain ever be pleasurable? According to evolutionary theory, for humans and other mammals, pain functions largely as a warning system, denoting the danger of a physical threat. For instance, getting burned or scalded hurts, and this discourages us from stepping into a fire and getting burned to a crisp or drinking boiling water and damaging our bodies irreversibly.

Yet, physiologically speaking, pain and pleasure have more in common than one might think. Research has shown that sensations of pain and pleasure activate the same neural mechanisms in the brain.

Pleasure and pain are both tied to the interacting dopamine and opioid systems in the brain, which regulate neurotransmitters that are involved in reward- or motivation-driven behaviors, which include eating, drinking, and sex.

In terms of brain regions, both pleasure and pain seem to activate the nucleus accumbens, the pallidum, and the amygdala, which are involved in the brain’s reward system, regulating motivation-driven behaviors.

Thus, the “high” experienced by people who find painful sensations sexually arousing is similar to that experienced by athletes as they push their bodies to the limit.

Possible psychological benefits

There is also a complex psychological side to finding pleasure in sensations of pain. First of all, a person’s experience of pain can be highly dependent on the context in which the painful stimuli occur.

Experiencing pain from a knife cut in the kitchen or pain related to surgery, for instance, is bound to be unpleasant in most, if not all, cases.

However, when a person is experiencing physical pain in a context in which they are also experiencing positive emotions, their sense of pain actually decreases.

So when having sex with a trusted partner, the positive emotions associated with the act could blunt sensations of pain resulting from rough play.

At the same time, voluntarily experienced pain during sex or erotic play can, surprisingly, have positive psychological effects, and the main one is interpersonal bonding.

Two studies — with results collectively published in Archives of Sexual Behavior in 2009 — found that participants who engaged in consensual sadomasochistic acts as part of erotic play experienced a heightened sense of bonding with their partners and an increase in emotional trust. In their study paper, the researchers concluded that:

“Although the physiological reactions of bottoms [submissive partners] and tops [dominant partners] tended to differ, the psychological reactions converged, with bottoms and tops reporting increases in relationship closeness after their scenes [BDSM erotic play].”

Another reason for engaging in rough play during sex is that of escapism. “Pain,” explain authors of a review published in The Journal of Sex Research, “can focus attention on the present moment and away from abstract, high-level thought.”

“In this way,” the authors continue, “pain may facilitate a temporary reprieve or escape from the burdensome responsibilities of adulthood.”

In fact, a study from 2015 found that many people who practiced BDSM reported that their erotic practices helped them de-stress and escape their daily routine and worries.

The study’s authors, Ali Hébert and Prof. Angela Weaver, write that “Many of the participants stated that one of the motivating factors for engaging in BDSM was that it allowed them to take a break from their everyday life.” To illustrate this point, the two quote one participant who chose to play submissive roles:

”It’s a break free from your real world, you know. It’s like giving yourself a freaking break.”

Potential side effects of play

People can also experience negative psychological effects after engaging in rough play — no matter how experienced they are and how much care they take in setting healthful boundaries for an erotic scene.

Among BDSM practitioners, this negative side effect is known as “sub drop,” or simply “drop,” and it refers to experiences of sadness and depression that can set in, either immediately after engaging in rough sexual play or days after the event.

Researchers Richard Sprott, Ph.D., and Anna Randall argue that, while the emotional “crash” that some people experience immediately after rough play could be due to hormonal changes in the moment, drops that occur days later most likely have other explanations.

They argue that feelings of depression days after erotic play correspond to a feeling of loss of the “peak experience” of rough sexual play that grants a person psychological respite in the moment.

Like the high offered by the mix of pleasure and pain in the moment, which may be akin to the highs experienced by performance athletes, the researchers liken the afterplay “low” with that experienced by Olympic sportspeople in the aftermath of the competition, which is also referred to as “post-Olympic depression.”

In order to prevent or cope with feeling down after an intense high during erotic play, it is important for a person and their partner or partners to carefully plan aftercare, both at the physical and psychological level, discussing individual needs and worries in detail.

Whatever a person decides to engage in to spice up their sex life, the key is always consent. All the people participating in a sexual encounter must offer explicit and enthusiastic consent for all parts of that encounter, and they must be able to stop participating if they are no longer interested and willing.

Research suggests that fantasies about unusual or rough sexual play are very common, and some people decide to take the fantasy out of the realm of imagination and make it a reality.

If you decide to stray from “vanilla” sex and try other flavors too, that’s fine, and there’s nothing wrong with you. Just make sure that you stay safe and you only engage in what you enjoy and feel comfortable doing.

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