Pain during sex is a common struggle for women. According to American College of Obstetricians and Gynecologists, up to 75% of women have experienced pain during intercourse and other forms of sexual activity at some point in their lives. However, sex isn’t supposed to painful, it should be pleasurable. Read on to learn about a few things to know and look out for.
Signs and Causes of Pain During Sex
Vulvodynia, vaginismus, and dyspareunia (to name a few) are medical terms that refer to sources of discomfort or physical pain a woman may experience in or the area surrounding the vagina. Dyspareunia is a sexual pain disorder generally used to describe genital pain that may be experienced inside the vagina or externally. Vaginismus refers to pain during penetration of any kind (e.g. via a penis, tampon, sex toy, finger).
There is an involuntary contraction of the pelvic floor muscles (pelvic inflammatory disease) that makes penetration painful, difficult, or at times, nearly impossible.
Vulvodynia is a condition where one may experience chronic pain, burning, or discomfort inside the vulva for at least 3 months that is difficult to link to any specific medical condition. Some women may experience a burning or stinging sensation, soreness, rawness, throbbing, itching, or pain insertion.
Pain can be located and experienced at the vaginal opening, along the vaginal canal, or during orgasm and can happen during thrusting, with superficial or deep penetration, rectal discomfort, clitoral pain, and lower abdominal pain.
What Causes Someone to Feel Pain During Sex?
When pain enters the bedroom, it can put a strain on people of all genders and ages and on the healthiest of relationships. With the right assistance, compassion, understanding, and professional support, it is feasible to overcome this challenging concern and re-experience the joys of sexual intimacy. Pain during sex can happen for many varied reasons, including but not limited to:
Physical problems
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- infections (bacterial, yeast infections, STIs)
- medical trauma
- chronic pain
- pregnancy/birth
- hormonal changes
- skin conditions
- endometriosis
- menopause
- vaginal dryness/lack of adequate natural lubrication
- pelvic floor dysfunction/injury
- fibroids or ovarian cysts
Psychological difficulties
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- anxiety
- depression
- fear
- negative body image
- low self-esteem
- upbringing in a sex-negative environment that creates shame/disgust towards intimacy
- lack of trust with partner
- fear of losing control
- stress
- trauma
- relationship strain
Many women report being misdiagnosed, treated insensitively, or told that their pain was psychosomatic, according to Deborah Coady and Nancy Fish in their book, “Healing Painful Sex.” It is important to know that you do not need to suffer in silence and that finding an appropriate medical and therapeutic support team is possible.
Understanding the Connection Between Mental Health & Pain During Sex
There are multiple studies testing the concept of psychological components in relation to painful sex. These studies have found that women who have chronic pelvic pain disorders also had higher rates of anxiety, depression, sexual or physical abuse, and low self-esteem related to body image. In addition, PsychCentral states that sexual pain may transform itself into muscle memory.
This means that when you experience painful sex once, your body braces for pain the next time sex may occur. From the understanding of Polyvagal Theory and the nervous system, the ANS (autonomic nervous system) is separated into two parts, the parasympathetic (freeze/shut down) and the sympathetic (fight or flight). What happens when fear or anxiety become connected to sex is the body tends to go into fight or flight. If shame or dissociation is connected to sex, you might go into freeze or shut down mode.
The behavioral consequence of these emotions may be a tightening or a clenching of the body, bracing for impact, which exacerbates pain that is experienced during sex. That is how the physical and the psychological become connected when it comes to sexual pain.
An additional factor that may play into the psychological component of pain during sex would be social/cultural narratives. For example, someone may have grown up in an environment where there is cultural or religious shame around sex, leading to conflicting emotions around sex as an individual.
We also live in a more patriarchal society in which penetrative sex is what comes to mind when people think about sexual intimacy. One way of working through this would be to expand your definition of sex that includes non-penetrative acts.
How to Reduce Pain During Sex
Something important to understand is that you’re not alone in this experience and you are not broken. Rest assured that there is relief and pleasure to look forward to after treatment. There are many different ways to manage, cope with, and treat pain during sex.
One of the best ways to cope with any type of pain is to talk about it. When people don’t talk about things that trouble them, it may lead to further shame, loneliness, depression, feeling broken, or embarrassment. Here are additional ways to process your experience:
- Seek out emotional support via a therapist, coach, or a sex therapist
- Seek out medical support via a gynecologist, urologist, or pelvic floor physical therapist
- Use of a water soluble lubricant or silicone-based lubricant to help manage vaginal dryness
- Engage in more non-penetrative forms of sex
- Prolong foreplay or change in sexual techniques/positions
- Apply ice packs to the vulva after sexual intercourse. You can even create your own self-care/comfort package of your favorite snacks and soft materials to cuddle up with post-sexual encounter
- Find time to relax or de-stress via meditation or pelvic floor breathing. exercises prior to sexual encounters
- Healthy communication with your partner
- Self-compassion
- Use of dilators
- Vaginal creams
- Topical estrogens or antibiotics
Talking about sex can be uncomfortable but know that you don’t have to live with sexual pain. Seeking out support is a sign of strength, and you do not have to travel down this path alone. Learn how to become your own advocate and know that the right solution is out there for you, and that it is not a “one-size-fits-all” approach. Life is too short to not have the kind of sex that you want to have.
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