Sex Shouldn’t Hurt

Pain during sex is something I don’t think is discussed enough. 75% of women report having painful sex at one point in their life or other. 1 in 10 women report that sex hurts everytime. Frequently I have women come and see me and their partner’s have no idea they have been in pain. One of the shocking facts is that very often these women have been in pain a long time. Painful sex cannot be diminished to just a medical issue OR a mind issue. In my experience even if it starts out as a medical issues is always becomes a mind AND body issue.

The frequency of painful sex only increases when women suppress the pain and do not communicate their pain to their partner. This can happen even after 1 encounter. Their mind and body make a connection that sex is painful and often it repeats with each encounter. There are many issues that can make sex painful. Common conditions include:

Vaginismus

The muscles at the opening of the vagina become tightly contracted, making penetration impossible and any insertion painful.

Pelvic floor dysfunction: The tightening of the pelvic floor muscles can create a sore pelvis and can cause pain with insertion.

Vulvodynia

Chronic pain at the opening of the vagina, including soreness, stinging or burning sensations, rawness, itchiness, and pain during sex.

Endometriosis

With endometriosis, the tissue that normally lines the uterus grows in other areas of the pelvis, such as the ovaries, fallopian tubes, or intestines. This can cause pain during intercourse.

Infections:

Yeast, bacterial or sexually transmitted infections can cause pain during sex and individuals often experience discharge.

Ovarian Cysts

These fluid-filled sacs on the ovaries often have no symptoms but when they rupture, they can cause pain and bleeding.

However, these are not the only prerequisite conditions for painful sex. Many women can have painful sex due to lack of lubrication, anxiety, depression, pregnancy, after child birth, post hysterectomies, and other life changes.

Many women are hesitant to discuss this openly with medical providers. There is a high amount of shame surrounding this issue and it is not widely discussed in educational or health settings. This leaves many women feeling helpless, not knowing where to turn, and having intene feelings of isolation, shame, and depression. They start to avoid sex and it can erode their sexual intimacy and relationship satisfaction.

What to do if you’re feeling pain:

While medical intervention is necessary, often women AND their partner’s need to work with a sex therapist on these issues. When sex has been painful for a very long time, it often takes learning compassionate and nonjudgmental communication strategies, learning and implementing alternative sexual intimacy practices, and sometimes a mental reframing and expansion on the definition of sex and intimacy. Additionally, seeing a pelvic floor Physical Therapist can greatly benefit women in reducing pain.

If you are experiencing pain, please do not keep continuing with sex in silence. First, make your partner aware of your pain, then make an appointment with your OB/GYN, and if you are experiencing emotional distress in yourself and relationship seek out a sex therapist.

My biggest suggestion is do not carry this burden alone or jump to blaming yourself. You are not deficient and experiencing pain is not your fault.