Ignoring Sexual Discomfort: There Is Hope
By Erinn Williams, LCPC
Experiencing pain during sex is a common problem that can affect anyone - and it’s more prevalent than you might think. Nearly 75% of women will experience pain during sex at some point according to the American College of Obstetricians and Gynecologists.
Just because painful sex is common, doesn’t mean that you have to accept or settle for it.
If sex is no longer a pleasurable experience, don’t stay silent. Speak up to your partner. Speak up to your therapist and speak up to your doctor. It’s important to understand that you are not broken and you’re definitely not abnormal if you are not enjoying sex due to pain or discomfort. This could be a one-time thing, on occasion, or a constant painful experience.
So, what do you do when sex isn’t enjoyable and causes more pain than pleasure?
A common misbelief is that sex is something that should be endured in order to have a healthy relationship.
Sex isn’t meant to be painful. When something hurts, it’s usually your body telling you that something isn’t working quite right. Often times, painful sex prevents us from being aroused or wanting to engage in sexual activity (alone or with a partner).
Most times, the symptoms and conditions associated with painful sex are not uncommon and the issues are treatable. This pain can be felt internal, external and/or emotionally, causing feelings of anxiety and an inability to enjoy sex altogether.
COMMON CONDITIONS RELATED TO PELVIC PAIN DURING SEX INCLUDE:
Dyspareunia (the general medical term for pain with sex). There are many potential causes including tight pelvic floor muscles, tissue quality issues and hormonal changes.
Vaginismus (contraction-like spasms in the pelvic floors felt in the genitals). This could be felt during any vaginal penetration (tampons, penis, fingers, sex toy, etc). Anxiety can also intensify these symptoms.
Postpartum & Postmenopausal Dyspareunia (recurring genital pain while having sex the first year after having a baby). Painful symptoms can also occur from dropping estrogen levels when a woman begins menopause.
Causes can differ when it comes to painful intercourse. Some feel pain during entry which could be associated with a lack of lubrication. It’s important to note (for both partners) that if there is a lack of lubrication, it doesn’t always mean that one partner isn’t turned on!
Injury, trauma or irritation could also be the culprit. Deep pain can occur with deep penetration. This might be felt more in certain positions. Certain illnesses and conditions such as endometriosis, uterine fibroids, ovarian cysts, irritable bowel syndrome and pelvic floor dysfunction (to name a few) can also be the cause.
Men can also experience pain during sex. Though less common, one survey found that 7% of men felt pain during the last time they had vaginal intercourse and 15% when penetrating their partner during anal sex. Infections, tight foreskin and prostatitis are just a few possible culprits.
EMOTIONAL FACTORS
The inability to enjoy a physical connection with a partner can also affect your mental health. Emotional factors such as psychological issues (think anxiety, depression, fear of intimacy, relationship problems) can be part of the cause. Did you know that your pelvic floor muscles also tighten in response to the stress in your life? A history of sexual abuse can also play a role.
Emotions such as fear, guilt and shame can make it hard to relax. When you cannot relax, arousal might become more difficult, resulting in pain. This stress can affect your desire to have sex.
Relationship problems with your partner can interfere with your sexual response. One partner may want sex more than the other and that’s okay. Additionally, issues like erectile dysfunction can make one (or both) partners anxious about sex, too - delaying orgasm and oftentimes resulting in long, painful intercourse for both partners.
THERE IS HOPE
Painful sex isn’t your fault and is 100% not something you have to endure. It can be uncomfortable to talk about, but you shouldn’t feel embarrassed to discuss your symptoms and pain. It is possible to feel confident again about enjoying sex.
Figuring out the cause of the pain can be an important step in helping fix the issue at hand, and ultimately, elevating your (pleasurable) sex life. Seeing an OB-GYN and Pelvic Floor Physical Therapist in addition to a Sex Therapist is a great start. Talking to your partner and making time for sex (with less distractions) can also help set the stage. Adopting sexual activities that do not cause pain (think oral sex or mutual masturbation) are great ways to jump in, too.
Treating painful sex can not only help your sex life, but boost your emotional intimacy and self-image at the same time!