Penetrative Pain & Discomfort
Why Pain During Sex Happens and What to Do About It
“Pain during sex, also known as dyspareunia, is more common than you might think. The important point is that there is conservative treatment out there for you and that the solution is not to ‘have a glass of wine and relax’ to reduce sexual pain. At Nurture, we’re here to break the silence, empower you with knowledge and guide you toward solutions that lead to empowered intimacy.”
Understanding Pain During Sex
Did you know that up to 1 in 5 women experience pain during sex at some point in their lives? You are not alone and fortunately, there is help available.
You may have come across words such as “dyspareunia” or “vaginismus” when searching the internet for answers. As of recent, these two terms fall under a new classification ‘genito-pelvic pain and penetration disorders, GPPPD’. We will discuss these terms and others in further detail in future blogs.
Studies have shown a lifetime prevalence of pain during sex to be around 28%, highlighting just how common this experience is. In a 2017 study by Mitchell et al., 7.5% of over 6000 sexually active women reported experiencing pain during sex, with a quarter of these individuals enduring frequent pain for more than six months. Postpartum experiences further emphasize the issue, with research by Banei et al. in 2020 revealing that 35% of postpartum mothers reported painful intercourse, an alarming 1 in 3. The prevalence rates were particularly striking: 42% at two months postpartum, 43% between two to six months postpartum and 22% up to a year postpartum.
Unfortunately, societal taboos surrounding pain during sex, menstruation, and other pelvic health concerns often lead to these symptoms being overlooked or dismissed. But this shouldn’t be the case. You deserve access to information, self-care strategies and the tools to manage your health confidently. More importantly, you have the right to feel empowered to advocate for your well-being when discussing these concerns with healthcare professionals. No one should have to navigate this journey alone.
Common Causes of Pain During Sex
There are many potential reasons you might be experiencing pain during sex. Some people have had these symptoms for as long as they can remember, this is referred to as primary pain. For example, you might have noticed discomfort the first time you tried to use a tampon. Others develop symptoms after a specific event, known as secondary pain. This can occur alongside an acute (new) infection, chronic conditions like endometriosis, a surgical procedure, an adverse life event, or postpartum recovery. In some cases, secondary pain may arise without any identifiable cause.
Pain can also be contextual, meaning it occurs only in specific scenarios, such as with certain people, in certain locations, or during specific sexual positions. Understanding the potential source of your symptoms can be a valuable step toward finding relief. Below are some categories to help you explore the possible causes of your discomfort.
Vaginal dryness, pelvic floor tension, endometriosis, nerve injuries.
Infection, inflammation, dermatological conditions (eg. lichen sclerosus, lichen planus). Hormonal changes associated with; menopause, pharmaceuticals, menstrual cycles or breast feeding.
Stress, anxiety, fear of intimacy, traumatic events (surgical, emotional etc), negative sexual experiences or challenges with body image.
Relational stressors, difficulty with communication about intimacy or mismatched expectations.
No or inadequate previous sex education, fear mongering regarding pleasure and intimacy or limited understanding of self pleasure.
The Body-Mind Connection
STRESS (mental, emotional, physical) can increase muscle TENSION which can in turn increase PAIN with attempts at penetration and thus further increasing STRESS and so the cycle continues. When the mind feels unsafe, the body responds with tension. Addressing both the physical and emotional factors can pave the way for relief.
Book RECOMMENDATION
Better sex through mindfulness – Lori Brotto
What to Do About Pain During Sex
The most important take home message from this information is that there is help out there in various formats, from at home self-guided courses to dedicated sexual health professionals. The route you take will depend on your personal preference, symptoms, severity, comfortability around the topic and budget or accessibility. Here are a few pointers to help get you started;
Seek Professional Help
General practitioner, gynae, urologist, endocrinologist, psychotherapist, physiotherapist or occupational therapist. All of these professionals work on managing pain. Depending on your specific concern, there will be a professional to support you.
Pelvic Floor Education:
When it comes to the pelvic floor, it’s not all about strength. We need to remember the value of length / flexibility and motor control through movement. Tip: If you are a clencher (jaw, bum, belly), this is a good indication that it is time to connect and learn to soften as this tightness could be the cause of pain during sex.
Lubrication and Vaginal Health:
Lubrication is wonderful, but not all of it is made equal, more on lube coming soon. If you have one that causes stinging / burning, its not the one for you (even if it says ‘natural’). Better yet, avoid those with colours, smells and flavours. Just like you lovingly moisturise your face and body, you may also need to moisturise your vulvar tissue, there are many options here, some hormonal and many non-hormonal, depending on your needs.
Communicate with Your Partner or Buddy
Communication and support is invaluable, you may find a therapist, accountability buddy, friend or partner to start a narrative with.
Self Help
If you are looking to begin your guided journey to pain-free intimacy from the comfort of your own home, I have developed the Pain to Pleasure guide just for you. Begin your self help here.
Breaking the Silence around Pain During Sex
