Sex: what a pain!

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Are you having problems with painful sex? If so you are not alone! One of the most common referrals I get as a sex therapist is from women who are experiencing pain on penetration. So I thought I'd go through some of the most common questions I get on the topic!

Is it a case of no pain no gain? Should I just bear it…?

No!! So many women live with painful sex unnecessarily. Your body is designed for pleasure. Sexual activity should definitely not be repeatedly painful.

So why is it sore??

The main cause of pain on penetration is simply lack of lubrication.

This pain is stingy, itchy, burning and occurs on penetration, but can also leave you feeling uncomfortable in the vagina throughout the day.

The vagina normally produces its own natural lubrication as part of the arousal response, but sometimes this doesn’t happen.

Why?

Probably hormonal reasons. The vagina is drier at certain times in a woman’s cycle and post and perimenopausal women will experience more dryness even when they feel aroused.

Equally if you have dry skin, you are more likely to have a dry vagina. If you moisturise your body after a bath or shower then you should also be moisturising your vagina. Most women are surprised when I tell them this, but it makes sense. There are now vaginal moisturisers available in most pharmacies.

But I use lubricant and it’s still sore…

You might be using the wrong sort of lubricant. Try something water based and unperfumed. If no success with that then get an oil based lubricant and mix it with a little water based so as it absorbs better. Unfortunately a lot of the over counter lubricants actually mess with vaginal pH levels and so although they might work during sex you might feel dry and uncomfortable for a few days afterwards. I would recommend yes, but it’s really about experimenting.

Equally remember to put the lubricant in and around the vagina rather than putting it only on the penis. You can put a bit on your partner to make penetration easier, but not too much as if he slides too quick that might also be sore.

My pain is different than this….its a deeper, internal pain

Again, this is not uncommon and there can be medical reasons for this deep, almost cramping sensation, like endometriosis, so it is definitely worth going to your GP to get it checked out.

However more often than that this pain is caused simply because penetration is happening too quickly.

Women and men go at different speeds and even though women might be more informed about their bodies and pleasure, the reality is heterosexual sex is still male lead. What I mean by that is when the man has the erection, he tends to penetrate, but men can get erect in only a few minutes whereas a woman’s readiness can take a lot longer. The issue is that we can’t see when we are ready and even if we feel it in our minds, our bodies might be one step behind.

One sign that you are ready for penetration is that your vagina has lubricated and feels wetter, but also the vagina expands internally and your uterus elevates to make room for the penis. This can be a little harder to sense!

I think my partner is too big… or maybe I am too small?

The vagina has a lot of a room, remember a baby’s head can get out of there! So pain on penetration is very rarely a case of the penis causing pain because it is too big, but what can happen is the penis bumps off the uterus. This can be sore during and after sex if there has been some internal bruising.

If this is happening then more foreplay is probably the answer and go easy on the lubricant because it makes the entry deeper and faster.

Equally you can change positions; missionary is better for woman who have trouble with deep pain.

Nope, my pain is another sort… the penis can’t even get in.

Okay…well that could be vaginismus; another type of sexual pain that is becoming more frequently identified and reported.

For some women it is lifelong and they have never been able to use a tampon or smear test let alone have penetrative sex, but for other women it occurs because sex is painful and when they emotionally brace themselves for a painful experience, the vagina physically braces itself by closing up to prevent the pain.

Vaginismus can be quite easily treated; I have a 90% success rate with it. It’s particularly well treated with psychosexual therapy input.

I think I’d like to know more….

If you have been experiencing sexual pain it might be worth coming in and having a chat so that we can work out where to go from there. If you have a partner, normally I encourage joint sessions so feel free to bring him or her in.


Linsey Blair is Psychosexual & Relationship Therapist at Strive Clinic Galway.

Linsey can help with many sex or relationship challenges including painful sex, loss of desire, premature ejaculation, sex after sexual trauma, sex addiction, lack of sex, anorgasmia, arguing, affairs, separation or divorce. 

If you are not able to make it to our clinic in Galway to meet with Linsey, you can also have an appointment online via our secure online telehealth platform, Strive At Home