Is painful sex normal?
The short answer is a resounding “no”. While pain during intercourse might be prevalent, it certainly isn’t normal and shouldn’t be ignored. Unfortunately, painful sex (the medical term being dyspareunia) is quite common and many people who are assigned female at birth experience discomfort during sex for a multitude of reasons. As many as 75% of vagina owners will experience pain during sex at some point. For some, the pain is rare or happens only once, but for others, it’s persistent. The reasons can be both physical and psychological, which in turn can cause anxiety, fear, a drop in libido, difficulties within a relationship and much more.
Sex is supposed to be a pleasurable, fun and enjoyable experience for everyone involved. Unless you’re engaging in a pain kink or a form of BDSM, then painful sex, whether that be pain on penetration, orgasm or post-sex, should be something you seek professional support and investigation into.
While talking about painful sex can be difficult, there is absolutely nothing to be embarrassed about. Most importantly, you are not alone, and there are multiple ways to explore sex and pleasure if pain is a part of your life.
Understanding your pain
Problems around sexual pain can be multi-dimensional, and they can consist of issues that are happening on a biological, psychological, and interpersonal level. I believe knowledge and understanding about one’s sexual pain are important for numerous reasons. The first is that experiencing pain during any sexual activity can diminish the enjoyment and satisfaction derived from intimate experiences. If we have the right tools and knowledge, we can learn to address and manage our pain and gain a sense of authority and action to create healthy and positive sexual experiences for ourselves. Secondly, when we understand why we are experiencing pain and how our bodies respond to specific situations, we can have a more comprehensive and unique approach to our care instead of a ‘one size fits all’, which may leave some even more fearful and confused than before.
Understanding painful sex and where it’s happening:
Dyspareunia: Pain experienced just before, during or after sexual intercourse. Experiencing pain during or after sex could be your body’s way of signalling an underlying issue. It’s important not to dismiss it and seek attention if needed. Most common causes:
- Endometriosis / Adenomyosis
- PCOS
- Pelvic inflammatory disease
- Vaginal dryness
- Menopause
- Fibroids
- STI’s
- Lichen Sclerosus
- IBS
Vulvodynia: The main symptom of Vulvodynia is pain in and around the vulva. The pain may be there all the time, or it may come and go. It can happen on light touch, e.g. from sexual intercourse or tampon use and sometimes feels like burning and soreness in the vulva area. The exact cause of Vulvodynia is not known, but it could be in relation to any of the following:
- Irritation or over-sensitivity of the nerves
- Damage from childbirth
- Previous vaginal infections
- Changes in levels of hormones, such as oestrogen
Vaginismus: Involuntary spasms which make it impossible or difficult to achieve penetration. Vaginismus does not always have an obvious cause. Some primary reasons for Vaginismus may include pain avoidance, sexual anxiety, trauma history, fear and even relationship issues.
- Primary Vaginismus: when vaginal penetration has never been achieved.
- Secondary Vaginismus: when vaginal penetration was once achieved but is no longer possible.
The most crucial step to better understand your pain is seeking professional medical help. The treatment for painful sex depends on the cause of your pain, where it’s happening, when and also how often. One thing I recommend doing if you are yet to explore answers to your pain is to keep a diary with details of your pain, your menstrual cycle and even sexual activity and pain and other symptoms that might be present. This way, you are prepared to help your healthcare professional explore the correct route.
Unlearning and relearning how to explore pleasure
Growing up, most of us were taught to believe that sexual satisfaction, pleasure and orgasms were only achievable through penetration when in fact, between 70% to 90% of those with a vulva and vagina are unable to achieve orgasm through penetration alone. This is particularly important to acknowledge for those who experience painful sex as exploring sex outside of what society deems ‘real sex’ should be challenged, and exploring sex that feels comfortable for you, which might not include penetration, still counts as sex. Our bodies are covered in erogenous zones which make us feel good, and a lot of them we can derive pleasure and even orgasm from.
It’s vital to recognise unhelpful and outdated social messages around sex so that they can help us identify when they do and don’t work for us and what might be blocking us from embracing and exploring what feels good rather than what is expected. Remember, sex is about pleasure, not performance. Let’s leave that to the professionals.
Here are a few ways to explore pleasure when experiencing painful sex:
Continue to explore non-penetrative sex:
This might include making foreplay the main play. Extending foreplay will not only encourage and increase genital lubrication for comfort but removing expectations of penetration will allow your body to relax and focus on what feels good rather than what’s expected. Here, during non-penetrative sex you can incorporate your favourite toys, explore massage and even look into sensate focus exercises or guided masturbation with a partner.
Explore fantasies and other forms of arousal:
This might include exploring erotic reading and books, audio porn or visual stimulation. Many of us are not pleasure-focused; as a society, everything is rushed, and we have forgotten how to slow things down. Taking the time to become aware of pleasure for our own body can provide us with more control and power over what we like and what feels good. Consider pleasure outside the realms of sex to get you going by thinking about what pleases you, what you enjoy touching, eating, and smelling, for example. Begin to acknowledge pleasurable moments and feelings so you can begin to bring your awareness to this state of mind and being and bring that awareness into sex. It takes some practice, especially in the world we live in, but trust me, you’ll thank me later.
Mindfulness masturbation and self-focus techniques:
Stress has been shown to impact both the mind and body during sex, and having enjoyable sex is all about being present to give and receive pleasure. However, that’s easier said than done when you have just endured a long day at work and even had to balance that alongside pain. When we learn to become more aware of what’s happening in our mind and body, we can lean into the parts that relax us, make us feel good and even let go of distractions and worries. I highly recommend investing in the book Better Sex Through Mindfulness: How Women Can Cultivate Desire by Lori A. Brotto if you want to explore this more deeply.
Keep up with kegel exercises:
Your pelvic floor plays a vital role in sexual comfort in both men and women. Being able to contract and relax the pelvic floor helps to optimise the blood flow during sex and also helps to increase vaginal lubrication and comfort. Kegel exercises will help strengthen the muscles of the pelvic floor, vagina, and anal area. Which in turn will help decrease discomfort and help relax spasmed muscles. You can see a Pelvic Health Physio or do pelvic floor relaxation exercises from home.
Embracing your own normal
You deserve safe, consensual and enjoyable sexual experiences. If you encounter any discomfort or pain during sex, don’t hesitate to discuss it with your doctor, and always ask for a second, third and fourth opinion if you don’t feel satisfied, heard or acknowledged. Additionally, keep in mind that sex doesn’t have to involve penetration exclusively! If intercourse poses challenges, there are plenty of other ways to enjoy a satisfying and pleasurable sex life. The world is your oyster, and sex is supposed to be explorative, and it’s most undoubtedly adaptable to your needs.
