Ask the Loveologist: Pain With Sex
I have been experiencing pain with sex for months now. It has gotten to be so painful that I dread saying yes even though I love my partner and want to have good sex with him. Even with my own natural lubrication and when I am really aroused, I still get this intense cramping. I haven’t talked to my doctor about this because it felt so awkward. Any ideas about what I can do?
Questions and fears about pain during sex are very common because this condition affects two thirds of all women at some point in their lives. Generally diagnosed as dyspareunia, a medical term which comes from an ancient Greek word that means “difficulty mating,” this condition was described in ancient Egyptian medical literature. Probably all women suffer some form of dysparuenia at some time in their reproductive lives. It is hard to say, because like you, more than half the women with this condition don’t talk to their physicians and many physicians also fail to engage their patients about their sex lives.
The most common symptom is pain on entry. The second most common symptom is deep pain. Other common symptoms include feelings of muscle spasms, cramps, or muscle tightness. There are some solutions that you can try at home, but if the problem persists, a conversation and exam by a good gynecologist should be scheduled. The exam, not unlike an annual exam will give your doctor a chance to check for medical issues that are treatable that could be causing the pain. Ovarian cysts, urinary tract infections, and endometriosis are all commonly associated with painful intercourse. Other common culprits that interfere with sexual satisfaction are yeast infections and genital herpes.
Other diagnoses that cause pain with sex are vulvodynia and vaginismus. These disorders, which cause itching, burning and spasms of the vaginal muscles are not well understood, although they impact over 16 percent of all women. The interaction between mind and body reigns supreme when it comes to sexual health. The association of pain and sex can and often does create problems of its own, resulting in a stress and tension response that makes sexual arousal hard to find. Many women get caught in a cycle of experiencing pain and then expecting pain which makes the vulnerability of sexual intimacy difficult at best.
Painful sex is never just in your head. Yet there is a great deal of negative attitudes about sex and misinformation about sexual functioning that can contribute to the experience of pain with sex. Pain with sex can be a mental health issue which is just as valid and treatable as a physical one. As challenging as it may be to discuss sex, the alternative is sure to exacerbate the issues you are having. Talking to your partner and/or your health care provider is an important first step to solving the problem.
For many women with pain at entry problems, the fix can be as simple as using good quality lubricants and making sure you are aroused before penetration. Many women have sensitivity to the petrochemical based lubricants on the market and switching to a natural product can be enough to solve the problem. For deeper penetration issues or pain that happens in the midst of sexual activity, sometimes all it takes is a change of position so that your sexual organs are better aligned and the thrust doesn’t bump uncomfortably against the cervix or an ovary. Try being on top where you have more control over the depth and direction of the thrust.
Sometimes women will experience pain during or after intercourse if they haven’t climaxed also. Just like the classic “blue balls” that men will get, if the blood rush to the pelvic region does not dissipate with the release associated with orgasm, she can be left with pelvic congestion that can feel like cramps or a dull ache.
Dealing with the many forms of sexual dysfunction that both men and women experience in their lifetime is no different than taking care of other aches and pains that come and go in the body. Honoring your right to a sexually healthy lifestyle means that doing nothing when faced with painful intimacy is not an option.
Wendy Strgar is a loveologist who writes and lectures on Making Love Sustainable, a green philosophy of relationships which teaches the importance of valuing the renewable resources of love and family. Wendy helps couples tackle the questions and concerns of intimacy and relationships, providing honest answers and innovative advice. As her online presence continues to grow, Wendy has become a trusted and respected source of information on lasting and healthy relationships. “I feel like I am inventing a language to give intimacy back to the people, take the fear away and open a space for physical love to serve as the glue that holds relationships together.” Wendy lives in Eugene, Oregon with her husband, a psychiatrist, and their four children ages 11-20.