Dyspareunia: When Sex Hurts

Dyspareunia, or painful sex, is a lot more common than most women think, yet it’s rarely talked about.

Sadly, the sense of shame that shrouds this condition keeps many women from reaching out and getting help.

It can be a lifelong problem or something brief or recurrent, and there can be a whole host of issues contributing to the pain that someone is feeling. It’s important not to suffer in silence – everyone deserves to feel good about their body and their sexuality.

Here are two important things to know about painful sex:

1) Pain can be caused by many things

Pain can be caused by many things, and you owe it to yourself to try to figure out what’s causing it.

Not enough lubrication can cause painful friction or burning, stinging pain after sex, as can the wrong lubricant, so don’t continue using something that might be irritating your delicate genital skin. Experiment with different lubricants or try something made for sensitive skin.

Different bodies fit together differently so sometimes certain sexual positions can be uncomfortable if the cervix is being bumped or hit. Experiment with different positions or supportive pillows or wedges. Sometimes a small re-adjustment in position can have a big impact on pain.

Things like pregnancy or certain medical conditions or medications can change the way your body feels and make things you previously enjoyed feel bad. Talk to your doctor and see what the options are to accommodate your situation.

Sometimes the muscles of the vagina and pelvic floor spasm, causing any kind of penetrative sex to feel very painful. This is called vaginismus, and is a more complex reason for painful sex. It can be overcome with things like physical therapy for the pelvic muscles and training with devices known as vaginal dilators.

2) Don’t grit your teeth

Don’t grit your teeth through painful sex. Stop forcing yourself to put up with pain during sex.

Your brain is a big part of your sexual experience and it can have a big impact on how much pain or pleasure you feel during sex. Every time you teach your brain that sex is a bad feeling by putting up with painful sex it affects the way you feel about sex the next time you have it, which is turn can make it a more negative experience and set the stage for it to be even worse the next time. Don’t get sucked into this vicious cycle.

Whether or not you see a health care provider to help you figure out what is causing your pain, you are NOT obligated to have sex that you don’t enjoy. Some activities may simply be off limits if they cause you pain, maybe just for now while you sort things out with your doctor or physical therapist, or maybe for good.

Seek out what gives you pleasure and re-train your brain’s response to sex. You may also need to re-envision what you and your partner consider to be “real sex” while you figure it all out, but the simple fact is: it’s all sex if it involves our sexual feelings and sexual pleasure. You and your body deserve to feel good.

About the author

Michelle Cohen, MD

Dr. Michelle Cohen is a family physician trained in Toronto who left the big city behind for a quiet farm in the country. She has a family practice in Brighton, Ontario and works in the emergency department of Trenton Memorial Hospital as well as the sexual health service at the Haliburton, Kawartha Pine Ridge Public Health Unit. She is an assistant professor in the Family Medicine Department at Queen's University's Health Sciences Faculty. She blogs about farm life at www.evamaefarm.com/blog and can be reached via email. See all of Michelle's articles.