Let's Stop Normalizing Painful Sex
The mood is set, the moment is right, and you are with someone that shares amazing sexual chemistry with you. There's just one problem--Dyspareunia, or painful sexual intercourse, occurs, dampening the mood for you and making the experience lackluster. Dyspareunia affects 3-18% of individuals, regardless of gender, though it occurs more commonly in people with vulvas. According to the American College of Gynecology, approximately 3 out of 4 women will experience dyspareunia during their lifetimes.
What Causes Painful Sex?
Dyspareunia can happen for a variety of reasons, including:
Medical conditions like endometriosis, ovarian cysts, uterine fibroids, interstitial cystitis, pelvic organ prolapse, or the position of a person's uterus
Hormonal changes, such as those occurring during menopause or the postpartum period or as a result of hormonal contraception, can contribute to vaginal dryness
Vaginismus which is when the pelvic floor muscles involuntarily spasm in response to penetration
Vulvodynia which is chronic vulvar pain that lasts more than three months
Hypertonic (tight) pelvic floor muscles
Skin conditions like Lichen Sclerosus or painful scarring from perineal tearing or episiotomy as a result of birth trauma
Orthopedic issues include hip or pelvic pain related to osteoarthritis, pubic symphysis dysfunction, chronic low back pain, etc.
Experiences of sexual trauma, perceptions about sex, and sexual shame
A Medical Treatment Option For Painful Sexual
Dyspareunia is complex, and often, people who experience it benefit from a team approach from medical professionals, which may include input from a gynecologist, primary care physician, urologist, pelvic floor therapist, and mental health counselor. If you are experiencing unwanted pain with sexual activity, your first step may be to speak with your primary care doctor or gynecologist, who may refer you to pelvic floor therapy.
Pelvic floor physical therapists help to identify musculoskeletal factors that contribute to dyspareunia. They create treatment plans to address these factors and educate patients with dyspareunia about managing these symptoms independently.
Here are four strategies that you should consider if you are experiencing painful intercourse:
1) Medical Tools To Help Ease Pain During Vaginal Penetration
Vaginal dilators can be an excellent option for some people with vaginismus. They are used to decrease the nervous system response that can occur in response to vaginal penetration. They are best used in consultation with healthcare providers. Also, an excellent book called "Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve" by Heather Jeffcoat thoroughly explains how to use dilators. The vaginal dilators I like to recommend are the Intimate Rose Vaginal Dilators, and the Intimate Rose website features several instructional videos on how to use dilators. If you use code MARYSA1 at check out, you will get $5 off your vaginal dilator purchase. The Intimate Rose website features several instructional videos on how to use dilators.
Additional Recommended Vaginal Dilators:
Another tool that can help with the pain that occurs during penetrative sex is therawands. Therawands are pelvic wands utilized to massage the superficial and deep pelvic floor muscles.
Lastly, a medical tool called the Oh-Nut, slides over the base of a person's penis, creating a barrier to limit penetration depth, which is excellent for people who only have pain with deeper penetration.
2) Lubricants Help Eliminate Sexual Discomfort
Water-based lubricants wash off easily and can be used with silicone-coated toys but may require reapplication. I frequently recommend Slippery Stuff, Sliquid H2O, and Ah! YES WB water-based lubricants. Silicone lubricants are long-lasting; however, they cannot be used with silicone-coated toys. I recommend Uberlube and Sliquid Silver silicone lubricants. Smitten Kitten has a fantastic guide for helping you find the lubricant that may work best for your needs.
3) Daily Stretching Can Relax Muscles Connected To Painful Sex
Several yoga poses can help relax the pelvic floor, hip, and trunk muscles. I often recommend:
Happy Baby
Wide Child's Pose
Cat and Cow
Yogi Squat
Figure Four pose or Half Pigeon pose
Supine Cobbler
Forward Fold
Supine twist
These stretches can be modified to suit your needs and level of flexibility, and with each of them, the goal is to find a depth where a comfortable stretch can be felt, in which you are not experiencing pain and can breathe comfortably. Dr. Bri's Vibrant Pelvic Health page on YouTube is one of my favorite resources to recommend, as she is a pelvic floor therapist with a host of informational videos.
4) Practice Mindfulness and Bodily Awareness
When sex is painful, a person's body may involuntarily create tension when sexual activity begins. You may find it helpful to perform a body check-in, during which you identify if and where you are carrying tension. Body check-ins are a quick way to develop mindful awareness of what is happening in your body. Common places for tension are the abdomen, hips, and jaw, which can increase tension in the pelvic floor muscles. Before intercourse, try two minutes of diaphragmatic breathing, body scanning, and pelvic floor stretches. If you begin to experience pain with penetration, have your partner pause and check in with your breath, belly, bottom muscles, and jaw.
It's Common To Experience Painful Sex, But It Shouldn’t Be The Norm
Dyspareunia can feel isolating, but you are not alone, and help is available. Below are links to websites that feature provider directories for pelvic floor therapists if you are interested in pursuing pelvic floor therapy to address pelvic pain:
https://pelvicguru.com/directory/
Article Sources:
Tayyeb M, Gupta V. Dyspareunia. [Updated 2022 Jun 11]. StatPearls [Internet]. Published January 2022. Accessed November 9, 2022. https://www.ncbi.nlm.nih.gov/books/NBK562159/.
When Sex is Painful. American College of Obstetricians and Gynecologists. Published September 2017. Accessed November 9, 2022. https://www.acog.org/womens-health/faqs/when-sex-is-painful.
Smitten Kitten's Hassle Free Guide to Lubricants. Smitten Kitten. Published December 20, 2020. Accessed November 9, 2022. https://www.smittenkittenonline.com/blogs/smitten-kitten-blog/smitten-kittens-hassle-free-guide-to-lubricants/
Sex should never be painful so, don’t downplay what your body is telling you. Don’t be afraid of speaking to your primary care physician to come up with an action plan to make sex pleasurable and enjoyable. Therefore, part of Lala's Bedtime Tales mission is to provide a safe space and judgment-free zone to educate yourself on sexual health & wellness. The Sexual Health & Wellness corner will have monthly articles dedicated to continuous education on living a positive and sexually healthy lifestyle. Subscribe to Lala's Bedtime Tales Newsletter and follow @LalasBedtimeTales on social media to never miss any sexual education to help you live the healthiest life possible. Also, check out Lala's Bedtime Tales Podcast and Lala's Oh So Exclusive Patreon account for even more content! If you’re browsing for sexy pleasure products or cute giftable items, then check out Lala’s Pleasure Shop.
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