Pain With Sex?

“Why can’t I have sex” or “Why can’t my wife have sex with me” depending on perspective, these are the most common Google searches for people who have pain with sex. 

 

Intercourse is very important to any intimate relationship and is what makes the difference between friendship and a parter but should not be painful. Research states that anywhere from 30-75% of women will experience pain with sex at least at 1 time in their lifetime. There are different reasons you may be experiencing pain. Pain with sex is termed dyspareunia and can be due to a multitude of reasons ranging from hormonal changes, aging, scar tissue or surgeries, emotional or sexual trauma, severe personal life stressors, inflammation, chronic pelvic pain disorders, etc. 

Vaginismus is another term you may want to be familiar with. Vaginismus is an involuntary muscle spasm of the pelvic floor muscles (see pelvic floor muscle blog). Vaginismus is commonly discovered on a person’s wedding night and can be difficult for both you and your partner. 

 

Although fairly common, there are ways to help manage pain with sex.

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Get a MD on your side:

Consulting a MD is very important regarding this condition because they can rule out any infections or other conditions besides the muscles. Once cleared they will typically refer you to a pelvic floor physical therapy; if not, ask for a referral! Throughout this journey, you will need to advocate for yourself! Don’t be scared of rejection, and trust your gut! If a MD does not have any options to help, make sure to get another opinion! 

 

Stretch:

Pelvic floor muscles are also hip muscles, so if you notice you have tight groin muscles, try a gentle stretching routine for the inner thighs! This can help minimize pain with initial penetration. 

 

Dilators:

Dilators can be helpful to slowly stretch your muscles. Typically, when starting dilators, the smallest one is utilized first and progress up towards larger sizes. Dilators help to stretch the muscles as well as help with exposure therapy to desensitize the vaginal region. Although it is important to recognize that they are not for all people-if having difficulty with them, make sure to consult your medical provider. 

 

What is all the hype about lube?!

Tissue quality whether  it be the skin or the pelvic floor muscles themselves, can thin or become dry over time due to hormonal changes, aging, scar tissue, etc. When these tissues are not as "plump" or lubricated, any type of friction around the genitalia can become more sensitive leading to pain. Just like you use lotion for your arms, it is important to be consistent and utilize recommended/ prescribed vaginal moisturizers, hormones, etc to help overall tissue sensitivity.

 

Why do I think it is just in my head?!

The brain is the biggest sex organ! This is why being in the right head space or addressing mental health concerns with a mental health therapist may be indicated.

 

If your brain starts to anticipate pain, this leads to muscle guarding or tightening prior to the act. This anticipation is fairly common with people who have pain with intercourse however, over time, this can become a habit that you may not realize. Stress management, meditation, as well as during foreplay think of all the reasons you are attracted to your partner as this can help ease the mind.

 

Pain with sex is multi factorial, and there are tons of things you can do to help with this! You are not broken. Check in with a pelvic floor physical therapist for customized treatment plans!