Sex should be a pleasure. An intimacy shared and enjoyed between two willing, interested partners. But what if you’re mentally agreeable, although physically… scared? If you’ve experienced painful intercourse, you have every right to be hesitant, and may even be actively avoiding sex. Painful sex can insert a blockade into your relationship and leave both you and your partner frustrated.
Why is sex painful?
There are several possible root causes of painful sex. Discomfort can be due to vaginal dryness (yes, even for women who are way too young to be experiencing menopausal symptoms) and can often be solved with lubricant. Low levels of estrogen could also lead to vaginal dryness, so if you’re experiencing this challenge over an extended period of time, it’s wise to consult your doctor and explore the root cause further.
Pain during sex can also be a symptom of vaginismus, which is an involuntary tightening of the vagina, even if you’re aroused and interested in penetration. It’s possible that stress is causing this reflexive response, and you may need to “retrain” your vaginal muscles to relax. Pelvic floor and kegel exercises are a good first step, but if you’ve tried to strengthen these muscles and are still experiencing painful sex, it’s best to refer to your doctor, who can examine you and determine the medical course of action to investigate the root cause.
Have you been diagnosed with endometriosis? If so, you likely experience pain during your period, but sex can trigger the discomfort as well. Anti-inflammatory painkillers might do the trick, but if not, check with your doctor to investigate hormonal medications which might help.
What if it’s uterine fibroids?
If you’ve been diagnosed with uterine fibroids, the fibroids themselves are the most likely culprit. According to a study by the International Society for Sexual Medicine (ISSM) 22% of women with uterine fibroids experience what is called deep dyspareunia, an intense, vaginal pain during intercourse.
When a uterine fibroid is present in the cervical area, vaginal penetration may cause a direct, sharp pain, making sex nearly impossible to enjoy.
It is important to note that while a correlation between deep dyspareunia and uterine fibroids has been shown, a direct causation has yet to be proven.
If it’s Fibroids, What Can Be Done?
Regardless of the source of pain during sex, it’s best to get examined by your doctor. In the interim, you might want to consider changing sexual positions. When you think about it, this is a logical temporary solution – if there is a foreign body (a fibroid) causing pain, shifting weight or changing angles could lessen or eliminate the pain.
Dyspareunia can be more of a problem at some points of your monthly cycle than others. Pay attention and document your month so you can determine whether you can predict your most comfortable times. If this describes your situation, your best course of action might be to have sex only during your pain-free weeks.
Also, investigate what soothes you! Painful sex can stem from the connection in your brain between painful intercourse in the past and the potential for pain in the future – it’s only natural to be hesitant to engage in sexual activity, tensing up automatically, since you’ve learned to expect pain. You may be able to train that sequence out of your brain by listening to relaxing music, by getting an indulgent foot massage from your partner, or through the practice of extended foreplay.
Treating your fibroids should also help alleviate the problem. These days, there are more and more options for treatment from medications to procedures, and the best way to determine your preferred method of treatment is to arm yourself with information.
Pain during intercourse isn’t a symptom to ignore. Make sure to talk to your doctor, and in the meantime, try some of these options so you can enjoy intimacy and a meaningful connection with your partner.