If you are reading this, it is possible that you have encountered painful intercourse firsthand. Alternatively, you may have a loved one confiding in you about an experience, and are here to better understand this. Understanding the underlying causes of painful intercourse can help one decide the best possible treatment option.
Does sex usually hurt?
Intercourse does not have to be painful for either partner. When engaged in healthy practices of sex (with plenty of foreplay and safety-creation!), it can be entirely painless and pleasurable.
However, certain conditions and underlying issues can cause intercourse to be painful and these often require professional and specialised interventions to heal.
What can lead to painful intercourse?
Pain during intercourse, or ‘Dyspareunia’ may vary in intensity, sensations, and locations. For some, this may feel like general discomfort, pressure, or tightness in the pelvic region. For others, they may experience sharp pain, or a dull persistent ache. There are various potential causes for Dyspareunia, including psychological and physical causes.
Psychological causes of painful intercourse often include deep seated fear, discomfort, or aversion to sex, which cause physical pain and tightness in the vagina. This often manifests in a condition called ‘Vaginismus’ in which the muscles of the vagina involuntarily contract upon any kind of penetration. This contraction makes penetration extremely painful and uncomfortable.
Physical causes of painful intercourse include:
- Anatomical causes: This includes dysfunction involving anatomical structures (including muscles and organs) that may lead to the sensation of pain.
- Hormonal causes: Imbalances or decrease in certain hormones may also lead to underlying conditions causing dyspareunia. This includes decreased estrogen, and endometriosis.
- Inflammatory conditions: These may include cysts, recurrent vaginal and pelvic infections, and other inflammatory conditions in the vaginal canal and the pelvic region.
- Physical injury: Physical injury, especially when unhealed, may lead to increased pain and discomfort during intercourse. This may involve perineal tearing during childbirth,, scarring due to C-sections or surgery, and the effects of radiation therapy.
- Other causes: Pain during intercourse may at times be due to other causes such as bowel issues, overall ill health, and other conditions involving pain around the vagina or pelvic region.
When should I seek help for painful intercourse?
It is always a good idea to seek professional support when experiencing pain during intercourse. This is especially important when one notices the following:
- Pain is persistent and prolonged
- Pain is increased in intensity.
- Physical symptoms of abnormal bleeding, pelvic pain, or urinary symptoms
- There is a general unease and fear of sex
- Significant impact on daily life and self-confidence
- Significant impact on intimate relationship
What can I expect when seeking help?
It is important to seek professional medical support from a health care provider specialising in treating dyspareunia. Professionals may administer tests and assessments to diagnose and identify the underlying causes of painful intercourse, after which appropriate treatment would be administered.
Treatment for dyspareunia depends on the nature of the underlying causes. Psychological causes are treated with psychological interventions which focus on addressing fears, healing unresolved conflicts, and creating safety and confidence. At Proactive for Her, we have a team of mental health professionals who are experts in treating this condition. Pelvic health physiotherapists address the physical symptoms accompanying painful sex, which includes body and vaginal training to help the body slowly adapt to penetration while experiencing comfort. We have expert pelvic health physiotherapists who specialise in helping women who are having challenges with penetrative intercourse.
Is healing possible? What is the ideal solution?
Healing and painless sex is definitely possible! It is important to remember that the journey to healing looks different for each individual, and your health provider may suggest an approach that is tailored for your condition. It’s important that you have a multidisciplinary team working together to optimize your health. Your gynecologist can help to identify any hormonal or medical conditions which may be contributing, your pelvic health physiotherapist will help address the physical symptoms, and your mental health therapist will help to address any fear or negative thoughts. Once successfully healed, intercourse can become entirely painless and pleasurable.
To summarise, painful intercourse, or dyspareunia, involves the experience of persistent and intense pain during sex. This may be caused by a number of factors which may be physical or psychological in nature. Treatment involves assessments to ascertain exact causes, and administering appropriate interventions, including medications, psychotherapy, and vaginal-training. Successful healing and treatment can lead to pleasurable and painless intercourse.
If you are experiencing any signs of painful intercourse, please do not hesitate to seek professional support from our team at Proactive For Her that specialises in treating dyspareunia.