When Sex Hurts
Intercourse is meant to be a pleasurable and intimate experience, but for some, it is accompanied by pain and discomfort. Painful intercourse, medically known as dyspareunia, is a common issue that affects both men and women, however it is never normal. In this blog post, we will explore the various causes of painful intercourse, shedding light on the physical, emotional, and medical factors involved.
Lack of lubrication: One of the most common reasons for painful intercourse is inadequate lubrication. Several factors can contribute to the lack of natural lubrication required for comfortable penetration including, insufficient arousal, hormonal imbalances, medications, stress, or anxiety. Using water-based lubricants can assist with this issue, but finding a further cause may be necessary.
Vaginismus: Vaginismus is a condition characterized by involuntary contractions of the pelvic floor muscles that work around the entrance to the vagina. It can make penetration painful or even impossible. Vaginismus is typically caused by underlying physical or psychological factors. Treatment may involve pelvic floor therapy, along with other collaboration with other healthcare providers. A pelvic floor specialist can help determine if other providers need to be involved in the treatment plan.
Infections or irritations: Infections such as yeast infections or urinary tract infections can cause inflammation and discomfort in the vaginal area, leading to painful intercourse. Sexually transmitted infections (STIs) can result in pain during sexual activity. Proper diagnosis and treatment of these infections are essential to address the underlying cause.
Vulvodynia: Vulvodynia is a pain condition affecting the external genitalia, known as the vulva. It can cause burning, stinging, or sharp pain during sexual activity, among other symptoms. The exact cause of vulvodynia can vary among each person and sometimes involves nerve damage or heightened sensitivity. Treatment is typically multifactorial, pelvic floor therapy being one of the primary treatments.
Endometriosis: Endometriosis occurs when the tissue lining the uterus grows outside the uterus, often on the ovaries, fallopian tubes, or other pelvic organs. It can cause pain during intercourse, as well as during menstruation and other activities. Management may involve pelvic floor therapy, medications, hormonal therapies, or surgical intervention.
Post-surgical pain or scarring: Surgeries in the pelvic or abdominal area, such as hysterectomy or C-section, can result in scar tissue formation or nerve sensitivity, leading to pain during intercourse. Pelvic floor therapy can help address scar tightness and sensitivity.
Psychological factors: Emotional and psychological factors play a significant role in painful intercourse. Stress, anxiety, relationship issues, past traumas, or negative attitudes towards sex can contribute to discomfort. Mental health therapists along with pelvic floor therapy can help address these concerns and improve sexual well-being.
Postpartum factors: After delivering a baby, some women may experience pain during intercourse. There are several reasons why intercourse can be painful postpartum. However, every woman's experience is unique, and not all women will experience pain. Here are some common reasons for postpartum pain with intercourse:
Perineal tears or episiotomy: During childbirth, the perineum (the area between the vagina and anus) can tear or be intentionally cut (episiotomy) to facilitate delivery. The healing process can cause discomfort or pain during intercourse until the area is fully healed and rehabbed in pelvic floor therapy.
Vaginal dryness: Hormonal changes after childbirth, particularly a decrease in estrogen levels, can lead to vaginal dryness. Reduced lubrication can cause friction and discomfort during intercourse. Breastfeeding may also contribute to lower estrogen levels, exacerbating vaginal dryness.
Pelvic floor muscle tension: The pelvic floor muscles may be strained or weakened during pregnancy and childbirth, leading to muscle tension or spasms. This tension can cause pain during penetration.
Pelvic organ prolapse: After giving birth, the pelvic organs, such as the uterus, may shift or descend from their normal position. This condition, known as pelvic organ prolapse, can cause pain or discomfort during intercourse.
Psychological factors: The emotional and psychological adjustments that come with new motherhood can impact sexual desire and arousal. Stress, fatigue, anxiety, and concerns about body image or the baby's well-being may contribute to pain during intercourse.
Painful intercourse can have various causes, including physical, emotional, and medical factors. It is essential to have open and honest communication with your healthcare provider to identify the underlying cause and develop an appropriate treatment plan. If your healthcare provider does not take your symptoms seriously, consider scheduling an evaluation with a pelvic floor therapist to help determine the root cause of your symptoms. Collaboration with multiple healthcare professionals is sometimes necessary for complete healing. The therapists at Pelvic Wellness have extensive training in treatment of painful intercourse. If you need help finding a pelvic floor therapist in your area, refer to this blog.
Remember, you are not alone, and there are solutions available to help alleviate your pain and restore a fulfilling and enjoyable sexual experience.
