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. 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 dryness 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 next steps.
What if it’s fibroids?
According to a study by the International Society for Sexual Medicine (ISSM) 22% of women with uterine fibroids experience what is called deep dysparenuria, an intense, vaginal pain during intercourse. The location of the pain will depend on where the fibroids are located, your age, how many children you have delivered and what your own mental state is. Additionally, women with other pelvic problems report higher incidences of dyspareneuria than those without these additional complications. It is important to note that while a correlation between deep dyspareneuria and uterine fibroids has been shown, a direct causation has yet to be proven.
When a fibroid is present in the cervical area, the sensation may be a more direct and sharp pain, rather than the deeper pain of dysparenuria. They can also become infected, causing further pain, bleeding and vaginal discharge.
What can be done about it?
Changing positions may be helpful. When you think about it, it makes sense. There is a fibroid, of whatever size, where there shouldn’t be anything, and shifting weight to another angle could lessen pain.
Dysparaneuria can be more of a problem at some points of your monthly cycle than others. If this may describe your situation, then time things accordingly.
Getting rid of your fibroids should also help alleviate the problem. These days, there are more and more ways to avoid invasive surgery. Medications have been developed (*check how that should be said*) that can entirely bypass the issue of surgery. Ask your doctor if you’re a candidate for this type of treatment.
What soothes you? Part of pain during intercourse can stem from the connection in your brain between painful intercourse in the past and the potential for pain in the future. 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.
Pain during intercourse isn’t a symptom to push aside. Make sure to mention this symptom when you visit your doctor.
