Painful Sex Is Not OK

One in five women experience pain with sex, but most are too embarrassed to talk with their doctor, or confide in a friend.  But want to know the good news? Painful sex is very treatable!


What Can Cause Painful Sex?

Sex can hurt for a whole lot of different reasons, but here are some of the more common causes:
  • Skin conditions of the vulva (skin outside the vagina) such as Eczema or Dermatitis, or vaginal infections such as Thrush
  • Not enough vaginal lubrication, which can be caused by hormonal changes with menopause or after childbirth, or by not being ‘turned on’ enough
  • A condition called Vaginismus, which is spasming of the pelvic floor muscles, ‘blocking’ the vaginal opening and making it very painful (or impossible) for anything to enter, such as a tampon, a penis, or a speculum when having a pap smear
  • A condition called Vulvodynia, which involves increased sensitivity in the skin, nerves, and/or muscles of the vulva and vagina
  • Other medical conditions such as Endometriosis and Adenomyosis

Sex, Pain And The Brain

Painful sex can often begin with a physical cause, like a thrush infection, but continues because of changes in the brain.  A vicious cycle can quickly develop from a painful sexual experience. Your brain is constantly on alert, looking out for danger and analysing messages from the body carefully. 
If your brain decides there is a threat or danger, your brain produces pain and muscle spasm to protect you. Ongoing experiences of painful sex further reinforce the brain’s sense of danger, leading to anticipation of pain, increased anxiety and spasm of the pelvic floor muscles. 
You may have thoughts like “I’m not normal”, “I’m not a good partner”, “I’ll never be able to have a baby”, and “My partner may leave me / find someone else if I can’t have sex”. These thought patterns make the vicious cycle even worse.

Pain: The Passion Killer

If sex causes pain, it’s natural to avoid it and for your libido to drop, meaning you experience reduced or even no desire for sex. You may find it very hard to relax and enjoy any intimacy such as a gentle caress or a simple cuddle on the couch. Despite wanting to remain close, you may find yourself withdrawing from your partner - a figurative “brick wall in the bedroom”. 
It can be really difficult talking about this with your partner, finding the right words to explain how you feel both physically and emotionally. It’s not uncommon for feelings of guilt, shame, inadequacy, and resentment to surface.

Who Should I See To Get Help?

Your first port of call should always be a GP. If you are too embarrassed to speak to your regular GP, finding a GP with a special interest in women’s health is a good option.  
Once you have a diagnosis, a team approach to recovery works best. The team may include a doctor, a pelvic floor physiotherapist and a sexual counsellor. Research tells us that this approach to treatment gets the optimal results.

How Can A Pelvic Floor Physio Help?

To successfully treat sexual pain, a Physio will treat the tissues of the body (the skin, nerves, and muscles), but must also work with the brain, exploring your thoughts, feelings, and beliefs about sex.  They will help you to relax tight pelvic floor muscles, and reduce anticipatory spasm and anxiety associated with intimacy and vaginal penetration.

Don’t Put Up With It

Remember, you are not alone.  Sexual pain is very common, and very treatable.  Don’t put up with it.  Seek help and you will be surprised – sex can be fun and enjoyable!
November 2018
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Women's Pelvic Health -
Pelvic & Sexual Pain



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