Experiencing pain during intercourse is very common. Nearly three quarters of womxn have pain during intercourse – medically termed dyspareunia – at some time during their lives. For some womxn, the pain is only a temporary problem; for others, it is a long-term problem.
There are a lot of potential causes of dyspareunia. It can be related to an underlying cause that needs to be treated.
- An infection, like pelvic inflammatory disease or a yeast infection.
- Endometriosis, which can be especially worse around the time of your period, but if left untreated, can cause pain all the time.
- Lichen sclerosis, a skin condition treated with topical steroids.
- Vaginal atrophy due to lack of estrogen, which is most common in the population of women after menopause.
But sometimes after seeing multiple doctors and ruling out those common causes, you’re still left with pain during intercourse. That’s when we often end up using terms that describe the symptom, rather than the underlying cause:
5. Vulvodynia, which is chronic, otherwise unexplained pain at the
opening of the vagina, or
6. Vaginismus, the involuntary spasming of the pelvic floor muscles.
These issues, when present for a while, fall under the term chronic pelvic pain.
Treatment of vulvodynia and vaginismus requires ruling out and treating any other underlying cause, but sufferers can benefit from a multi-disciplinary approach. One approach suggests re-wiring the brain to stop interpreting normal touch as painful.
This includes cognitive behavioural therapy, mindfulness meditation, sex therapy, pelvic floor physiotherapy, along with medications to control muscle spasms, topical anasthetics, or even sometimes injections of pelvic floor muscles with Botox. It’s important to note that some of these treatments are only offered from pain specialists.
Another approach to treating vulvodynia and painful sex includes acupuncture. According to a study published in the Journal of Integrative Medicine, more than one-third of womxn report regular pain during sex. The study aimed to discover whether targeted acupuncture could improve womxn’s pain during sex.
The subjects were split into groups: One received generalized acupuncture two times per week for five weeks, the other received more targeted acupuncture to areas supporting the pelvic region. In the group receiving targeted acupuncture, reports of vulvar pain and dyspareunia were significantly reduced, and womxn’s self-reported scores suggested significant improvement in sexual functioning in those receiving targeted acupuncture versus those who received generalized acupuncture.
Couples who are trying to overcome painful sex might try a variety of positions in order to relieve pain. If a womxn’s pain is experienced with deep penetration, any position in which the womxn is on top and better able to control the depth of penetration is likely going to feel more pleasurable for both partners. Side-lying or spooning is another less-penetrative option. Avoiding penetration altogether and concentrating on mutual masturbation or oral sex can also be a satisfying experience.
If you’re experiencing chronic vaginal pain, you should know two important things: It’s not your fault, and there is help. See your family doctor to rule out any treatable underlying causes, and maybe ask to be referred to a pelvic floor physiotherapist. These specialists are trained in the pelvic floor muscles and structures that support your sexual function. They can help create an individualized care plan and help you get back to feeling more like yourself.