If you’re finding sex painful, you’re not alone: a whopping 30% of women reported pain during their last sexual encounter, according to the National Survey of Sexual Health and Behaviour. Here are the main reasons why it happens, and how to reduce it:
1. VAGINAL DRYNESS DUE TO LACK OF AROUSAL
We’ve all been there: you’re not in the mood and simply aren’t getting turned on. Lack of arousal is an extremely common cause of painful sex. Petra Boynton, social psychologist, sex researcher and agony aunt at The Telegraph says that lack of arousal is by far the most common reason for painful sex.
“I’m asked about vaginal dryness and pain due to lack of arousal every single day. Not a day goes by that I don’t get asked about it.”
When you’re not getting turned on and you don’t produce enough fluid for lubrication, the rubbing will cause friction, heat, and burning. This pain can last for hours, or sometimes days. Petra explains that women may get wet during foreplay but they don’t necessarily stay wet during penetration, and on top of that oral sex could even be making things even worse:
“Oral sex can cause even more irritation and often people find that strange as they think saliva can be used as lubrication. In fact, it’s not very good because it just dries and makes it sore. But the penetrative sex, either the rubbing of chaffing, dries you out. Or all the things that got you wet have stopped and although it may be enjoyable it may not necessarily be what women want.”
So what’s the solution to something that so many women experience? Petra suggests doing the things that you enjoy more, which may not be the penetration.
“There are always good reasons to why you are not getting wet and to change that requires you to find a bit more about your body, and for you and your partner to talk about it. It’s a barrier many women face.”
A simple remedy in this case may be the use of lubrication, which many don’t consider.
“Many women think that if you’re using lubricant you’re failing, like you’re cheating because it isn’t an organic response. Quite often I hear a lot of women say I was turned on but wasn’t wet enough and in that situation using a lubricant makes sense.”
2. Menopause and post-menopause
A survey by Menopause Matters, said that a staggering 88% admitted to experiencing vaginal dryness, and many are uninformed or too embarrassed to ask about it. During the menopause many women experience changes in the vagina (the blood supply, support, elasticity, sensitivity, lubrication and responsiveness of the vagina) that can cause a lot of discomfort. This is due to the lack of estrogen, which causes dryness and thinning of the vaginal tissues making sex uncomfortable and painful. Karen Morton, gynaecologist and obstetrician at Dr Morton’s – the medical helpline says,
“If you’re taking HRT, you shouldn’t really need anything else. But if for one reason or the other you aren’t, then put some estrogen cream, or an estrogen pessary, into the vagina twice a week. This will be plenty to keep the tissue well-nourished and healthy and resistant to germs.”
Your body goes through so many changes after childbirth and having sex may be the last thing on your to-do list. You may be tender from stitches after childbirth or just more tired and understandably not so keen, but Karen says many women don’t realise that when you’re breastfeeding you’re essentially menopausal and that’s why you don’t have periods.
“Breastfeeding effects your hormones, the levels of estrogen will be lower just like during menopause. So the vagina will be dry and undernourished, a bit like sandpaper. This can easily be treated by rubbing some estrogen cream to nourish it. In this case, lubricant will work as well.”
4. Vaginal tear
This condition effects women of all ages and it can be excruciatingly painful. Karen describes the condition as a split at the back of the entrance of the vagina, at 6 o’clock, or right down the middle of the entrance of your vagina.
“If you hold up your thumb and index finger, and tighten the skin between them the split feels like this. This skin will take the brunt of penetration when you are having sex, so you can imagine how painful this will be.”
Karen says you could always of had this split in your vagina, which becomes apparent the first time you have intercourse, sometimes it happens after childbirth when you have been stitched a little more tightly or sometimes it can occur later in life when you simply aren’t as stretchy as you were.A simple operation, called the Fenton’s procedure, which is done under a general anaesthetic, will take away that tight bridge. A cut is made at the vaginal entrance, vertically towards the rectum and then stitched horizontally. This widens the opening to the vagina.
“I do this operation more than any other I do, but it’s a very ignored condition. GPs tend to suggest lubricant, or perhaps suggest that is is psychological. No it isn’t, it’s an absolutely dreadful pain, almost like a paper cut.”
Vaginismus is a condition that causes your vagina muscles to involuntary spasm shut, making any penetration very difficult, extremely painful or simply impossible. And it isn’t just sexual encounters that it can occur, also inserting tampons, and gynaecological exams can be a problem.It seems to be mainly a psychomatic syndrome, which means that it’s your brain and not your body causing the issue. There are a lot of possible triggers for vaginismus, some factors include being stressed out and anxious, being taught a negative education about sex that emphasis fear and pain, previous sexual abuse, experiencing painful vaginal conditions such as a UTI, yeast infections or vulvodynia and thinking the vagina is too small.The good news is that it can be treated and how it is treated is dependent on the cause of it. The first step to take is if penetration is causing you pain, then stop doing it. If the cause is psychological, sex therapy could be recommended. This could be counselling or cognitive behavioural therapy (CBT), as well as treatments such as vaginal trainers and relaxation techniques.
If you have a deeper pain during sex:
Pain can also be experienced deep inside the pelvis. This could potentially be the following (all of which should be discussed with your doctor):
Endometriosis often affects the womb and surrounding tissues. It makes them very tender, particularly near period times. The pressure of the penis on an area of endometriosis may cause intense, deep pain.
Ovarian cysts can cause deep pain. Pain may also be caused if the tip of the penis hits an unusually positioned ovary.
Pelvic inflammatory disease (PID) can cause the tissues deep inside to become inflamed and the pressure of intercourse can result in deep pain.