What Is Painful Sex
The medical term for painful sex is dyspareunia, which is “painful penetrative sex,”. It can be any pain associated with sex, so that means pain with first insertion of a penis into the vagina or when it is deeper in the vagina, or both. Dyspareunia is extremely common: almost three out of four women have pain during intercourse at some point in their lives. For some women, it’s a temporary problem, but others cope with it long term.
According to a 2017 study, dyspareunia is more common in younger women (age 16 to 24) and older women (age 55 to 64) as opposed to those in middle-aged groups. But “morbid pain” — defined as pain that occurs very often or always, and causes moderate or intense distress — occurred more frequently in the older group. Menopause is a major contributor to this phenomenon. While estimates vary, anywhere from 17 to 45% of postmenopausal women say they have painful intercourse.
Older women can have some additional reasons for having painful sex than younger women due to decreasing levels of estrogen. The vagina can be drier than it was, and the tissue within the vagina can change, which can make sex more uncomfortable.
It can be hard for older women to get diagnosed with and treated for dyspareunia. Some are embarrassed to talk about sex or problems that they are having with sex — and this includes pain — because they feel that they are too old to have sex. Much of the attitude about sexual activity in older women is rooted in society prizing younger female bodies over older ones. It also shows the lack of representation of older women and older female bodies participating in and enjoying sex.
Why Is Painful Sex a Taboo Topic
If speaking about sex in general is hard to do, speaking about problems with sex is even harder, say women. Aside from the pervasive cultural taboos, normalisation of pain during sex may be another reason women are reluctant to discuss dyspareunia with their doctors or anyone else. Most often doctors come across this problem while taking a patient’s medical history and asking them questions about their sexual health . Most women tend to think that it’s okay to have pain with sex and that it is something that a woman needs to ‘just get over.’ They ignore many of the physical reasons why sex can be painful for them.
If speaking about sex in general is hard to do, speaking about problems with sex is even harder, say women. Aside from the pervasive cultural taboos, normalisation of pain during sex may be another reason women are reluctant to discuss dyspareunia with their doctors or anyone else.
There’s a many reasons intercourse may be painful for women. Pain on insertion (otherwise known as “entry pain”) may be due to a lack of lubrication, injury, irritation, inflammation, infection, or a condition called vaginismus which involves involuntary spasms of the vaginal wall.
Additionally, congenital abnormalities, such as a blockage of the vaginal opening, could make insertion painful. “Deep pain” is the term for dyspareunia that occurs with deep penetration, which can be caused by pelvic inflammatory disease, scarring from surgeries, and/or medical treatments such as radiation and chemotherapy. Emotional issues — psychological trauma, stress, a history of sexual abuse — can also contribute to the development of dyspareunia.
It is Important to Talk About Dyspareunia
Some people don’t want to talk about painful sex, because they don’t want to make their partner feel responsible for it, or for themselves to feel less of a woman. But if you don’t speak up, not only will you continue to suffer, but your relationship can suffer as well.
Sex is one of the ways that you can form a connection with your partner. If sex is painful, you may not enjoy it when you have it or you may begin to avoid it all together. Without open conversations with your partner and a doctor, you are likely never to find a solution and also jeopardize your relationship and self esteem.
Dyspareunia is extremely common: almost three out of four women have pain during intercourse at some point in their lives. For some women, it’s a temporary problem, but others cope with it long term.
For some people — particularly those who may have been raised to keep quiet on the topic of sex and older individuals who feel shame around even having sex — speaking up can be scary. If you are struggling to talk to your partner about it, consider getting help from your doctor in addressing this issue along with your partner.
Diagnosing and Treating Painful Sex
When it comes to diagnosing dyspareunia, there are several steps involved. In most cases, a medical professional will take a thorough health history and ask questions about the pain, including when it started, how often it happens, and whether certain sexual positions prompt it.
A pelvic exam can help a doctor look for signs of infection, irritation, or anatomical issues that may be causing dyspareunia, and a visual exam of the vagina can also help with diagnosing any obvious physical reasons for the pain. In some cases, other tests, such as a pelvic ultrasound, may be necessary to make an accurate diagnosis.
In terms of treatment, there are many options available. If an infection or medical condition is at the root of dyspareunia, medications may be necessary to help resolve the problem. For postmenopausal women, this might mean using a topical cream on the vaginal area to address declining estrogen levels and help improve lubrication. In some cases, an over-the-counter lubricant may do the trick.
If dyspareunia is due to discomfort associated with vaginal dryness, personal lubricants will help alleviate the discomfort.
In other cases, desensitisation therapy (which involves learning relaxation exercises) or visiting a sex therapist or counselor can help treat dyspareunia. Pelvic floor physical therapy which may involve working with an expert to stretch and strengthen certain muscles may help as well. But the first step is speaking up about painful sex. You can’t get help for it if you don’t ask for help.