Why do some women feel pain during intercourse?

Pain during intercourse is a serious ailment that many women complain about. He can take his toll effectively by taking away the joy of sex and negatively affecting relationships. Why does sex hurt? Where does this ailment come from?

1. Dyspareunia is recurring pain or discomfort in the genitals before, during, or after vaginal penetration. It is caused by physical causes
2. Penetration and pain sexual dysfunction are recurring difficulties during sexual interactions involving penetration or potential penetration. Their cause cannot be entirely attributed to physical factors and mental disorders
3. Although medical classifications separate physical and psychological causes, in practice they often coexist and interact – explains sexologist Katarzyna Nicman
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Penetration pain

Penetration is often associated only with penis-vaginal intercourse, but the vagina can also be stimulated with other parts of the body or with erotic accessories. Oral and anal sex should also be considered. In non-erotic situations, penetration occurs during the insertion of a tampon, menstrual cup, or during a gynecological examination. Sometimes, unwanted pain is associated with penetration. It can affect the genitals (including the penis), pelvis or anus. In this article, I would like to focus on the difficulties of vaginal penetration of people with vaginas.

Pain may appear in various forms, e.g. dull, sharp, burning, stinging. It is located in the area of ​​the vagina (i.e. vagina), vulva (i.e. vulva) or pelvis. Although medical classifications separate physical and psychological causes, in practice they often coexist and interact.

What is dyspareunia?

Dyspareunia (based on the ICD-11 disease classification) is recurrent pain or discomfort in the genitals before, during, or after vaginal penetration. The causes are physical. Some of them are:

1. infections and inflammation
2. allergies (e.g. to latex condoms, washing powder, intimate hygiene liquid)
3. vulvodynia (e.g. vulvodynia – chronic pain in response to or independent of touch, not caused by any known medical cause, so-called diagnosis with exclusion)
4. scars and adhesions of tissues in the pelvic area
5. disorders of the tone and / or elasticity of the pelvic floor muscles
6. endometriosis
7. ovarian cysts
8. uterine fibroids
9. irritable bowel syndrome
10. genital cancer
11. genital radiation therapy, chemotherapy
12. changes in the tissues of the mucous membranes caused by menopause
13. anatomical structure

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Dyspareunia does not include the lack of vaginal lubrication. It is a common cause of pain during intercourse. It may occur in the case of too little arousal during the penetration attempt, but also in the case of diabetes, some drugs (e.g. antidepressants, contraceptives), hormonal changes.

It happens that difficulties arise when intercourse with people with a large penis. The vagina is very flexible and increases its volume under the influence of excitement, so it is worth taking care of it. A solution may also be to adjust the sexual position and / or use buffer rings on the penis. Actual anatomical mismatch is rare.

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What is Penetration and Pain Sexual Disorder?

Sexual pain-penetration disorder (based on ICD-11) is a recurring difficulty during sexual interactions involving penetration or potential penetration. They occur despite adequate sexual desire and stimulation. Their cause cannot be entirely attributed to diseases that adversely affect the pelvic area, insufficient vaginal lubrication, postmenopausal changes, and mental disorders.

Symptoms of sexual penetration and pain disorders may include:

1. Penetration difficulties including involuntary tightening or tightening of the pelvic floor muscles
2. ache
3. anxiety or restlessness about pain

The disorder is only recognized when the symptoms are a problem for the person.

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Factors that may influence penetration difficulties include:

1. past and / or present sexual abuse (rape, harassment, but also sexual activity despite the lack of genuine will)
2. negative beliefs about sex
3. fear of pregnancy
4. fear of sexually transmitted diseases
5. high and / or chronic stress
6. negative body image
7. difficulties in the relationship with your partner

How can you help with penetration difficulties?

Regardless of the causes of the penetration difficulties and the diagnosis, the help of specialists is possible. Always see your doctor first in order to rule out or find out any medical causes.

The basic tip to increase comfort in sexual penetration is to decide on it only when the person wants it and is aroused enough (before that, it is worth focusing on what is stimulating and pleasant for someone). It is helpful to use a lot of lubricant and to look for the correct body position.

However, in the case of more serious or longer-lasting problems, it is worth visiting a sexologist. It will help in getting to know your sexuality and your body, developing communication skills, and finding a way to increase sexual satisfaction. It is important that sexuality is not only associated with difficulties and that it is realized in harmony with a given person at that particular moment. Forcing yourself to do something, trying to overcome the pain by force makes it even more permanent or even deeper. There may be a lot of frustration, misunderstanding, and a feeling of helplessness, so it is important to talk. Sometimes couples therapy is beneficial.

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If there are psychological and / or relationship problems, psychotherapy may be the solution.

Increasing importance is attached to the role of urogynecological physiotherapist. It affects the surface tissues, for example, to desensitize them, but also the muscles and fascia, especially in the area of ​​the pelvic floor. He has methods of working directly through the vagina, but also other methods, so they can be adapted to the needs and capabilities of the patient. Sometimes, after a while, the physiotherapist may turn on the use of dilators. Their use is individually discussed. As a sexologist, I also suggest using them in a sexual context (it does not have to be penetration). I believe that positive associations redirect attention from the problem to getting to know yourself, being good to yourself and seeking pleasure. I think that it also supports the subjective and respectful treatment of oneself during the physical therapy exercises themselves.

I also see the importance of working with the body to increase awareness, acceptance and feeling. The basic tools are mindfulness, breathing and movement.

In conclusion, it is worth reaching for the help of specialists. This is very important when the cause is a disease and / or the person wants to increase their comfort and satisfaction in sex life.