Pain During Sex: Causes, Symptoms, and Treatment

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Pain During Sex: Causes, Symptoms, and Treatment
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Pain During Sex: Causes, Symptoms, and Treatment

Pain during sex is more common than you might think, in many different forms. Each type of pain has a different scientific name. We list them all, and also discuss the treatment.

Genitopelvic pain

“Because all the different terms can be quite confusing, we are globally encouraged to use the term ‘genitopelvic pain’,” says pelvic floor expert Hedwig Neels.

“Genitopelvic pain stands for pain during sex. Sometimes it is more superficial pain, in others it is deep pain. It can occur during touching, penetration, or even during a gynecological examination. In some women, vaginal cramps occur, making insertion or sex impossible.”

Also read: What causes vaginal dryness and what can you do about it?

Appareunion

Apareunia is the physical or psychological inability to have sex. Inserting a tampon or finger is possible. Apareunia can manifest itself in various forms, including vaginismus.

Also read: Postcoital dysphoria (PCD): feeling down after sex

Vaginismus

With vaginismus, the pelvic floor muscles around the vagina automatically contract, making sex painful or even making vaginal penetration impossible. Even inserting a tampon is not possible in such a case. Vaginismus can be congenital, but can also occur suddenly, for example after an operation, childbirth, due to an infection or vaginal dryness, but emotional problems can also be the cause, such as anxiety, trauma or stress. The pain varies from mild to burning.

Also read: Anorgasmia: difficulty or inability to reach orgasm

Dyspareunia

Dyspareunia is a persistent or recurring pain just before, during or after sex. Some women only have a burning pain during penetration (also when inserting a tampon), others feel pain when thrusting during intercourse, but it can also be a throbbing pain that persists for several hours afterwards. Causes of pain during penetration can be: vaginal dryness (for example due to the impact of childbirth on your sex drive or during breastfeeding), an episiotomy (vaginal incision), irritation, trauma, urinary tract infection, skin problems in the genital region, vaginismus or a congenital defect. Pain during thrusting (deep penetration) is mainly caused by a certain disease or condition (endometriosis, uterine prolapse, fibroids, irritable bowel, etc.) or by internal scars, for example after an operation. In addition, emotional factors can also play a role.

Also read: No more sex drive since giving birth? Sexologist Vanessa offers advice

Vulvodynia

Vulvodynia is a long-term irritating, stinging or burning pain in the entire vulva region, which not only causes you a lot of discomfort during sex, but also when cycling and sitting, among other things. Both hormonal and genetic factors can cause vulvodynia. In vulvar vestibulitis syndrome, a common form of vulvodynia, small red spots are visible due to inflammation.

How can you treat pain during sex?

It is possible that the pain will go away on its own if you wait a few days before having sex, for example, if it is a small internal wound that has healed in the meantime. Be sure to take enough time for foreplay and use lubricant if necessary. Does the pain persist? Then it is advisable to visit your GP or gynaecologist. In addition, you can certainly also go to a physiotherapist who specialises in the pelvic floor, so that you can use the right exercises your pelvic floor muscles regain control and your vagina can 'open the door to those who are welcome'.

Also read: Why are pelvic floor muscle exercises not only important for pregnant women?

Don't keep it to yourself

It is important not to ignore the symptoms, because the pain is not only treatable, those who have pain during sex also risk ending up in a vicious circle. Sexologist Vanessa Muyldermans guides women and couples who go through something like this:

“The most important thing is to work on the emotional connection between the couple. So create peace, and we do that by taking the focus away from sex for a while and making sure that both partners feel more confident about themselves and the relationship. Step by step we will try to identify the negative, inhibiting thoughts and put a stop to them by replacing them with positive, helpful thoughts. In addition, we will look for what the woman and this couple need to feel good and safe, and we will pay attention to creating these circumstances.

We also start with exercises to relax mentally and physically, in order to gradually return to a somewhat nicer, more positive image of sex and of the sexual identity of the person and the couple in question. At the same time, we slowly build up penetration again, so that the woman can get used to it and enjoy it again. That process takes three weeks for some women, three months for others, but that doesn't matter. We follow the woman's pace, so that she learns step by step how to think sexually positive again, how to relax the pelvic floor muscles and how to better deal with frightening situations and negative thoughts.”

Also read: How does relationship therapy work and what does it cost?

Sources:

Last updated: September 2023

Pain During Sex: Causes, Symptoms, and Treatment

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