Navigating Painful Sex: A Guide for Vulva Owners from a

2024-05-31
Posted by PSEDEN

Have you been led to believe that pain with sex is normal, or that sex is supposed to hurt? If so, you’re definitely not alone, but I am here to tell you that painful sex is NOT normal and should NOT be tolerated. Yet, pain with sex is incredibly common, and up to 40% of those who experience this do not seek out medical care. In this blog, I am going to break down what exactly painful sex is for vulva owners, what can cause it, and what can be done about it. Just a brief clarification before we get started – pain with sex is very broad and complicated in nature and can present differently from person to person. If you are experiencing any kind of pain with sex, I hope this blog post gives you some confidence to do something about it and take back your sex life, because you deserve a satisfying and pleasurable sex life if you want one.

Terminology Breakdown Regarding Painful Sex

First, I want to describe exactly what I mean when I say “pain with sex.” I am referring to genitopelvic pain, or pain originating anywhere in the external genitals (including the vulva, external clitoris, perineum, labia majora, and labia minora) or in the internal genitals (including the vagina, cervix, ovaries, and uterus) during sexual activity. Dyspareunia is the medical term for pain with penetrative sex and can occur before, during, or after sexual intercourse. Vulvodynia is the medical term for pain in the vulvar region that greatly varies from person to person and depending on the cause. Your pain may come and go, remain relatively constant, or only flare when the area is touched or provoked. It can also occur outside of sexual activity/the area being touched. You may experience burning, soreness, stinging, rawness, or a sharp/knife-like pain. If you are experiencing any sort of sexual pain, it will be important to get specific with your doctor.
One of the biggest details to consider is where exactly does it hurt? If you are unsure how to describe this, it can be helpful to become acquainted with your genitals. Though it may be uncomfortable at first, grab a handheld mirror and take a look down there. You can also print out an anatomy sheet and try to identify your own parts. This can help you be clearer with your doctor and other professionals when trying to describe where exactly it hurts. *If you become self-conscious or experience shame when looking at your genitals, challenge this! Genitals come in so many different shapes and sizes and are all beautiful. You could journal about where this shame may originate from, where you learned it, and how it impacts you. A sex therapist can also help you work through this.

Some other things to consider before visiting your doctor about painful sex:

Is the pain constant or does it come and go?
When does the pain start? If it does stop, when does it usually stop?
When did you first notice the pain?
Do you experience pain with the insertion of a finger or tampon?
Does the pain occur every time you have sex or only in certain situations?

The Vast Array of Potential Causes of Pelvic Pain for Vulva Owners

As I mentioned earlier, sexual pain is complicated and there are many things that can contribute to it. It’s also important to note that there likely isn’t one single cause, but several, all contributing to the pain. It may feel overwhelming, but fear not! It is treatable. Knowing the potential cause(s) of your pain is a big step towards being able to treat it. Here are a few of the many potential causes:

Lack of adequate lubrication – foreplay is important! Make sure your body is prepared for penetration and sufficiently lubricated. If your body does not produce enough lubrication on its own, use lube! For more on which type of lube would work best for you, read our blog
Tight pelvic floor muscles
Inflammation, infection, and skin disorders
Hormonal changes – including from hormonal contraceptives, endometriosis treatments, removal of ovaries, medications for breast cancer, medications for acne, and menopause
Endometriosis
Injury or trauma to the affected area
History of sexual trauma
Anxiety
Negative ideas about sex or one’s sexuality
Negative body image