Painful sex, also known as dyspareunia, may be the result of any number of things—a new detergent, a new partner, an infection, pregnancy, breastfeeding, menopause, anxiety, and other issues can all change a person’s sexual response. Genital pain may be caused by hormonal issues, physical issues, emotional or psychological concerns, and/or relational issues.
Women need not suffer alone. In many cases, they need not suffer at all. Here are some steps you can take to get the relief you need:
- Find a gynecologist who specializes in genital pain. This is key. Numerous women have told me that they went from gynecologist to gynecologist and heard the same advice: (1) just relax, (2) have a glass of wine, and (3) use lubricant. Though these clinicians mean well, for some women, this just doesn’t cut it. A gynecologist who specializes in genital pain will evaluate for vestibulodynia, vaginismus, deviated septum, intact hymen, hormonal imbalances, infections, scar tissue, cysts, and a number of other potential issues. For some women, something as simple as a specific cream may resolve their issue. Finding a gynecologist who specializes in genital pain can be difficult, so I recommend scouring hospital bios and looking for those who specifically list a specialty in genital pain, vulvovaginal disorders, or female sexual dysfunction. A competent sexual health evaluation will provide referrals if pelvic floor physical therapy is necessary.
- Contact a sex therapist in your area. You can find a certified sex therapist by searching GoodTherapy.org’s directory. Carefully read each clinician’s bio to find out where he or she received training in sex therapy; you may need to contact the therapist to solicit this information. Some therapists list it as an area of expertise, but do not have advanced training in the area. A sex therapist can help you address the emotional, psychological, and relational reasons behind the pain you’re experiencing. He or she can also help address any conflict or difficulties arising from this issue within your romantic relationships, as partners may also be affected emotionally and/or physically. If you have trouble finding a gynecologist whose specialty is genital or sexual pain, a sex therapist may be able to help with that, too; sex therapists often have connections with experts in this area.
- Discontinue having sex until the issue resolves. Pain is your body’s way of telling you to stop doing what you’re doing. If you touch a candle flame, your finger sends a rapid signal to your brain that it hurts. Your vagina is telling you something. Speak to your partner about your wish to not have sex until the issue is resolved. Enjoy the other aspects of intimacy. You might consider trying extended foreplay (45 minutes to an hour) to give you more time than usual to become aroused. Enjoy kissing and other activities that do not cause pain. Although artificial lubricants can help, give yourself sufficient time to try to get lubricated on your own. Listen to your body if it is telling you that it is not ready for penetration. If other sexual activities are making you nervous or anxious, hold back on those activities and do only what you are comfortable with. You are in control of your body and do not have to engage in anything that causes discomfort.
Seeking help from a gynecologist, a sex therapist, and/or a pelvic floor physical therapist can help you address the physical, emotional, psychological, relational, and medical aspects of your issue. Working with this team of professionals, your genital pain can be lessened or eliminated altogether, allowing you to enjoy sexual activity free of any anxiety or worry. Get the help you need today.
Danielsson, I; Sjoberg, I; Stenlund, H; Wikman, M. (2003) Prevalance and Incidence of Prolonged and Severe Dyspareunia in Women: Results from a Population Study. Scand J Public Health. 31(2):113-8.
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