Sex should feel good — but sometimes it just doesn’t. In fact for some, it can be quite painful. If this is the case for you, you’re not alone. Indeed, nearly 30% of women report experiencing some level of pain during intercourse. The medical term for painful intercourse is dyspareunia.
You might suffer from vaginal atrophy — the inflammation, dryness, or thinning of the vaginal walls. Dyspareunia is usually diagnosed with a pelvic exam and review of your medical history.
Your health and wellness doctor or gynecologist may ask:
Where does it hurt?
How does the pain feel?
Does it happen with every sexual partner?
Does it vary according to sexual position?
The pain may be the result of vaginal dryness, usually caused by low levels of estrogen. This can be treated through hormone therapy, as well as a change in diet that includes eating more food rich in mono and polyunsaturated fats. It’s important to stay hydrated. We’d also recommend using a water based lubricant during sex.
The drug ospemifene (Osphena) has been approved by the FDA to treat women who have problems with vaginal lubrication. It acts like estrogen on the vaginal lining. Bio-identical hormone replacement therapy may be a better option and can provide relief within days.
Some birth control pills can cause dryness in the vagina. These pills often result in a hormonal imbalance. This can be treated by hormone replacement therapy that can return the hormones to a more balanced state in order to reduce the pain of intercourse.
Pelvic Floor Contraction
Sometimes during sex, an involuntary spasm of the pelvic floor muscles can take place — a condition known as vaginismus. This often happens to women who have been the victims of rape, sexual abuse, or face some deeply seeded fear regarding sex. More likely than psychological injury, the event caused injury to fascia and persistent kinks are still causing pain. This condition can be treated with pelvic floor exercises designed to strengthen and give more control to the pelvic floor, and therapies that unkink the injured muscles and fascia (myofascia).
Counseling or Sex Therapy
For some sufferers of dyspareunia, the cause is not physical but psychological. You may be experiencing a negative response to sexual trauma or fear. You may need help communicating with a partner about what you are feeling and what they can do to help you restore sexual intimacy. But never allow well-meaning healthcare professionals to “talk you out of” disabling persistent pain that you know is real.
Some women may benefit from sexual counseling. This can help you address past trauma, fears, and inhibitions. This kind of therapy can sometimes be done in conjunction with a partner. Hypnotherapy may prove helpful as well.