When Sex Hurts

Isn’t sex supposed to feel good? If you are one of the millions of women who have had pain with sex (aka dyspareunia), you know that one’s experience of sex is more complicated. 

Dyspareunia may be experienced as pain upon vaginal entry, pain deep in the abdomen during penetrative sex, or pain during climax. Additionally after sex when couples might typically experience closeness and happiness, a woman with dyspareunia might have abdominal cramping and sadness. 

A common cause of pain during sex is hypertonic pelvic floor muscle dysfunction, which means having tight pelvic floor muscles, and can be treated rather than tolerated. Unfortunately most women suffer with pelvic pain for many years before finding a provider who understands and treats the pelvic floor. Living with persistent or chronic pelvic pain can affect not only sexual enjoyment but also sexual desire, intimate relationships, self-esteem, and body image, and can lead to relationship distress, anxiety, and depression. Because tight pelvic floor muscles cause sex to be painful rather than pleasurable, women who have pelvic pain often become disconnected from their sexual selves and potentially emotionally distant from a partner due to avoidance of sexual experiences. 

Once pelvic floor pain is treated, a woman’s sexual desire usually does not immediately and automatically return, as the body and mind have learned to associate sex with pain, and a natural response is fear, anxiety, and avoidance rather than desire. 

As a sex therapist, I work with women who are in treatment for pelvic pain to assist with managing anxiety about potential pain, navigating sexual relationships with partners, and rediscovering how to enjoy sex again.

If you are experiencing pelvic pain and are not working with a specialist, ask me to connect you with pelvic pain specialists who can help you find relief from chronic pain and feel more connected to your body again.