Why is sex painful?

Pain with sex is one of the most common things I see in my office, and unfortunately, it is also one of the least talked about and still taboo topics.  People who experience pain with intercourse feeling really alone and unsure of what to do to help themselves get better.  Or, even worse, they don’t realize that this isn’t normal and there is something that can be done to improve their symptoms.  

Today we are going to debunk some myths about painful sex and chat about some strategies to help manage painful intercourse.

Myth #1: Pain with Sex is Normal

Like I said in the intro, THIS IS NOT SOMETHING YOU HAVE TO LIVE WITH.  One of my favorite phrases when I am talking with clients is; “common, but treatable”.  Pain with sex is common, but very treatable.  I did talk about some pelvic pain conditions in my last post which you can read here.  But there are many reasons that pain can occur in regards to intercourse.  It can be from a pelvic pain condition, it can be post delivery due to perineum tearing or episiotomies, it can be following emotional or physical trauma or many other things.  It is also important to know that pain with sex counts as pain during, before or after sex. 

Myth #2: Weak Pelvic Floor Muscles Are the Problem

Doing kegels may not always be the solution to painful sex.  Sometimes tightness or tension in the pelvic floor can be the problem when it comes to pain with sex.  Often learning to relax your pelvic floor can help more with painful sex then doing kegels will.  I will be talking about pelvic floor tension in my next post so stay tuned for that. 

Myth #3: You Aren’t Attracted to Your Partner

Too many times, pain with sex, especially without an explanation gets blamed on the desire for sex or not being attracted to your partner.  And I just want to say this is never the case, and if a provider tells you this, please get a second opinion.  Most often pain with sex, especially in conditions like vaginismus are outside of the person’s conscious control and are not related to attractiveness to ones partner or desire to have sex.  However,  because there is a very close emotional connection with sex, it is common that people who experience pain with sex to also have decreased libido (after all who wants to do something that hurts?). 

Myth #4: Drinking Wine Helps

There is no research or evidence to support that alcohol helps to relax the pelvic floor.  Your pelvic floor does not have receptors that directly respond to alcohol, so this is absolutely not an effective coping strategy to help get around pain with sex.  And if this has been provided as a legitimate suggestion, please get another opinion. 

What to do? 

Painful sex can be a really devastating thing to experience but there is help.  Here are my top six suggestions for managing pain with intercourse. 

1. See a pelvic floor PT: getting an assessment with a pelvic floor physiotherapist can be really important to help you manage your pain symptoms and figure out where the pain is coming from.  Getting a specific treatment plan is the best way to deal with painful sex. 
2. Talk to a counsellor: As I mentioned, there is a very close emotional connection when we are talking about sex, and looking after your mental health is a really important part of getting good care and dealing with painful sex.  There are specific counsellors who can deal with sex and intimacy.  This works really well in conjunction with pelvic PT. 
3. Use lubricant.  Lube gets a bad wrap sometimes, but I personally think it is one of the easiest tools in your toolbox for painful sex.  There are a few different types of lubricant, oil-based, silicone-based and water-based.  Water-based is good, but doesn’t last as long as other lubricants.  Silicone-based is good and can be used with silicone toys without breaking them down.  Oil-based can be more natural products, but can damage silicone toys and should not be used with condoms if you are using this as a form of birth control. 
4. Foreplay! Again, an underrated aspect of sex, but taking your time and using foreplay can be a great way to help your body warm up for sex and get ready for sex. Also if you struggle with penetrative intercourse, remember that foreplay and other acts of intimacy can be a good alternative option with you and your partner.  Being intimate is still important if you are able to tolerate it. 
5. Pelvic floor relaxations prior to sex: Learning how to relax your pelvic floor and having a ‘warm up routine’ for sex can be a great way to help reduce pain.  Spend about 5-10 minutes stretching and relaxing your pelvic floor before you are ready to be intimate and if tension in the pelvic floor is your problem, this might help bring your tension down.  For some stretches and tips to relax your pelvic floor, check out the videos on my instagram page here. 
6. Use an OhNut! If you have pain with penetration, using an OhNut which you can find here can help reduce the depth of penetration.  This will help you and your partner relax because you aren't worried about pain AND it's super easy to use.  Use the code 'PELVICLAURA7' for $7 off your purchase.

Pain with sex can have a major impact on physical and mental health as well as your relationship with your partner if you have one.  But there is help and you can change some of your symptoms and improve your sex life.  If you have any questions, please feel free to reach out! You can contact me here.