The sex we have in real life is rarely like the love scenes we see in films. The lighting isn't anywhere near as good, we don't all end up with perfectly tousled hair afterwards, and the sex itself doesn't always feel as great as it looks on-screen.
Sometimes, it can even be painful.
Although we don't talk a lot about painful intercourse, it's not all that uncommon and one study actually found that 1 in 5 Australian women have experienced it before [1].
This is a high number, but the one reassuring thing to take away from it is that those who have felt pain during sex aren't alone. But while common, painful sex doesn't have to be normal or something you have to live with.
Read on to better understand what causes painful sexual intercourse, with expert insights from sexual health therapist and author of "Sex Down Under", Matty Silver.
The 2 types of painful intercourse
Pain during sex — specifically, during vaginal intercourse — is also called "dyspareunia" and it can be categorised into 2 different types:
- Entry or superficial pain, which occurs around the entrance to the vagina or on the skin of your vulva and might feel like a burning, itching, or stinging sensation.
- Deep pain, which occurs further inside your body with deep penetration.
What causes superficial intercourse pain?
If you experience entry pain, it may be a result of:
Vaginal dryness
Vaginal dryness is one of the most common causes of painful sex and it can occur for several reasons:
- Reduced oestrogen levels as a result of menopause, breastfeeding, postpartum or taking hormonal contraception
- Lack of sexual arousal
- Stress
- Dehydration
- Smoking
- Certain medications, like antidepressants, allergy drugs and cancer treatments
Vaginismus or vulvodynia
Vaginismus occurs when your pelvic floor muscles tighten to the point where it's painful, and sometimes impossible, to have penetrative sex or even insert a tampon.
Vulvodynia, on the other hand, is chronic pain that occurs on the vulva and around the entrance to the vagina.
Like many reproductive health conditions, vaginismus and vulvodynia aren't things we talk about every day, but that doesn't make them any less real.
Vulvodynia, like some other chronic pain conditions, is said to occur more frequently in women who've experienced physical or sexual abuse in the past [2]; and vaginismus can also be triggered by traumatic or difficult experiences with sex, childbirth, or medical procedures.
“When a woman has vaginismus it can feel as if her partner is running into a solid wall when they try to enter her. The vagina is perfectly normal and capable of intercourse without pain in these women, as long as the pelvic floor stays relaxed,” says Silver, emphasising, “It is the pelvic floor spasm, and resulting compression of the vagina, that causes the pain and obstruction, not problems with the vagina itself.”
Both conditions can be treated, although the treatment — as those who live with either condition would agree — isn't as simple as 'just relaxing'.
Silver regularly refers her clients to specialists and physiotherapists, who can coach them through pelvic floor exercises that retrain their muscles, and notes that a pelvic floor physiotherapist, or continence nurse, can be of "enormous help" to clients.
Infections
Infections like thrush, bacterial vaginosis, trichomoniasis, genital herpes, and urinary tract infections — the dreaded UTIs — can have symptoms of pain on your vulva or inside your vagina.
Hygiene
Parts of our personal hygiene routine can irritate the vulva: for example, soap, moisturiser, tanning lotion, and waxing products can all react negatively with our skin.
Things like laundry detergent and even tight, synthetic clothing can also cause painful reactions.
Condoms and lubricants
Many condoms and dental dams are made of Latex, but a small part of the population can be allergic to Latex and experience pain and swelling when it comes in contact with their skin.
Condoms made of lambskin, polyurethane (plastic), or polyisoprene (rubber) are a great alternative for anyone who can't use Latex.
When it comes to lubricant, it might be a good idea to ditch anything that's scented, flavoured, or provides warming or cooling sensations, as these kinds of lube sometimes include additives that can react negatively with sensitive skin.
Instead, stick to water- or silicone-based lubes without additives, like Kin's Fertility Lube.
What causes deep intercourse pain?
Deep sexual pain occurs further inside your body — at the top of the vagina, at the cervix, and around the pelvic floor — and can sometimes feel like burning, tightness, tearing, aching, or cramping similar to what you might experience during your period.
Silver says there can be a number of things behind it: for instance, having sex too soon after childbirth or surgery can cause injury and pain, as can having sex with an active infection or STI.
Pelvic inflammatory disease (PID), which is caused if an infection is left untreated or unnoticed and spreads to the uterus and ovaries, can also be a culprit.
There are so many potential causes of painful sex, and it can be extremely difficult to figure out for yourself what is causing your specific pain.
We recommend speaking to your GP if you're experiencing any regular pain during sex, and take heart in Silver's advice that treatment need not be complicated or painful.
Image credit: Getty Images
.svg)