I asked experts how to manage painful s9x.
There are definitely ways to help with this very common issue.
Hey babe,
Happy 2023! I missed you so much over the holidays and I’m so happy to be back in action with y’all. Hope you’re ready for a smokin’ year of piping hot G-Spot Goodness!
I’ll be bringing you more blogs, expert sourced pieces, and G-Hot Q&As this year … not to mention more Internet Sex Therapy videos on YouTube! The newest will drop on Thursday.
Speaking of which - not to be a bummer - but we should chat about painful sex.
Pain during sex is incredibly common and very distressing for those who experience it. It can have real and lasting impacts on your life and well-being. We need to be talking more about this topic because, frankly, it doesn’t get enough airtime AT ALL.
Moushumi Ghose, MFT, a licensed sex therapist, told me in an interview that pain may “prevent [a] person from going on dates, from seeking or even talking to potential partners, [and] it may even prevent [them] in many cases from making eye contact or associating altogether.”
It can be incredibly isolating. “The pain is always there,” Ghose says. “This brings a great deal of embarrassment, avoidance, and resistance. This, in turn, can feed into low self-esteem and self-worth, [along with] mental health issues.”
Let’s break down the causes of painful sex for AFAB (assigned female at birth) people, and the ways to help manage it. Everyone deserves a rich, pleasurable, pain-free sexual life.
Defining painful sex.
For AFAB people, pain during sex is defined as “persistent or recurrent pain with attempted or completed vaginal entry and/or penile-vaginal intercourse.” This pain can be “superficial” (on the outside of the vulva or vaginal entrance) or “deep” (internal pain during penetration).
Pain can have both physical and psychological causes. It happens when the brain recognizes that there is something wrong. If there is physical damage to tissue or nerves, the brain will respond accordingly by sending pain signals.
But it’s not always when something is biologically wrong that we experience pain. If there is no damage to the tissue and pain is still present, it means the brain is recognizing something as painful, even when there isn’t a physical reason for it. This does not mean the pain isn’t real. All pain is real and should be treated as such.
Ghose says that often pain has psychological roots in trauma. “Our body holds onto unresolved emotions, traumas—and this can express itself as pain during sex,” she explains. “From messages we may have received about sex all the way to violent trauma, [these] can all be sources of unresolved pain and trauma.”
Some common types of sexual pain.
Laurie Mintz, Ph.D., a licensed psychologist, certified sex therapist, and author of Becoming Cliterate, told me via email that the following four types of pain can manifest in the vagina and/or vulva.
Pain with vaginal penetration (dyspareunia).
Inability to have vaginal penetration due to the involuntary clenching of the pelvic floor (vaginismus).
Pain on the vulva/vaginal area when touched (provoked vulvodynia).
Pain on the vulva/vaginal area without touch/more constant pain (unprovoked vulvodynia).
Each type of pain is treatable and can be managed through physical therapy, psychosexual therapy, and other medical interventions.
The causes of painful sex.
There can be any number of reasons why someone may experience pain during sex. Sarah Melancon, Ph.D., a sociologist, clinical sexologist, and resident expert at the Sex Toy Collective told me that “Pain during sex can be caused by biological, psychological, relationship, mental health, and/or sexual factors—and it is common to have multiple causes at once.”
Melancon breaks pain into four factors: Physical, sexual, relational, and mental health.
1. Physical Factors
Injury, surgery, or medical procedures in the pelvis, vulva, clitoris, vagina, or anus.
Childbirth and birth-related injuries such as tearing.
Inflammation.
Vaginal infections, especially repeated infections.
Pelvic floor dysfunction.
Hormonal changes.
Health conditions, including endometriosis, pelvic inflammatory disease, uterine prolapse, uterine fibroids, ovarian cysts, hemorrhoids, cystitis, and irritable bowel syndrome.
2. Sexual Factors
Frequently engaging in sexual activity with little or no desire, arousal, or lubrication.
Frequently engaging in sexual activity that is rougher than desired.
Lack of engagement in sex acts one desires or engaging in sex acts you don’t desire.
History of sexual abuse.
History of sexual boundary-crossing.
Poor sexual communication.
Low interoception (a lack of inner-body awareness).
Sexual shame.
3. Relationship Factors
Insecure attachment.
Conflict.
Poor inter-partner communication.
Trust issues due to infidelity.
lack of emotional intimacy.
4. Mental Health Factors
Chronic stress.
Burnout.
Anxiety.
Depression.
How to manage pain during sex.
Unfortunately, pain is a multifaceted experience that can manifest during sex. But there are several ways to manage it.
1. Ask for help.
Mintz tells us that the best way to manage pain and to have great sex is to recruit proper professionals to help you on your journey. “Seek the services of an experienced practitioner in one of these categories, who will also likely involve the others,” she says.
Find a sex therapist in the American Association of Sexuality Educators, Counselors, and Therapists directory here.
Find a pelvic floor physical therapist here.
Find a sexual medicine provider here.
2. Use lube.
Painful sex often results from a lack of proper lubrication, and this is not fun for anyone. You want to use a high-quality lubricant that is free from petrochemicals and glycerin. Check out this full guide to lube that I wrote just for you.
3. Mindfully observe pain patterns.
Understanding pain often takes a lot of mindfulness. Pay attention to the times when you’re feeling the most pain and note what that experience is like. During times when there is less pain, take stock of what helped. Melancon says you should communicate this with your partner so that the two of you can take action to help manage the pain.
4. Focus on reducing pain and increasing pleasure.
“Focus simultaneously on addressing pain and seeking pleasure—when pain is involved, too often ‘good sex’ becomes ‘sex without pain,’” Melancon says. “But painless sex is not necessarily pleasurable, so acknowledging yourself and communicating your desires to your partner is equally part of the recovery process.”
Painful sex can be very difficult, but know that you are not alone. You deserve a satisfying sex life with all the pleasure in the world.
This week’s mantras:
I deserve pleasure.
I don’t need to endure pain to make my partner happy.
Life is too short for bad sex.
I will love myself.
I love you. Have a great week!
XOXO Auntie Gigi
This newsletter originally appeared on TheBody.
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That’s it for me this week, pals. I love you. You are a beautiful snowflake you deserves all the pleasure on the planet.
