When sex is painful: ‘A lot of women think it’s their fault’

Women who experience pain during intercourse find it difficult to talk about

Women must learn not to settle for painful and rushed sex and must take the time to examine their own bodies so they can learn what gives them pleasure sexually, says Emily Power-Smith, sexologist and sex therapist.

The first time Claire* had sex she believed the pain she felt was normal. At school her friends had talked about the discomfort of losing one’s virginity. What Claire felt was far from discomfort but she dismissed it as normal. Six months later, when she realised the serious pain she felt during intercourse was not going away, she arranged to see the doctor at her university.

“She just said to me to use bigger tampons and try and stretch the area. That was the only advice I had to go on for the next few years.” Three years later, after a year and a half of “torturous sex” with her boyfriend, she spoke to a nurse who prescribed a numbing agent for her vagina.

“Looking back it was really difficult emotionally and I felt a lot guilt and obligation to have sex. Once we had sex I’d feel relieved we wouldn’t have to do it for another week or two. My boyfriend was quite good in that he tried to get me comfortable and excited about other things, but I didn’t find pleasure in anything.”

Maeve Whelan, a chartered physiotherapist based in Dublin, works with women of all ages who, like Claire, suffer from painful sex. She says women who continue to ignore the pain and push through will only experience more severe pain and discomfort.

Painful sex means that when a couple attempt to have intercourse the woman experiences pain at the entrance to the vagina, says Whelan, adding that a number of different conditions lead to pain during sexual intercourse.

Young women often suffer from vaginismus, the involuntary contraction of the pelvic floor muscles, which happens when an attempt is made to insert an object into the vagina. The pain caused by the muscle tightening can range from mild discomfort to severe burning and aching.

Vulvodynia, also known as vulvar vestibulitis, is a condition whereby women experience burning and soreness on the vulva, sometimes just from a light touch on the area.

Women who suffer from re-occurring urinary tract infections, those who have recently given birth – particularly women who undergo an episiotomy during childbirth – and women who have gone through menopause can also experience serious discomfort during sex.

“Throughout all of that you’ve got postural changes, tension, postural adaptations, overtraining, muscle holding, how people hold themselves, hip position, lumber spine position, tight tummy, tight hips, all of that feeds into it too,” says Whelan.

“We see less people when they’re older, they don’t have to face up to it as they might be passed pushing themselves to have a sexual relationship. Young women expect more. They’re also into their deadlines for relationships – not being able to have children if they don’t address [the issue].”

According to a study into pelvic floor dysfunctions carried out by researchers from University College Cork, in 2013, nearly half of women surveyed said they experienced some type of sexual dysfunction. Some 31 per cent said they experienced pain during sex while 25 per cent complained of vaginal tightness or vaginismus. The survey was carried out with 1,774 women who had never given birth to a child.

Whelan says many women are led to believe the pain they experience is just in their heads. “They are told to just have a drink, relax and you’ll be okay by people who don’t understand,” she says. “Sometimes they’ve been to counselling with the best in the world and they still don’t understand. A lot think it’s their fault.”

Emily Power-Smith, sexologist and sex therapist, says women often feel guilty because they might not be able to have the kind of sexual relationship their partner expects.

“Across the board, whatever kind of pain it is, they’ll have lowered confidence,” says Power Smith. “They’re going to feel that they’re the only ones, isolated, embarrassed and ashamed.”

“Also because there’s so little education around it, partners can become very insensitive and impatient because they just don’t understand. It can fracture a relationship.”

A lack of education around the functionality of sex means many women go through life without ever questioning or speaking to someone about the pain they’re experiencing.

“What sometimes causes pain for people who are new to penetrative sex is not understanding their arousal cycle and not giving themselves long enough to lubricate properly,” says Power Smith. “Women expect themselves to have the same arousal cycle as men because we know a lot more about men’s arousal from movies.”

Women who continue with intercourse regardless of lubrication can suffer from a rawness or burning, as well as internal muscular pain.

“People are always looking for a practical answer but all along the emotional side is building and becomes a causal factor in itself. So much of vaginismus is created by pain expectation, worry, fear and feeling like a failure that you can’t relax into the experience. They see it as a personal failing.”

Women must learn not to settle for painful and rushed sex and must take the time to examine their own bodies so they can learn what gives them pleasure sexually, says Power Smith.

Clare is now seeing a women’s physiotherapist, where she receives internal massages to ease the pain. She recently moved job and is sleeping better at night.

“Part of me feels really tired of it all, just a bit battered by the whole thing. It’s such a maze and so hard to find out what the problem might be.

“I’ve started taking a much more healthy approach to life in general. I’m really happy I’ve changed my job, I’m eating healthily and am sleeping enough. As a whole I think it’s got the potential to be a seriously life-changing experience.

“The more I learn about chronic pain, the more I learn my body is a powerful, sensitive instrument that is trying to give me signals to bring more balance into my life.”