This week on our podcast we are talking about painful sex and how to heal. To hear Dr. Rose Schlaff (a pelvic floor therapist and licensed coach) speak about this topic, listen to our podcast here! Or keep reading to hear a few of my take-aways from the episode.
Painful Sex is Normal, but It Shouldn’t Be!
According to Dr. Schlaff, about 75% of people with vulvas (i.e. biological women) experience painful sex in some period of their life. 33% have painful sex consistently.
If so many women experience painful sex, then why aren’t we talking more about how to fix it? Unfortunately, most women are taught from a very young age that sex simply hurts sometimes. Most women believe that sex is going to hurt the first time they experience it. In addition, too many women believe there is no way to fix pain during sex and that they should just “push through it” so they can please their partners.
Thinking that pain during sex is a fact of life is wrong! Sex is supposed to be pleasurable for both parties involved. If it is painful, you shouldn’t try to just grin and bear it! In fact, continuously having painful sex will train your body to expect pain during penetration. Just like you might clench your arm muscle if you knew a punch was coming, your pelvic muscles will clench if you expect sex to be painful. This clenching will only make penetration hurt worse! In addition, our brains are in charge of deciding if we are in danger. That subconscious reaction to pain will heighten your nervous system, making you much more aware of any pain that comes up.
Different Types of Painful Sex
There are a few different ways people with vulvas experience pain during sex. These different areas of pain have different root causes and should be addressed in different ways.
- Pain at the Opening of the Vagina: If you feel pain just at the beginning of penetration, the most likely culprits are hormones or congenital sensitivity. Hormones are a big factor in keeping those areas wet and flexible. If this pain has developed over time (maybe with a change in birth control, after giving birth, starting menopause, etc.) a new hormone balance could be causing that pain. If you’ve always had this pain, you could have congenital (meaning something were born with) sensitivity in that area.
- Pain When Going Deeper: This experience can feel like “hitting a wall” of pain. In this case, your pain is most likely caused by your pelvic floor muscles. This can be linked to psychological response (if you are afraid, your pelvic floor is one of the first to clench up). You could be affected by general stress, or it could be fear of sex specifically. It could also have nothing to do with psychology, and just be a sign something physical is affecting your pelvic floor.
- Pain at the End of Penetration: This type of pain is most likely caused by changes in length of the vaginal canal. The vaginal canal gets longer when you are turned on. If you are feeling pain, it could be because you are not aroused enough. If this is a persistent problem, there are devices such as the Ohnut that stop the penis from penetrating too far.
- Other Health Complications: There are still so many other types of pain during sex and causes of that pain. For example, Endometriosis (which 1/10 women struggle with) results in restrictions of tissue structures that can cause tugging or deep pain during sex. PCOS (Polycystic Ovarian Syndrome) is another common medical condition in women that causes dryness of the vagina and thus painful intercourse as well. If you are struggling with one of these medical conditions, talk to your OB/GYN or primary care doctor about possible help.
Pain during sex is very rarely caused by one factor. The nervous system, hormones, and our muscles all interact in the sexual experience. Our psychology and expectations play a very real role in our physical experience of sex.
What to do About Painful Sex?
There is so much to be done about painful sex. If this is a persistent problem for you, you may want to consider seeing a pelvic floor physical therapist or getting help from someone like our podcast guest (Dr. Rose Schlaff) to receive help more specific to you. However, here are some of the best generic tips from a pelvic floor therapist for anyone experiencing painful sex to try out!
11 General Tips for Dealing with Painful Sex
- If you’re in pain, stop what you’re doing! Too many Christian women don’t bring it up or realize there is something wrong. As mentioned before, this will only make things more painful!
- Be aware that just the fear of having a traumatic experience can cause tension and then pain. Be gentle and kind with yourself as you try to figure out where this pain is coming from.
- Create a code word with your partner for when you are feeling pain. When you use your code word, stop what you are doing, try taking three deep breaths, and then slowly try again.
- There is more to sex than penetration and orgasm! It’s okay to take a break from penetration if you are in pain. Sometimes taking a break for a few weeks can help you feel more calm and let your pelvic floor relax.
- Try diaphragm breathing: inflate the diaphragm fully and get blood moving to the pelvic floor. Deep breathing can also calm your brain and shift it away from a “fight or flight” panic mindset.
- Hip position is really connected to the pelvic floor. Maybe try a position where your legs are supported, taking stress off the pelvic floor.
- Kegel exercises can be helpful, BUT be aware that alone won’t fix everything. Often times, sex is painful because your pelvic floor is trying to hard. Your muscles there are already too tense, and then sex just makes them tenser. In this case, exercising your muscles more won’t help. You need to learn to help those muscles relax. In addition, most people do Kegel exercises incorrectly (leading to more pain), so don’t try them without reading up on them in the Intimately Us app, this article about the pelvic floor, or talking to a pelvic floor physical therapist first.
- Don’t hold your breath! Contracting and holding won’t help with orgasm. Allowing oxygen into your body, breathing in and out in a rhythmic way, and letting that blood flow through your sexual organs will aid relaxation and actually help you orgasm better.
- Incorporate LOTS OF FOREPLAY! A lot of women need to be aroused before their body begins to want sex. If you want to learn more about foreplay, try reading these two posts! Foreplay All Day Long and Fun Foreplay
- Create a very safe place for you to relax. Try changing up the power dynamics by having the wife be the one to initiate or vice versa. It can be empowering and calming for a lot of women to know she won’t get touched until she is ready for it.
- Advice for husband: her pulling away often has nothing to do with you or her losing interest in you. Don’t push her further than she is willing to go and maybe consider using toys to avoid penetration for a while. Let her know “it means a lot to me that you enjoy this” and that she can trust you to be sensitive to her pain.
A lot of women experience painful sex, but it doesn’t have to be that way! If you are in pain, stop what you are doing and explore these tips. If you are having trouble finding something that helps, consider consulting a pelvic floor therapist. Sex is meant to be pleasurable for both parties, and there is always a way for both you and your spouse to love the sex you’re having. Don’t give up. Sex should be a wonderful place for you both to go.
Written by Amanda Severson (with help from Dr. Rose Schlaff) with Get Your Marriage On!
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