Painful sex is more common than you think – but there are solutions.

Affecting one in six women, this issue has a number of causes that can depend on where you are at in life’s journey. The good news is there is always a solution – so there is no need to suffer in silence.

Our doctors see at least one person each day who is experiencing pain with intercourse. For some, the pain is a symptom of a physical problem, which can be as simple as a skin condition, while for others, it can be a psychological reaction to past trauma or emotional discomfort manifesting in a physical way. It’s really important that you don’t struggle on with pain, as much for the sake of your relationships and personal happiness as for the sake of your health.

Diagnosing dyspareunia

In terms of diagnosis, your doctor will want to know whether the pain is experienced at entry to the vagina or deeper into the pelvis. If it’s the former, the pain is likely due to an issue with the skin around the vagina, which can be exacerbated by an STI or dermatitis. A gentle gynaecological examination will determine whether any of these are present. If you are young or new to sex, an imperforate hymen can sometimes be the cause of pain, but this can be easily treated with minor surgery.

In the majority of cases, the cause is what’s known as a hypertonic pelvic floor. This is when a person involuntarily contracts their pelvic floor muscles as soon as sex begins. Pelvic floor physiotherapy works wonders for this condition in most cases. For some the next step after trying pelvic floor physiotherapy may be a Botox injection in to relax the pelvic floor muscles. This can be administered by a gynaecologist as part of a treatment plan.

If the pain is felt deeper in the pelvis, your doctor will want to rule out endometriosis or ovarian cysts using the usual investigations. Another possible reason for this kind of pain can be a birth trauma caused by damage to the genital tract. If this is the case, treatment is now funded by ACC, which is great news. Your gynaecologist, GP or pelvic floor physiotherapist can make a claim on your behalf. 

Psychological causes

Where there are no obvious physical causes, your doctor can help you determine if there is a psychological reason for your pain. This can be as simple as a lack of connection with your partner or it could be due to a past traumatic experience.

If required, your doctor can make a referral to a clinical psychologist specialising in sex therapy, who can help you unpack the problem and find solutions. If you have experienced an unwanted sexual experience and need further help, there are many local services available to you, which your doctor can recommend depending on your circumstances.

Remember that sex is supposed to be fun and pleasurable, not something to endure. So no matter the reason, it’s imperative that you don’t suffer in silence. 

To help find the right solution for you, call us or book an appointment online.

Where to get help if you’ve had an unwanted sexual experience:

Women’s Refuge (0800 733 843)

The Cambridge Clinic (03 366 0067)

Safe to Talk (0800 044 334)

Victim Support (0800 842 846)

National Network of Family Violence Services