Why you’re finding sex painful and how to treat it – from simple exercises to vaginal dilators
SEX is supposed to be a pleasurable experience - but as many as three in four women find it painful.
And it can cause so much discomfort, lots of women even go to great lengths to avoid getting intimate with their partners.
The American College of Obstetricians and Gynaecologists revealed just how common painful intercourse can be - with their study showing 75 per cent of women experience painful sex at some point in their lives.
The medical name for it - dyspareunia - covers a variety of reasons why intercourse might hurt including thrush and endometriosis.
And then there is a anxiety, lack of sexual arousal and/or a previous traumatic experience of sex.
Thankfully, understanding the specific discomfort you're experiencing can help you find the right way to solve it.
Here we look at why sex might be painful for you and the best ways to treat it.
The reasons sex might be painful
1. You're not fully aroused
One of the main causes of painful sex is that you may not be fully aroused.
The myth that men are always ready for sex can make women feel guilty about needing more time for foreplay.
And this in turn can result in penetration that may feel too tight.
2. An infection
Sexually transmitted infections like chlamydia and gonorrhoea can cause pelvic pain during intercourse.
Or if you're experiencing pain around the vulva, it may be due to a herpes outbreak.
A yeast infection is not an STI but that too can make sex feel uncomfortable given it causes external itching, chafing or internal burning.
3. The menopause
When a woman goes through the menopause her sex hormones drop, which can cause dryness and soreness down there.
Vaginal dryness is an easily treated condition but can cause severe distress for a women when it stops her having sex.
Your oestrogen levels are what keeps your vagina muscles healthy and also helps produce the discharge that not only cleans your lady garden, but also provides lubrication during sex.
This can also lead to the thinning of the vaginal walls, known as vaginal atrophy, which can make having sex quite painful.
Luckily, there are plenty of hormone-based therapies to treat the condition so speak to your GP.
4. Vaginismus
Another major cause of painful sex if vaginismus, which causes a woman's pelvic floor muscles to knot up and spasm.
It happens during penetration, whether with your man or using a sex toy, is attempted.
Even using tampons or a visit to the gynaecologist can leave sufferers in agony.
Vaginismus can completely disrupt a woman's sex life and cause her to lose all confidence in the bedroom.
And it can also lead to relationship problems even preventing women get pregnant.
The condition varies from person to person - some women are unable to insert anything into their vagina, some can use a tampon but cannot have sex and some can have sex but find it extremely painful, according to the NHS.
5. Allergic reaction
Just like anywhere else on your body, you can suffer an allergic reaction down there.
Things like latex in condoms, spermicide in lubes and any other product used below the belt can cause irritation.
Anything that causes swelling, redness, burning, stinging or irritation down there is bound to cause pain during sex.
If you have suffered an allergic reaction make sure you work out what caused it and stop using it immediately.
6. Psychological factors
Fear and anxiety around sex can lead to women unconsciously tensing up their pelvic floor muscles during sex.
Dr Shannon Chavez, a psychologist and sex therapist in LA, says: "Maybe they had a negative sexual experience so they anticipate pain and discomfort, or they have experienced trauma such as sexual abuse, violation of boundaries, sexual assault."
As a result, the mind can go into fight-or-flight mode, which can cause the body and pelvic floor muscles to clench up.
Poor self-esteem and body image issues can also decrease arousal or cause someone to become tense or nervous during sex.
7. Endometriosis
Endometriosis is a condition where tissue that normally lines the inside of your uterus grows outside it, resulting in a painful buildup of scar tissue that especially hurts during intercourse.
Organs move around a bit during sex, and if scar tissue is making your pelvis and cervix less mobile, it’s going to feel painful.
On top of this, endometriosis can result in cysts on your ovaries which can cause discomfort.
8. Childbirth
It goes without saying that if you've just pushed a baby out of your vagina then things are going to be a little sensitive for a while.
The NHS recommends waiting at least six weeks before getting down and dirty again - and any hanky panky before two weeks you are risking postpartum haemorrhage or uterine infection.
Sarah McMullen, head of knowledge at parenting charity NCT, said it depends on what kind of birth you had and when a women feels ready to have sex again.
She said: "There isn't really a right or wrong answer here, it's very personal.
"But general recommendations are to wait until having your GP check after six weeks, just to make sure that everything has healed properly and that mum is feeling OK and ready.
"Having said that, you might have got the OK from your GP and you might not feel ready."
How to treat painful sex
1. Vaginal dilators
Dilators are often used to "retrain" the vagina to cope with penetration.
Dr Jennifer Gunter, author of The Vagina Bible, says: "Vaginal dilators help de-sensitise the nerves and muscles.
"You proceed at your own pace in your bedroom with no pressure. They come in sets of four or five.
"You start with the smallest, inserting as far as you can go and stopping when you feel pain, and then holding it in place for five minutes.
"Focus on slow, deep breaths to help relax your pelvic floor.
"Some dilators are vibrating, and many women find that helpful.
"Dilator exercises depend on forming muscle memory; it is more important to do them 5–10 minutes a day every day than thirty minutes once a week."
2. Pelvic floor exercises
Pelvic floor exercises can be very helpful when it comes to pain in sex.
Physiotherapist Amanda Savage said: "Like all muscles in the body the pelvic floor muscles can perform in different ways.
"Many women report they are able to reach orgasm more easily, and that their orgasms are more powerful, after focusing on pelvic floor muscle exercises."
3. The Ohnut
One woman who was suffering with painful sex invented a product known as the Ohnut which she hopes will end the agony of sex for millions of women.
It's a "comfy wearable" rubber ring that can be fitted on to the base of a man's penis or a sex toy.
It stops a man's penis from thrusting too deep - giving a woman more control to ease the pain.
Speaking about her product Emily Sauer said: "One of the new kids on the health-tech block is Ohnut, a doughnut-shaped intimate wearable designed to address deep dyspareunia.
"With a series of interlocking polymer blend rings that slip down the penis or dildo, Ohnut allows users to customise the depth of penetration."
The device, which costs £60, is made up of four separate rings, allowing a couple to vary the depth of penetration as is comfortable.
And the bonus is, the ring feels good for your partner too - still giving the feel of full penetration.
4. Involve more foreplay
The vagina is self-lubricating, but it takes a little work and dedication to get everything flowing.
Talk to your partner and ask for more stimulation and foreplay and don't rush into penetrative sex.
Dr Mary Jane Minkin, a clinical professor of obstetrics, gynaecology and reproductive sciences at Yale School of Medicine, says: "It's the equivalent to a male erection — the woman needs stimulation and foreplay or else sex is probably going to be uncomfortable or painful."
Slowing things down and being more mindful about foreplay and sexual arousal can really help.
5. Botox
Some women have reported having great results using Botox.
Botox is thought to weaken the muscle spasms that are causing the vaginismus.
The treatment involves injections into the vagina muscles while under anaesthesia, but it is thought to only last about four months.
As for how long it will take before the treatment works, it varies from woman to woman.
6. Work with a psychologist
If there's an emotional reason or anxiety that's causing your pain, a counsellor or sex therapist may be able to help .
Your GP or sexual health clinic can refer you to one.
Dr Gunter says: "Working with a psychologist to address trauma, anxiety, and any relationship issues may be part of the treatment plan.
"This doesn’t mean that your pain is in your head, it means that pain affects your life.
"Addressing this impact can help reduce suffering.
"Women who have extreme anxiety responses to the thought of or attempts at penetration may find working with a therapist especially helpful."
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