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Experiencing painful sex

Words by: Lauren French, MSexol (Curtin) Australian Institute of Sexology and Sexual Medicine

As a sexuality educator and sexologist, I see clients daily who experience pain and the compounding effects that the stigma creates. Physically, they describe their pain as a sharp, burning, stinging, and stabbing sensation experienced on their outer genitals, inside their vagina, or even when they try and use a tampon. Mentally, they describe feelings of guilt within their relationships, feeling like they are broken or somehow less of a woman.

If this is sounding familiar to you, you’re not alone. Research shows us 1 in 5 vulva owners will experience painful sex at some point in their life, many suffering for years before finding an effective treatment. So why are so many of us dealing with this pain?

A common misconception is that first-time penetrative sex will hurt, though this is not always the case and shouldn’t be the case. What is actually happening here is if we don’t do adequate foreplay, work with our partner to get them to a high state of arousal, and use lubricant before penetration, our partner will probably experience pain. Yet, everyone takes this pain for the first time as fact, causing many vulva owners to not even realise the extent of their sexual pain until they find this ‘once off pain’ isn’t going away.

Sex should always be pleasure-focused; in fact, sexual pleasure is a human right as outlined by the WHO. Yet many vulva owners have spent years either gradually avoiding sex, or continuing to have sex but ‘pushing through the pain’. No one should have to be counting down the seconds until it's over. Gritting our teeth and baring it doesn’t help us, our pain, or our relationship.

When we keep having painful sex, we get stuck in a pain cycle in our brain, try to think of it as a pain feedback loop. You experience painful sex (ouch!), then your brain associates sex with pain, therefore the next time you go to have sex your brain tenses up, trying to avoid this pain it thinks is coming. Your pelvic floor tightens and BAM, sex is painful. Our brain and body are working together against us, causing painful sex all in the name of avoiding painful sex!

Outside of the physical pain vulva owners experience, there is a huge mental burden associated with any sexual dysfunction or sexual pain. It becomes a silent weight we carry, as the stigma surrounding it means we very rarely open up and talk about it. If we believe sex should be this easy natural thing, any issue we’re experiencing must be a reflection of ourselves. We must be the problem. This can cause us to mentally shut down around sex, as it's no longer a fun activity but rather a shame-filled failure. When we get to this mental space our pain is no longer merely physical, if it ever was. We now have a huge negative view of sex, shame tainting our pleasure, and potential fear around getting back to your normal sex life.

While treatment does exist and is very effective, many will spend years stuck in this pain cycle. Female sexual pain can also be difficult to manage as it can be misdiagnosed by GPs or belittled like so many other female health concerns. However, help can’t be found if we don’t look! The stigma around any sexual issue is huge, and the idea that everyone should be able to have great, pain-free sex

without any help seems to be the norm.

With a growing awareness of sexologists, we are realising that there is support out there. Everyone needs help sometimes, there is no shame in saying ‘hey, I’m having painful sex and I don’t want to be anymore!’. The first step can feel the biggest, but it won’t take too many more before we reach pain-free pleasure. Pain doesn’t need to be your norm.

For anyone experiencing sexual pain please stop having penetrative sex! There is no need to keep feeding that pain cycle, so let's just focus on outercourse for a while. You can still be intimate and sexual without that pain. I would then recommend you to book in with a sexologist and pelvic floor physio team to help you get back to pleasure.

If you are experiencing pain or discomfort, please consider speaking with a sexologist at Aissm.

Lauren French is a proud First Nations woman, Victorian Secretary of the Society of Australian Sexologists & a clinical Sexologist working with the Australian Institute of Sexology and Sexual Medicine. Lauren is also a sexuality educator with Body Safety Australia, a non for profit organisation specialising in childhood sexual abuse prevention.

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