Women and painful sex
Sometimes the cause of painful sex is commonplace: if you don’t feel like having sex or you accept penetration without prior arousal and without moving and relaxing pelvic muscles or properly lubricating the vagina, penetration can be unpleasant or even painful.
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If this is not the case, you need to pinpoint whether the pain has existed since very first sexual relations, or whether it has begun unexpectedly after a particular event (operation, infection, childbirth) and whether the pain is at the entrance or within the vagina.
The cause of the pain can be physical (gynaecological, urinary, vascular, dermatological, ligaments) or psychological. Often the causes are combined; you lose self-confidence and your body “freezes up” if the physical causes have been going on for a long time.
Identifying the causes of painful sex
A woman first needs to examine herself to see if there is a scar or change to skin surface on the labia or vaginal entrance:
- Place a finger into the vagina to detect the painful spot, a muscle that is too tense or contracted;
- Pinpoint whether the pain is the only symptom or whether burning, itching and/or discharge accompany it;
- Note whether the pain is linked or not to menstrual periods or a particular lovemaking position;
- Note whether the pain lasts during the whole sexual act or only at the beginning, end or if it even appears in the hours afterwards or the next day.
Pain at penetration
Doctors will most likely find one of the following causes to pain at penetration: infection (often cystitis, thrush or an STI), dermatological (such as eczema), or anatomical (after a difficult birth or immediately following an episiotomy). A medical examination can quickly reveal rare cases of ligament hypertonia, a too tight hymen or vaginal malformation.
- Deeper pain is due to gynaecological diseases: the most often being uterine fibromas, large ovarian cysts, endometriosis (with sterility and significant pain during periods), surgical or hormonal treatment, cervix lesions or salpingitis (fallopian tube inflammation).
Non-physical causes of painful sex
Apprehension before penetration can prevent muscle relaxation and lubrication, making penetration painful: the vicious circle of pain sets in, with increasing apprehension; the pain becomes stronger (see Vaginism).
Fear can be about disease, belief that the man’s penis is too big, feelings of incompetency and/or relationship conflicts (revealing a problem within the couple). The cause can also be less obvious, linked to subconscious conflicts.
Checking how real these obstructive beliefs are, respecting your own desire, learning to relax, regaining the desire for thinking about your own pleasure and imagining it, can all be useful ways to progress to a situation where sex is desired rather than dreaded or suffered.
Through their explanations and advice, your GP, gynaecologist or sex therapist can help to put many of these situations into perspective, so don't hesitiate to talk about it... Sex should be enjoyable, not painful!
Copyright © 2010 Doctissimo
Posted 20.07.2010
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