East Toronto Therapy

When Sex Hurts

For far too many women, sexual intercourse is painful. Yet when the address this pain with their doctor, they may be told that there is nothing wrong with them. In fact, these women may have vulvodynia or vaginismus. Vulvodynia and vaginismus are common causes of pelvic pain and dysapreunia (painful intercourse).

Vulvodynia refers to chronic pain in the vulva with no identifiable cause. For some women the pain is constant, while for other women the pain only occurs when the area is touched, for example when inserting a tampon or having intercourse. Women with vulvodynia may describe the pain as itching, burning or stabbing. Vaginismus refers to the involuntary contraction of the vaginal muscles. This muscle contraction causes vaginal penetration to be painful or even impossible. Women or their partners may report that it feels like there is a wall or barrier preventing entrance to the vagina. At times, vulvodynia and vaginismus occur together.

Treatment for vulvodynia may include vulvar care measures (such as avoiding the use of perfumes and chemicals around the vulva), medication, physiotherapy, sex therapy, or a combination of the above. Treatment for vaginismus may include physiotherapy, relaxation and stretching techniques, and sex therapy.

Seeing a sex therapist can help a woman who has pain during intercourse find an answer to what is causing the pain, develop strategies for coping with or eliminating the pain, and address the emotional impact the pain has had on the woman and her partner.

Often when a woman has repeatedly experienced pain with intercourse, she understandably develops negative thoughts about sex. These negative thoughts can make the pain experienced during sexual activity even more distressing. When pain prevents a couple from experiencing pleasure during sex, both partners may feel frustrated and disappointed. The woman may feel guilty for not wanting sex and her partner may feel guilty for still wanting sex. Sex therapy can address the impacts of sexual pain and help the woman and her partner rediscover sexual pleasure.