When you turn on the television and see an ad for sexual dysfunction, you may notice how there are two underlying messages. For men it is an emphasis on “performance.” The message is “in order to make your partner happy, you must be able to get, and maintain, a long lasting erection.” For women, in heterosexual relationships, the underlying message is “you are the receiver, sex is your duty, so grin and bear it, but this pill will help it be less painful.”
When the joys and pleasures are removed from intercourse, what are you left with? So many of the couples I work with express dissatisfaction within their sex lives. Shame and embarrassment results from societal pressures to perform and endure, thus some of these individuals are slow to report that much of the dissatisfaction is due to pain experienced during intercourse. If this is you, and/or your partner, YOU ARE NOT ALONE.
When you experience pain during intercourse, it makes sense that performance and pleasure is affected. It also makes sense that if you associate pain with intercourse, a strain is placed on your relationship. Treating the pain will not only bring joy and pleasure into your sex life, but can also help your emotional intimacy and sexual self-image.
Here are two things you can try if you and/or your partner are experiencing pain during intercourse: 1) Talk to your medical doctor and 2) Talk with a sex-positive therapist.
Consult with your Medical Doctor
When individuals or couples come into my office and share that they are experiencing recurrent pain during intercourse, the first thing I suggest is for them to make an appointment with their medical doctor. Painful intercourse can occur for a variety of reasons, for both men and women. Causes of physical pain can range from insufficient lubrication, to infection, inflammation or irritation. It can be caused by physical trauma, a congenital abnormality, a skin disorder or an allergy. Certain illnesses, surgeries or medical treatments can result in changes in the body that cause pain. The list of possible causes is long, thus why it is important to investigate with your primary care doctor or gynecologist.
Consult with a Sex-Positive Therapist
Knowing that sex is both physical and psychological, when it comes to painful intercourse it can be difficult to decipher whether the pain is a result of a physical condition, emotional condition or both! This is when talking with a sex-positive therapist can be incredibly beneficial.
Psychological conditions such as anxiety, stress, depression, low self-esteem, concerns about body image, fears around intimacy, a history of sexual trauma and relationship struggles can all contribute to low levels of arousal and result in physical pain and discomfort.
A common fear I hear from individuals is “I experienced painful intercourse and now I am afraid that it will always be painful. I can’t relax during sex because I’m afraid it will hurt.” Fear of pain can result in making it more difficult to relax and be present during intercourse, which then can result in fear of intercourse in general. Like with any type of physical pain, it is normal to want to avoid the activity associated with that pain! If you and/or your partner are experiencing pain during intercourse I encourage you to take these two steps. You deserve to be pain-free and have a joyful, and pleasurable intercourse experience! And remember, great sex doesn’t mean that intercourse has to be involved, but that topic will be for next time!
Etta Skoch is a marriage counselor who specializes in couples counseling, intimacy counseling and LGBTQ counseling.