These are NOT My Definitions of Painful Sex
Experiencing pain with sex is common for many diagnoses. Pain with sex is experienced by both men and women. I treat a lot of patients who have painful intercourse, but there are so many more people out there who haven’t even discussed this with a health professional and may never feel comfortable asking for help. Hopefully this post can be of assistance to those people as well.
Sex is such a large topic for so many people and it effects people differently. Sex is such a large part of how we use our pelvis. Sex is a large part of romantic relationships with other people and feeling sexual and being sexual is a large part of our relationship with ourselves. When the ability to be intimate in a way that we have always been familiar with or in a way that we have always wanted to be is hampered by pain, it can be devastating. If sexual intercourse, feeling sexual, or being sexual has always been a part of your life and right now that part of you is being compromised by pain, it’s so important not to write this off.
This post will focus on painful sex for women.
If you’ve told your doctor about your pain with sex, hopefully they have suggested pelvic floor physical therapy instead of telling you to just relax.
I had a “friend” who had painful sex and this is “her” story:
I was married and saw a gynecologist for painful sex. He did an exam on me and said “Well, the muscles are a little tight, but you should be able to have sex. You have vaginismus.” (Note – I didn’t have vaginismus.) Then he looked at my ring finger and then at my face. “If you want to keep that ring on your finger, I suggest you try to keep having sex. Just drink some wine and relax.” Then he gave me a massive plastic dilator. Massive. He said “Here, work on getting this in. I have full confidence that you can insert this completely.”
He didn’t tell me to use lube. He didn’t tell me what to do with it. I remember lying on my floor watching Oprah and trying to get it in. It went in and it went in without pain, but my muscles kept pushing it out. And I still had pain with sex.
This was a gynecologist fail. He didn’t have empathy, he made her feel guilty about her problem and she still had pain with sex. Good God it must have been her fault! It must have been because she didn’t love her husband enough. She must have sex or he would divorce her! And her pelvic floor continued to tighten with each attempt at sex….
I think that painful sex in women has three categories and textbooks think that painful sex has a different three categories. These categories are boring words that sound like dinosaurs.
Boring Words that Sound Like Dinosaurs…
1. Dyspareunia – This means that you are having painful intercourse and it is an umbrella term. The big term, dyspareunia (dis-par-OO-knee-ah), basically means that sex hurts. Vulvodynia means you have pain at the vulva – the crotch or external pelvis that you can see – and vulvodynia can be a type of dyspareunia. You can have dyspareunia without vulvodynia which means you have painful sex without any pain at the crotch or the external pelvis. Vaginismus and vestibulodynia (a type of vulvodynia) are both part of dyspareunia. But, you can have dyspareunia without having vaginismus or vestibulodynia. So, if you have this diagnosis without the vaginismus or vestibulodynia or any vulvodynia for that matter, then it is most likely because your pelvic floor muscles are overactive and cannot relax during sexual activity.
2. Vaginismus – This is a type of dyspareunia. This means that the pelvic floor muscles become so tight that they do not allow anything to go into the vaginal canal. That’s it. That’s vaginismus.
3. Vestibulodynia – This is a type of dyspareunia. This means that a specific part of the vulva, the actual vestibule itself feels irritated and painful (this is still vulvodynia).
But…these are NOT my definitions of painful sex.