How can you overcome painful sex?

The shocking scale of painful sex

Around one in ten British women finds sex painful. These results come from a study of over 6,500 women, published in BJOG: An International Journal of Obstetrics and Gynaecology.

A quarter of those surveyed experienced pain very often or always, for over 6 months, and it was causing them distress. Women in their late 50s and early 60s are most likely to be affected, followed by women aged 16-24.

Some women said they avoided intercourse because they were so afraid of the pain. Painful sex was strongly associated with lack of enjoyment and anxiety about sex. And it associated with relationship problems and physical and mental health, including depression.

But you can do something. Modern professional approaches, such as Sexological Bodywork, offer a way to learn about your unique body, desires, and sexuality. Not only can you overcome pain, you can also open new possibilities of enjoyment and self-expression.

What are the effects of painful sex?

Painful sex leads many women to avoid intimacy because of fear of penetration. And that leaves women unsatisfied and distressed, and causes problems for relationships.

Women can feel that there’s something wrong with them. They can feel depressed. They are disconnected from their bodies and suffer stress from hiding the situation from a partner or enduring painful penetration.

For anyone wanting to start a family and get pregnant, painful sex is a major hurdle. Creating a new life can be a joyful experience, but when sex is painful, it can create deep emotional distress.

And medical examinations can bring a great fear of pain, with many women avoiding gynaecological check-ups and risking more serious issues going undiagnosed.

Shame can stop women reaching out for support with sex

Shame is one of the biggest obstacles to overcoming painful sex. You might find talking to someone, even your partner, about sex and pain is difficult.

But nothing is wrong with you and you have nothing to be ashamed of. Sexological Bodyworkers train to listen and be accepting of you, your experience, and your history, with compassion and without judgement.

With time, practice, and determination, you can overcome painful sex. And Sexological Bodywork practices are an enjoyable way to overcome those problems.

You might meet challenges on your journey – particularly finding the courage to book a session – but the rewards are a life full of intimacy, enjoyment and good relationships.

What are the causes of painful sex?

The medical name for pain attempting, during or after intercourse is dyspareunia.

The causes of painful intercourse can include:

  • Not enough arousal and lubrication
  • Injury, physical trauma or irritation
  • Surgery or medical treatments
  • Infections, such as thrush or sexually transmitted infections (STIs)
  • Irritation, possibly from soap, shampoo, spermicides or latex condoms
  • Physical conditions, such as fibroids
  • Change in hormone levels, especially in the menopause
  • Vaginismus
  • A differently formed vagina
  • Psychological issues
  • Stress
  • History of sexual or emotional abuse

What is vaginismus?

Vaginismus is a particular type of painful intercourse (dyspareunia). Vaginismus is when the vagina suddenly tightens up or spasms when you try to insert something inside, like a finger, tampon or penis. The body automatically tightens as a reaction to the fear of penetration.

If you have vaginismus, you might experience pain ranging from a mild discomfort to severe. You might feel a burning or stinging sensation, or feel like your vagina is “too tight” and being painfully stretched.

What are the symptoms of vaginismus?

Common signs of vaginismus are:

  • Using a tampon is difficult
  • Vaginal penetration during sex, or self-play is painful
  • You feel a burning or stinging pain during sex

You might also have a fear of sex and a loss of sexual desire. Although many women with vaginismus experience sexual pleasure and orgasms from manual or oral stimulation.

Medically, if you’ve had pain every time something has entered your vagina, or you’ve never been able to insert anything, this problem is known as primary vaginismus. It’s sometimes called lifelong vaginismus.

If you’ve had penetration before without pain, but then it becomes difficult or impossible, that is called secondary vaginismus. It’s sometimes called acquired vaginismus.

It’s possible for vaginismus to occur only in certain circumstances. For example, you might have no pain masturbating with a dildo, but experience pain having penetrative sex with a partner.

What causes vaginismus?

Many things can bring on Vaginismus, including forced penetration, or penetration before you are ready. Trauma, anxiety and stress, STIs, and changes in your body such as childbirth, surgery or menopause could all cause it.

Vaginismus often has no physical cause. The reasons you have painful sex might be unclear to you and to your doctor. But you might have an unconscious belief, or a memory of pain, that makes your body tense to protect itself. For example:

  • A bad first sexual experience
  • An unpleasant medical examination
  • Being told sex is shameful or wrong
  • Any other historical pain in your vagina, such as from an STI or thrush

How can you treat painful sex?

Start by visiting your GP or a sexual health clinic to check for physical issues, infections and disorders. If that hasn’t helped, specialist help may be the answer. In particular, Sexological Bodywork can help you learn about your body, emotions and responses and find your own path to enjoyable sex.

You can absolutely overcome painful sex. You can learn more about your genital anatomy and how your body naturally becomes aroused. You can learn how your body responds to stress, fear and anxiety. You can break old habits, learn fresh approaches and re-train your mind and body.

This learning and re-orientation can take time, and you’ll need practice and gentle determination. But the rewards of self-confidence, better relationships and enjoyment in life are enormous.

So in the rest of this article, we’ll investigate some common issues and some practices to explore yourself or with a professional. If you would like support, I offer Sexological Bodywork and sexual coaching sessions in-person in London, and online, that can help you discover enjoyable sex. I specialise in supporting women when there psychological reasons behind painful sex, such as trauma or strong beliefs, fears or emotions.

Lubrication is essential for enjoyable sex

A lack of lubrication often causes painful sex, particularly pain on first entry. Lubrication can be affected by a drop in oestrogen after menopause or childbirth and by certain medications, including antidepressants, high blood pressure medications, sedatives, antihistamines and some birth control pills.

You might try to fix the problem by using a lubricant and, although lubricants can be useful, they can mask an underlying problem: a lack of arousal and foreplay. With adequate foreplay and arousal, most women will lubricate naturally. And more than lubrication, their vulva and vagina will more likely become aroused and ready for sex that feels far more pleasurable.

Take your time getting aroused

One of the sad traps of painful sex is when women make sex quick to “get it over with”. But spending longer and taking the experience slowly is one key to an enjoyable experience.

The vagina takes around 30 minutes of stimulation to engorge fully with blood. So taking more time building arousal using mental and emotional stimulation and physical stimulation across your whole body before penetration is often the key to enjoyable sex.

If you find getting aroused is difficult, or you have little idea how to have an enjoyable arousing experience for 30 minutes, then a Sexological Bodyworker can help you explore what works for you. We know hundreds of possibilities for exploring your sexuality, and the best ways won’t be from a list or a textbook. The best ways of becoming aroused will emerge as you connect to your true self, your desires and your authentic expression.

Learn about the amazing way your body prepares for sex

Your vulva and vagina go through an amazing transformation during arousal. Noticing these changes can help you know when you’re physically ready for penetration.

You might notice how your inner and outer lips swell, becoming puffier and changing colour. Your clitoris swells, sometimes becoming more prominent and sometimes disappearing into its hood.

Inside the vagina, your tissues swell with blood and, if you can feel inside, you’ll notice a much “puffier” feel. Deep inside, your whole vagina changes shape with your cervix and uterus lifting inside your body to make more space. This movement is called “tenting”.

You can notice these changes and build a deeper relationship and appreciation of your body with a few simple practices.

Develop a mindful relationship with your vulva and vagina

One practice is to take a few moments of quiet stillness to notice how your vulva and vagina are feeling. You can call this mindfulness, or body focusing. What sensations can you notice? Is there movement, pulsations, tingles, tensions, pains, the throb of blood flow? Just notice the sensations without changing anything.

Do this practice before you are aroused. Then do the practice again after 30 minutes of mental, emotional and whole-body erotic stimulation. What differences do you notice?

Repeating this practice over many weeks or months will help you develop a deep conscious connection to how your vulva and vagina are feeling, what you like, and when you are ready sexually.

If noticing your body is difficult, perhaps overwhelming or scary in some way, then there are Sexological Bodywork approaches that can gently and safely help you establish a relationship with your body. Simply get in contact and we can talk through what’s possible.

Develop a relationship with your vulva and vagina using a mirror

Try looking at your vulva with a hand mirror. Use the mirror and spend a few minutes noticing whatever you notice, before and after a long period of arousing activity. Take the time to notice the shape and colours of your vulva, especially your lips and clitoris. And perhaps feel the textures, firmness and thickness of your lips with your fingers.

This mirror practice is especially useful if you noticing sensations in your vulva and vagina is difficult or if you struggle to keep your attention there.

Notice the beauty of your vulva and vagina

Any practice of noticing your vulva or vagina works best if you can be curious and have a sense of wonder about this amazing part of your anatomy. So, if negative thoughts or feelings appear, try to put them aside and notice the beauty instead.

If you need support with these practices or struggle with repeated negativity towards your body, you can get support in Sexological Bodywork sessions with me.

Physical practices to heal painful sex and vaginismus

Once you’ve started mindfully noticing your vulva and vagina, you might try practices to engage with the muscles or improve what you can notice. As Sexological Bodyworkers we teach many practices, and here are two that you can try yourself:

  • Breathing exercises
    • Although we think of breathing being in our chests, breathing involves muscles right down to our pelvic floor. So, try taking deeper breaths than usual and see how far down your body you can notice the breath? Can you take a breath that you feel in your pelvis?
    • If you can notice a deep breath going down to your pelvis, then, when you exhale, allow your whole body to relax and extend that relaxation into your vulva and vagina.
    • Carry on this slow pulsation of inhalation and relaxation, noticing the breath relaxing your vulva and vagina for at least 10 minutes, and notice how you feel afterwards.
  • Pelvic floor exercises
    • Try squeezing and releasing your vaginal muscles.
    • Learning to relax is as important as learning to squeeze. Fully let go and relax the muscles after each squeeze. Use a big exhale of the breath to help. And you can also visualise your muscles and vagina opening up.
    • You can try clenching your fist and then releasing to give you a reference experience of tensing and releasing. Then notice if you can feel something similar as you squeeze and release your vagina. Again, focusing on the release and relaxation.
    • If you have vaginismus, you’ll generally best to do the minimal squeezing  – just enough so you can notice the muscles – and really focus on the relaxation.

Working with beliefs and the unconscious

Many issues around painful sex, and particularly vaginismus, come from beliefs you might have that sex is bad or shameful, or from difficult experiences or trauma that are “remembered” by your body and your vagina.

You might benefit from a talking therapy that uncovers beliefs and history behind any fears or tensions that create pain in sex. Therapies that encourage you to notice sensations in your body will be most successful.

I offer talking sessions using Clean Language: an elegant way to explore people’s experience without imposing your own worldview. It integrates body focusing, which is a way of mindfully becoming more aware of your body and sensations. And Clean Language allows you to work with your own inner symbols and metaphors to bridge to the unconscious. I find Clean Language and body focusing a deeply empowering way for people to achieve their goals, and solve issues themselves.

And if you have a painful or traumatic past, Clean Language provides ways to resolve that pain and trauma without re-experiencing it, unless you choose to do that.

Vulva and vagina mapping

Vulva and vagina mapping is a Sexological Bodywork practice where you or your practitioner methodically touch your vulva and vagina in a structured way. The practice builds neural pathways so you become more consciously aware of different parts of your vulva and vagina, where feels good, where doesn’t, where tensions are and what kind of touch you like.

The simplest touch is placing a hand over your vulva without moving. You might also try having a finger over the entrance of your vagina, but with no intention of going inside.

As you explore different touch, you might choose to go “round the clock”, placing a touch at “12 o’clock”, “1 o’clock” and so on, starting outside the vagina and then (if comfortable) at different depths inside the vagina.

With every touch, you stop and mindfully notice the effects of the touch. You might also alter the touch – for example, more or less pressure, or to make a slight vibration or circular motion.

This practice develops your conscious awareness of your vulva and vagina, and helps you release tensions and pain and discover what is pleasurable. You’ll also connects to your “emotional brain” so you can discover where your vagina is “storing” emotions or reactions.

Often, as you discover tensions, pains or stored emotions, simply the act of keeping touch and attention on that sensation is enough to release them.

You may have heard about other similar practices, but be aware that Sexological Bodywork has a strong code of ethics, a professional body and a foundation of consent and empowerment that keeps you as in control and safe as possible when doing such intimate practices.

Always do bodywork with a trauma-informed specialist

Vulva and vagina mapping can release emotion and potentially access past trauma. So make sure you choose a professional who is certified and a member of a professional body (such as the Association of Certified Sexological Bodyworkers) and has experience working with powerful emotions and trauma.

I once experienced past trauma and a strong body reaction in session with a practitioner who wasn’t able to support me. And I shut down and avoided repeating that experience for over a year. Eventually, I revisited that body reaction with skilled practitioners who enabled me to process that experience. So, I’ve experienced first-hand the importance of working with the right person.

My background is working with women who have sexual assault in their history. So, I’ve held space and supported women through strong emotions of rage, shame, guilt and grief. I’ve supported them through intense body experiences and through recollection of assault and abuse. I know from how they’ve blossomed into freedom after these sessions, the value of having a strong, supportive practitioner to guide you.

I’d be honoured if you considered me as someone who could support you too.

– Paul

Continuing your exploration...

If you'd like to find out more, feel free to explore the articles on this site or read about the work I do both online and in-person in London.

And when you're ready, you can schedule a free friendly chat with me to explore what's possible and whether we'd be a good fit to work together.

There's no pressure to do anything or sign up for sessions, so if you think this work might help you, then feel free to schedule some time with me - I'd love to meet you.

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