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Dr Gabrielle Morrissey: Sexologist

Dr Gabrielle Morrissey has been a sexologist — sexuality educator, sex therapist and sex researcher — since 1990. She is also the author a number of successful books. ASK ME A QUESTION

When sex is too painful

Gabrielle Morrissey
Wednesday, August 3, 2011
Image: Thinkstock
Question: I was wondering if you know anything about pain during intercourse? For the past two or so years, I have been experiencing superficial-entrance pains (pain on entry). It takes ages of foreplay for me to feel comfortable with sex and we’ve tried so many things but none of it has helped.

Pain occurs every time that we have sex and it has also caused me to fear having sex because I anticipate the pain. My libido has decreased somewhat since I hit around 20 (I am now 22 years old). However, I still masturbate regularly because I have never been able to achieve an orgasm during intercourse.

I'm not sure whether my pain is due to psychological or physiological causes. I went to a gynecologist and everything is apparently fine, anatomically speaking. I have regular STD checks, pap smears and I have had an ultrasound of my ovaries to check for growths, and everything is fine. I hate perceiving sex as a chore and a burden. I want to please my partner more than once a week, but it's so difficult to bring myself to face the pain more often than that. If you could offer any advice I would greatly appreciate it.

Answer: Pain during intercourse is called dyspareunia, but really it is a broad term and encompasses a spectrum of possible issues.

As you say, dyspareunia can be caused by psychological or physiological factors, and often a combination of both. Once an even semi regular pattern of pain during sex is established, it is then natural to feel anxiety about intercourse, or any activity which will lead to pain. We instinctively avoid things that are painful and gravitate to, desire and even crave things which are pleasurable. Sex should be pleasurable and not painful. If it feels good, we desire it and our libido is stimulated to want more of it. If it hurts though, our brain will steer us away from it as a protective mechanism.

So take heart in knowing that your body, in its reaction to pain, is working perfectly normally. This is a good response. When trying to understand what could be causing an inappropriate response to sexual stimulation (that is, to feel bad or painful, rather than good) it is helpful to know that your body’s reaction is normal. Because you are young, and your pain is consistent every time, and it has been several years, I would suggest you see a sex therapist. If a GP has cleared any potential physiological issues, you could have a condition called vaginismus. Women with vaginismus have an uncontrollable reflex to clamp down their pelvic floor muscles in response to sexual stimuli and the anticipation of penetration. In many cases, penetration of any kind is impossible. The woman cannot control this response — she does not consciously tighten her muscles. But it can be treated, with the help of a therapist guiding you through the exercises, and understanding what has caused it.

It’s also important to realise that it may not be a case of this either: you state that you masturbate because you don’t experience orgasm during intercourse. Many people — men and women — don’t understand that this is normal. The female body is not built with primary sexual sensitivity inside the vagina. The nerve endings that are similar to the penis are outside the body in the clitoris. So to expect a orgasm through intercourse is a little like expecting a man to orgasm by stimulating his thighs alone. Most women requite clitoral stimulation to orgasm, just as most men require penile stimulation to climax. So perhaps some sexuality education and some experimentation with sexual techniques could help teach your body to respond with pleasure rather than pain and anxiety. The purpose of experimenting, at least at first, is to understand your body, rather than orgasm or feel pleasure instantly. If you pressure yourself or have too high expectations right away, that pressure will be counter productive and actually make your goal more elusive.

If seeing a sex therapist isn’t possible near where you are, try reading a book to educate yourself on what you can do to improve and remove the painful response to sex, and the anticipation of sex. A highly recommended book is called The Elusive Orgasm by Dr Vivienne Cass, but a Bing search would also reveal a range of books on the subject.

No one should have to “put up” with sex or see it as a chore, so good for you for reaching out for help. Do not suffer in silence any longer. Sexual pleasure is your absolute right. There is a solution to change the pain to pleasure but I recommend some help getting there — two years is now too long to have pain during an experience that should be the opposite for you. You’re young and you deserve decades and decades of a healthy happy love life ahead of you.

User comments
I have also been experiencing the same things this article has helped heaps
thank you - i found this article really good & have been experiening the same thing.


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