Sex can be one of the most profound ways of expressing love and intimacy between two people. For some people, this intimate union is, unfortunately, actually impossible or can sometimes even be quite painful, according to Sexologist Maha Nasrallah.
The recurrent or persistent experience of genital pain upon or during penetration, or after sex is referred to as dyspareunia. For women, this pain can be superficial, vaginal, or deep. Superficial pain occurs when penetration is attempted, and is usually resulting from anatomic or irritative conditions, or even from vaginismus. Vaginal dyspareunia refers to when the pain is related to the friction of intercourse, which is typically linked to lubrication and arousal issues. Deep pain in dyspareunia is related to pain during thrusting, and is often associated with pelvic disease and/or relaxation.
There are numerous possible medical conditions that may help cause dyspareunia. Some of those are frequent yeast infections, infections of the vagina, lower urinary tract, cervix, fallopian tubes, or even sexually-transmitted infections such as chlamydia and herpes. Vulvar vestibulitis (VVS or Vulvodynia), which is a chronic pain syndrome in the vulva not explained by vaginal infection or skin disease, can also cause dyspareunia. Vulvodynia can occur not only during or after sex, but also during other instances such as inserting tampons, or even from prolonged pressure on the vulva. In addition to possible inflammation, it has been suggested that there is an altered neuronal sensitivity in women with VVS and that these women show an enhanced sensitivity to pain not only in the vulvar area but also in other parts of the body. It is therefore sometimes advisable to conduct a meticulous yet gentle medical examination to uncover any underlying physical causes and be able to form an accurate diagnosis and create a comprehensive treatment plan.
A common factor that can cause or worsen the pain is inadequate lubrication that is likely due to lack of arousal. If you feel you are not being sufficiently aroused, it is important to try to find out why. Are there relationship issues that are leading to a less satisfying and pleasant sexual relationship? Or maybe there are some personal issues that have recently come up, changes in your life, some added stress or burdens that are preventing you from being relaxed and allowing yourself to be aroused. When women experience pain during sex, they often learnt to expect to feel pain and are thus apprehensive of it in sexual situations. This can lead to less arousal and consequently less lubrication, which in turn increases the likelihood of experiencing pain. Though it is not entirely clear whether less lubrication causes the pain or whether the apprehension of pain is what causes less lubrication, there is a clear association. Learning to relax and be less fearful about potential pain could help in enhancing your arousal levels and lubrication.
Another slightly easier difficulty to overcome is vaginismus, where a woman finds herself unable to have penetrative sex or, in extreme cases, have any object inserted in her vagina. The vaginal muscles clamp up forming some sort of a wall that is quite difficult to break through. Practicing certain sensual and body exercises such as exploring the vagina and relaxing the corresponding muscles through the help of vaginal dilators can help to slowly begin to accept the insertion of smaller objects such as a finger and ultimately a penis.
Behind every woman and relationship lies a different and unique story and there are a number of convoluted issues within each woman facing this type of difficulty; common ones are believing that sex is immoral and shameful, past trauma, and general anxiety. It is also not shocking to learn that many times there is an underlying deeper fear or past experience that leads to shutting the partner out and preventing “allowing someone in”. Perhaps there is a fear of getting hurt or feeling pain, a fear of being truly exposed and vulnerable, a fear of being judged, or a fear of letting go and not being in control. Or maybe there is a painful memory that comes up during moments of intimacy – a distressing experience such as sexual abuse. Bringing all these issues to the light in order to understand and confront them is an important step in personal growth and in ultimately dealing with this concern and receiving love.
Although we all want to be loved and believe we are willing for it, we do not always really allow love in. But it is only when we learn to truly receive love that we can excel in giving it back.