Dyspareunia: Why Do You Find Sex Really Painful?

Sex isn’t always smooth-sailing, but when it’s downright painful your wellbeing may be at risk of dyspareunia. This is the clinical term for painful sex, which can cause a burning, sharp, searing or cramping pain in your abdomen, pelvic region or vagina. The pain can also affect you externally, but why does dyspareunia have such an impact on your wellness?

 

The exact number of women whose sexual health is affected by dyspareunia is unknown, but, back in 1986, Masters, Johnson, and Kolodny discovered that roughly 15% of adult women have painful intercourse on at least a few occasions in a given year, but 1-2% suffer more often than that. Then, in 1990, Spector and Carey reviewed the literature on dyspareunia and reported incidence ranging between 8% and 23% percent across studies. The cause of each case may be due to any number of given factors, or the precise cause may not be identifiable at all. As with most cases of sexual dysfunction, the causes of dyspareunia can be classified as either organic (physical or medical factors such as illness, injury or drug effects) or psychosocial (including psychological, interpersonal, environmental and cultural factors).

 

As a woman, your dyspareunia may be caused by dozens of underlying physical conditions – basically anything that leads to poor vaginal lubrication. Commonly, drugs that have a drying effect – such as antihistamines, certain tranquilizers, marijuana – and disorders such as diabetes, vaginal infections, and oestrogen deficiencies can cause discomfort during intercourse. Still, the buck doesn’t stop there. Other causes of dyspareunia include:

 

• Blisters, rashes and inflammation around your vaginal opening or vulva


• Clitoral irritation or infection


• Disorders of the vaginal opening, such as scarring from an episiotomy, intact hymen or remnants of the hymen that are stretched during intercourse, or infection of the Bartholin’s glands


• Disorders of the urethra or anus


• Disorders of the vagina, such as surgical scarring, thinning of vaginal walls (be it due to ageing or oestrogen deficiency), and irritation due to chemicals found in contraceptive materials or douches


• Pelvic disorders such as infection, tumours, abnormalities of the cervix or uterus, and torn ligaments around your uterus

 

There are also psychosocial causes of dyspareunia. These may be as frequent and varied as organic ones, but it’s harder to see the clear link between such factors and the condition itself. According to many authorities, developmental factors – such as a troubled parent-child relationship, a negative family attitude towards sex, a traumatic childhood, a traumatic adolescent sexual experience and a gender identity conflict – may all predispose you towards developing a sexual dysfunction. When it comes to dyspareunia, if you’ve been brought up to believe that sex is wrong or will cause you pain, you’re more likely to feel pain with intercourse as an adult. Similarly, a one-off painful sexual experience may make you expect painful intercourse in the future.

 

Then you have personal factors at play in dyspareunia, such as anxiety or fears or pregnancy, intimacy and rejection. These feelings, and others, may block your brains’ pathways of sexual response, and instead cause you to feel pain. Dyspareunia can also result as a consequence of relationship problems or interpersonal conflicts, including power struggles, hostility towards your partner, preference for another partner, distrust, poor communication and lack of attraction to your partner. Other personal factors involved in painful sex include feelings of guilt, depression and poor self-esteem. That said, it is not always clear which came first, the feelings or the dysfunction. If you suffer from dyspareunia, this can cause you to feel depressed or unconfident, and so identifying a problematic feeling does not always mean it caused the dysfunction.

Categories: Causes, Dyspareunia, feel pain, Pain During Sex, painful, painful intercourse, painful sex, personal factors, sexual dysfunction, sexual experience, vaginal opening

What To Expect AFTER You’re Expecting: Vaginal Changes

It’s natural for your vagina to change after giving birth, but these changes can be a real dampener to your sense of sexual health, on top of the other things affecting your wellbeing once you become a mother. Still, you can deal with these post-pregnancy vaginal changes as long as you know what to expect and how you can help speed your recovery.

 

1. Wider vagina: According to Dr Suzy Elneil, consultant in urogynaecology at University College Hospital, London, ‘The vagina can feel looser, softer and more “open,” as well as looking and feeling bruised or swollen. This is nothing to worry about, as the swelling and openness should start to reduce a few days after your baby is born. The chances are that your vagina won’t completely return to its pre-birth shape, but Dr Elneil says, ‘We always recommend pelvic floor exercises.’ Also known as kegels, pelvic floor exercises help to tone your vaginal and pelvic floor muscles, and this prevents incontinence, firms your vagina and improves sexual satisfaction.

 

2. Vaginal dryness: When you were pregnant, you had higher levels of oestrogen in your body but now that they’re gone your vagina feels dryer than usual. However, this vaginal dryness should improve with time. Dr Elneil explains, ‘Once you stop breastfeeding and your periods have returned, the levels of oestrogen revert to pre-pregnancy levels.’ If this dryness is causing problems in your sex life, it’s important to talk to your partner about it so you don’t have to worry alone. You may need to start using a water-based lubricant (oil-based ones can tear or rip latex condoms) to make sex more comfortable until the dryness subsides.

 

3. Soreness and stitches in the perineum: Dr Elneil notes, ‘The vaginal area can feel painful or sore in the immediate period after childbirth. This usually improves within 6–12 weeks after the birth. We always recommend pelvic floor exercises to help make the situation better in this case, too.’ It’s common for the perineum to feel sore after giving birth, especially if your skin tore or you needed stitches to repair a tear or episiotomy. Although over-the-counter painkillers can help, you should consult your midwife, GP or pharmacist first if you’re breastfeeding. Keeping the perineal area clean is important, which means you need to change your sanitary pads as soon as you need to, wash your hands before and after you change them and have a bath or shower every day to keep your perineum clean. If you have a lot of pain or discomfort or you notice a smell in your perineal area, talk to your health visitor or GP.

 

4. Pain during sex: Having sex again after you’ve had a baby is a decision that’s different for everyone, as there’s no right or wrong time to start. However, you should refrain from rushing into it, no matter how much you won’t to, as painful sex won’t be pleasurable – and where’s the fun in that? Again, lubricants may be able to help if your vagina feels dry, but if the pain during sex is caused by discomfort around your perineum, it might be worth visiting your health visitor or GP, as these medical professionals can look and check that it’s healing in the right way. Giving birth, looking after a baby and feeling tired from those experiences can make you feel less like having sex these days, which it totally normal. However, instead of avoiding sex, talk to your partner so you both know what the situation is, and you can deal with it together. If you do start having sex again, don’t neglect contraception as you may end up getting pregnant three weeks after giving birth, and surely you want a bit more of a break than that!

Categories: dr elneil, floor exercises, giving birth, health visitor, Pain During Sex, pelvic floor, perineal area, recommend pelvic, vagina feels, Vaginal Changes, vaginal dryness

On-Top Tips: Five Positions That Can Fix Any Sexual Problem

Trying new position doesn’t just help to spice things up; it can fix your sexual health and wellness problems. Whether you have confidence issues, pain or you’re ready to get pregnant, there’s an ideal position for any goal. Get ready to meet the positions that will boost your wellbeing, and get you the outcome you want.

 

1. Making Babies: While all kinds of sexual positions can lead to pregnancy, sex coach and certified sexuality educator Amy Levine, founder of SexEdSolutions.com, recommends the missionary position with a pelvic tilt. ‘Putting a pillow under the tush can help elevate your pelvis, and create a slide effect—providing an easy path for his swimmers to make their way through your cervix on their journey to your ovum,’ she explains. ‘Typically, women who try this tend to maximize the ejaculation, since it stays in their body a little longer compared to positions in which you’re upright, allowing the semen to drip out of the vagina.’

 

2. Building Confidence: You on top. These are the three words that Debby Herbenick, PhD, author of Because It Feels Good: A Woman’s Guide to Sexual Pleasure and Satisfaction, says that every women needs to memorise in order to feel more confident and in control. ‘It can be confidence-building because it physically helps women to be in control,’ she notes. ‘Make sure to do it your way, though. Woman on top can be done kneeling, squatting, facing forward or facing backward, so show off whatever you or he loves most about your body.’

 

3. Having Orgasms: You might not have heard of the coital alignment technique, but it’s an absolute must-try for female pleasure. According to Dr. Herbenick, ‘This is a wonderful variation on missionary and one of the few sex positions that has ever been researched and found to be helpful for women who would like to orgasm during sex. It involves the guy sliding himself forward, with his shoulders past yours, and your pelvic areas grinding and not thrusting so much. This targets more stimulation on a woman’s clitoris, making it easier for some women to feel pleasure and possibly orgasm.’

 

4. Lasting Longer: Levine advises men who want to increase their staying power to try the missionary position with the man on top. ‘It can work for him if he has trouble going the distance,’ she comments. ‘The key is that he’s in an easy position to stop and start when his arousal is increasing at a fast rate, and can take it down a notch so he can last longer.’ Ava Cadell, a sex educator and founder of Loveology University in Los Angeles, adds, ‘The “fox” position is a variation of missionary, in which the woman’s legs go all the way up and over her lover’s shoulders. Penetration of the vagina is very deep in this position. She is contained in the boundaries of his body and he can dive totally inside her, maintaining his arousal and lasting longer.’

 

5. Relieving Pain: Dr Herbenick outlines two ideas for fixing intercourse-related pain. The first is to use lots of water-based lubricant, and the second is to keep the reins in your hands, and get on top. This position ‘gives the woman more control over taking sex at a pace that is comfortable for her,’ Dr Herbenick clarifies. If your pain is because your man is too well-endowed, try Dr Herbenick’s solution: ‘The guy lies on his side; she lies perpendicular to him with legs spread as they rest over his body. This allows her to hold the base of his shaft if she wants to limit his range of motion, and allows her to use pelvic rocks to create an in-and-out sensation.’

Categories: conception, dr herbenick, lasting longer, missionary position, nbsp, Pain During Sex, position, positions, woman, Women

How to Deal with Post-Childbirth Changes to Your Vagina

After giving birth, it’s natural for your vagina to change (after all, you have squeezed a human being out of there). Still, these changes can be a real dampener to your sense of sexual health, which is certainly unhelpful considering all the other things affecting your wellbeing, such as coping with the challenges of motherhood. The best way to prepare and deal with these changes is to find out what to expect and the ways you can help speed recovery.

 

1. Wider vagina: According to Dr Suzy Elneil, consultant in urogynaecology at University College Hospital, London, ‘The vagina can feel looser, softer and more “open,” as well as looking and feeling bruised or swollen. This is nothing to worry about, as the swelling and openness should start to reduce a few days after your baby is born. The chances are that your vagina won’t completely return to its pre-birth shape, but Dr Elneil says, ‘We always recommend pelvic floor exercises.’ Also known as kegels, pelvic floor exercises help to tone your vaginal and pelvic floor muscles, and this prevents incontinence, firms your vagina and improves sexual satisfaction.

 

2. Vaginal dryness: When you were pregnant, you had higher levels of oestrogen in your body but now that they’re gone your vagina feels dryer than usual. However, this vaginal dryness should improve with time. Dr Elneil explains, ‘Once you stop breastfeeding and your periods have returned, the levels of oestrogen revert to pre-pregnancy levels.’ If this dryness is causing problems in your sex life, it’s important to talk to your partner about it so you don’t have to worry alone. You may need to start using a water-based lubricant (oil-based ones can tear or rip latex condoms) to make sex more comfortable until the dryness subsides.

 

3. Soreness and stitches in the perineum: Dr Elneil notes, ‘The vaginal area can feel painful or sore in the immediate period after childbirth. This usually improves within 6–12 weeks after the birth. We always recommend pelvic floor exercises to help make the situation better in this case, too.’ It’s common for the perineum to feel sore after giving birth, especially if your skin tore or you needed stitches to repair a tear or episiotomy. Although over-the-counter painkillers can help, you should consult your midwife, GP or pharmacist first if you’re breastfeeding. Keeping the perineal area clean is important, which means you need to change your sanitary pads as soon as you need to, wash your hands before and after you change them and have a bath or shower every day to keep your perineum clean. If you have a lot of pain or discomfort or you notice a smell in your perineal area, talk to your health visitor or GP.

 

4. Pain during sex: Having sex again after you’ve had a baby is a decision that’s different for everyone, as there’s no right or wrong time to start. However, you should refrain from rushing into it, no matter how much you won’t to, as painful sex won’t be pleasurable – and where’s the fun in that? Again, lubricants may be able to help if your vagina feels dry, but if the pain during sex is caused by discomfort around your perineum, it might be worth visiting your health visitor or GP, as these medical professionals can look and check that it’s healing in the right way. Giving birth, looking after a baby and feeling tired from those experiences can make you feel less like having sex these days, which it totally normal. However, instead of avoiding sex, talk to your partner so you both know what the situation is, and you can deal with it together. If you do start having sex again, don’t neglect contraception as you may end up getting pregnant three weeks after giving birth, and surely you want a bit more of a break than that!

Categories: childbirth, dr elneil, floor exercises, giving birth, Pain During Sex, pelvic floor, vagina feels, Vaginal Changes