Painful intercourse

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by Guest Posts on Mon Mar 14, 2022 2:13 pm

Painful intercourse

I have extreme pain during sex and smears. I cannot help but scream or shove my fist in my mouth. I have had this since my late 20s.
There have been lots of tests and scans and nothing is seen.
It is the bony bit that the speculum or penis touches, i assume my pelvic opening.
Is there anything you can suggest?
I'm only 52 and haven't had sex for ages. No partner (now), post menopause, have fibromyalgia and Sjogren's Syndrome and arthritis. (Heidi)
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Dr Naomi Sutton
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by Dr Naomi Sutton on Tue Mar 15, 2022 9:36 pm

Re: Painful intercourse

Dear Heidi,

It is difficult to know exactly what is going on but it may be that you are suffering from Vulvodynia (unexplained pain in the vulva), vaginismus may be one element of this. I am not sure if this has every been something which has been mentioned as a possibility, or thought about?

Vaginismus is a relatively common cause of sexual discomfort in women of all ages and it can be present from the first attempt at penetrative sex or can develop later on in a woman's sexual journey, sometimes as a result of pain from medical procedures, a bad sexual experience or assault or other types of physical or psychological trauma. Very often no cause for this condition is identified. It can affect women to varying degrees, from light burning pain to inability to have any kind of penetration.
It is caused by the muscles of the pelvic floor (surrounding the entrance to the vagina) tightening up if you try to have sex or put something into the vagina, like a tampon or a speculum.

Vaginismus can be helped by understanding what is happening within your body. The first thing I advise all women to do a bit of self exploration, alone.
With this condition, just touching the vaginal opening can trigger tightness of the pelvic floor, or it may be that you can insert one finger comfortably. I would always recommend seeing a pelvic physio who has expertise in this problem who can help you understand your pelvic floor and advise on use of dilators if indeed this problem exists and is appropriate.
The severity of the vaginismus and the goals of the patient, for example is the goal to have penetrative vaginal sex, will guide what therapy is needed.
As well as working on relaxation of the pelvic floor for this condition, I would recommend anyone suffering with any form of sexual dysfunction to work with a CORST registered psychotherapist. Sexual dysfunction of any category is often caused by a psychological issue, or causes them, or a big old mixture of the two! It is not just the physical elements of these problems which need working on to be able to heal.

A really great book to read is 'My Broken Vagina by Fran Bushe'.

The other point to add is that penetrative sex is NOT always necessary. Most women cannot orgasm from penetrative sex alone anyway so why do we put so much pressure on penetration of a penis as the goal of sex?
I would argue that if something is painful don't do it! There are so many more ways to 'have sex' and be intimate without vaginal penetration.

I hope some of this helps.

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