“Endo means I find sex painful a lot of the time” – Denver
For those who have PCOS, or Endometriosis, pain during sex can be common and not just attributed to vaginal dryness. In Endometriosis, the pain can be caused by pressure on endo lesions, or stretching of endometrial growths in the cervix and pelvic area. For those with PCOS, pressure on cysts can be very sore, and women routinely report vaginal dryness as a symptom of the disease, which is thought to be related to the way sex hormone production is affected by PCOS. “Oh wow, the pain during a flare up can be something else – it stops all play, that’s for sure”, cries Denver, 29. “Endometriosis has meant that I find sex painful a lot of the time – whether it’s because the position feels like it’s hitting a patch, or I’m tense from the pelvic pain I get.” Denver feels that her libido is much lower than when she was younger and the endometriosis hadn’t progressed as much. “No one tells you about this side effect and when it happens in your twenties, it’s far from ideal”.
If you have PCOS or Endometriosis and the pain is affecting your libido, it’s important to discuss this with your physician for further investigation.
“I was worried Lichen Sclerosus was a horrible infection” – Ashley
While vaginal pain is a common cause of pain during sex, we need to also consider the vulva. The vulva can be more sensitive than we might think – especially when our hormones are out of balance. When Ashley was in her early thirties, she started to see spotting in her pants and a stinging sensation when she went to the toilet. After an examination by her doctor, Ashley found that the spotting was due to small tears in the delicate vulval skin. “I felt so embarrassed, like I’d done something silly to cause the tears. I was really worried I had picked up some kind of infection.” The doctor explained that this was a condition called Lichen Sclerosus, a relatively uncommon condition that causes white, itchy and painful skin in the vulva. “It explained why sex had felt painful and it stung as my husband entered me.” Ashley uses topical steroids to manage the pain and inflammation and a vulval hydrator suitable for LS. “It’s much better than it was, but the doctor explained it doesn’t just disappear overnight. Managing the symptoms is key for me,”
Another condition, vulvodynia, can cause painful intercourse for women. Vulvodynia is chronic vulvar pain, that doesn’t present any clear cause but is persistent. It makes touch and pressure, including during sex, painful. The exact cause of vulvodynia is still under research, but gynecological experts believe that hormonal changes are an important factor in the presentation of the condition.
“I get so tense that penetration is difficult and painful” – Jessel
Lastly, our mental well-being plays a pivotal role in our sexual health. Conditions like anxiety and depression can significantly impact libido and how our body responds to sexual stimulation. It can also be intrinsically linked to how we feel about our bodies or feeling self conscious. This can lead to “spectatoring”, where you feel more focused on how you appear, or a sensation of observing yourself, rather than enjoying the moment and feeling ‘in’ the sexual activity. This can lead to decreased arousal and, in turn, less natural lubrication and a feeling of ‘being dry’.
“I’ve put on weight since I entered perimenopause, and I am so self conscious when we make love that I can’t separate my fears and worries about what my body looks like and just enjoy the moment,” Jessel bravely shares. “I can’t get ‘wet’, I get so tense that penetration is really difficult and often painful. My partner is understanding but frustrated. I know I need to relax, but I can’t work out how anymore.”
Body image and feeling connected to yourself during sex is important for intimacy. If you are feeling this disconnect is affecting your libido, speaking with a therapist can help unlock some of the barriers that you are experiencing and help you process negative thoughts.
4 Quick Steps To Take To Alleviate Painful Sex
Here’s four quick tips that will help relieve painful sex today… and actually work:
- Hydration is key! Using a vulval moisturizer or hydrator, like Glow by Hormone University’s Intimate Hydrator, can help to soothe irritation and burning, protect delicate tissues, and improve the ability of cells for lubrication.
- Hormone Replacement Therapy (HRT): For those suffering from severe vaginal atrophy or other hormone-related issues, HRT can be an option. However, it’s vital to discuss the risks and benefits with your physician to ascertain the best treatment pathway for your symptoms.
- Pelvic Floor Therapy: Women’s health physiotherapists specializing in the pelvic floor can offer exercises and treatments to improve muscle tone and reduce pain.
- Counseling and Therapy: For those who believe that their pain is linked to a psychological cause, therapy can be beneficial. It can also be a safe space to discuss fears or traumas related to intimacy. A sex therapist may also be able to help you with feelings that are a barrier to intimacy.