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Painful Sex: Why We Need to Break the Stigma and Start Speaking About It

Painful sex – a common issue which is rarely talked about. According to the American College of Obstetricians and Gynaecologists, nearly 75% of women and people with vulvas will experience pain during sex at some point in their lifetimes. For many, dyspareunia, the medical term for pain during or after sex, is experienced very sporadically or only during the one occasion. However, for others, this pain can become persistent, with significant effects on their sexual function, relationships and mental health.

It isn’t normal.

Despite being a common issue, painful sex shouldn’t be normalised. And it is certainly not an experience that women and people with vulvas should accept or tolerate. The diminishment of women’s pain, particularly in relation to sex and penetration, has been longstanding and prevailing. The misogynistic notion that women’s pain is acceptable in order to facilitate other’s pleasure is outdated and highly inadmissible. After all, sex should be a pleasurable, painless experience for everyone involved.

Painful sex can be a rare conversation topic amongst partners and friends, with many women and people with vulvas suffering in silence and sadly internalising guilt and shame around the issue. Moreover, it is thought that the prevalence of people experiencing dyspareunia is underreported, with some feeling too embarrassed or uncomfortable to speak to their doctors. Destigmatising this common issue is therefore imperative, and should be seen as a valid an issue to discuss and seek help for as any other condition.

Possible causes of painful sex:

It is important to note that there are many reasons that painful sex may occur, including various conditions, infection, physical problems, and psychological factors, and never the person’s fault. Pain during sex can be experienced in or around the vulva, in the vagina or deeper in the pelvis and lower back.

A common reason for this pain is dryness, which can be exacerbated by contraceptive use, breastfeeding, and menopause. Although traditionally thought of as an issue predominantly affecting peri-menopausal and post-menopausal women, it is important to highlight that dryness can occur at any age, including at young women. Dryness can also disturb the vagina’s balance of good bacteria, increasingly the possibility of infections in this area which can also contribute to painful sex. If dryness is identified as the cause of painful sex, exploring the use of water based lubricants is an option.

Pain during sex can also be a sign of a gynaecological problem, such as endometriosis, a condition that occurs when tissue that normally lines the inside of the uterus is found elsewhere in the body. Lesser known conditions, amongst others, that can cause painful sex are vulvodynia, which is defined as persistent, unexplained pain in the vulva; vaginismus, which is defined as painful spasming and involuntary tightening of the vaginal muscles in response to penetration; ovarian cysts which can be aggravated and even rupture during sex and cause pain; and pelvic inflammatory disease which is defined as inflammation of organs such as a the uterus, ovaries, and fallopian tubes, often caused by infection.

Pain during sex can also be in relation to psychological processes such as stress, fatigue, fear, embarrassment, shame, self-consciousness, and sadness; all of which can lead to difficulty in relaxing, problems with arousal and desire, and may manifest as pain. Relationship problems, everyday stresses, and mental health can also effect sexual desire and arousal, and lead to painful sex.

With so many causes of painful sex, it is always best practice to seek help from your GP to discuss, diagnosis, and receive treatment for any treatable causes.

Let’s break the stigma.

Painful sex is a common issue that women and people with vulvas may experience, with a multitude of contributing factors. Similar to the pivotal destigmatisation of mental health, it is vitally important that this trend is extended to sexual health. Ideally, conversations such as those around painful sex should become commonplace, and normalised, leading to increased awareness, intervention, and support for those affected. It is so important that people who experience painful sex don’t suffer in silence, know that they are not to blame for their pain, and feel comfortable approaching their doctor for advice, especially when treatable underlying causes are at play.

Let’s break that stigma and start speaking.

Madeleine Caven

St Andrews '25

Madeleine is a Graduate Medicine student at the University of St Andrews in Scotland. She is passionate about women’s health and rights, feminism, psychology, and healthcare accessibility. In her spare time, Madeleine enjoys music, photography, hiking, fashion, travelling, and looking after her plethora of houseplants.
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