Pain with sex

Pain with sex is a distressing symptom that can lead to low mood, poor self esteem and relationship issues. Women regularly describe not being listened to by health professionals and feeling that their issues are dismissed.

Sexual issues can arise for a variety of reasons.

A vulval condition such as lichen sclerosis can be associated with sexual dysfunction. The condition can cause pain, irritation and scarring that can make sex difficult. Many women with a vulval problem have negative feelings about their vulva which can impact on their ability to become aroused or feel sexual.

Vulval pain conditions such as Vulvodynia can lead to pain which makes sex unbearable. This pain is often associated with a muscle spasm of the pelvic floor called vaginismus which exacerbates pain.

Infections can cause irritation of the vulva and vagina, making sex uncomfortable. Having recurrent infections of thrush or bacterial vaginosis can lead a woman to avoid sex for fear of passing an infection to a partner. Infections can be associated with strong feelings of guilt or a sense of being unclean.

The vulval skin can tear with sex and although tears heal, they can reopen during penetration, leading to significant pain.

The hormonal changes of perimenopause and menopause commonly cause women to notice changes in libido and sexual arousal as well as reporting lack of vaginal lubricant and painful sex.

Emotions are essential when it comes to enjoyable sex. Negative feelings can significantly impact pleasure. Fear of infections or pregnancy, body image issues or difficulty conceiving are all examples of where feelings can interfere with a normal sexual experience. Understanding the nature of painful sex is the first step to addressing symptoms.