Although not everyone wants, needs or enjoys penetrative sex, for some people this is something they would like to do but can’t due to pain. The primary terms used for female pain and penetration problems are vulvodynia, dyspareunia and vaginismus. Vulvodynia is persistent, unexplained pain in the vulva. The vulva is the female external genital area including the skin surrounding the opening of the vagina. Dyspareunia describes pain during penetrative sex. Vaginismus is an involuntary spasm of the pelvic floor muscles resulting in the closing of the vagina, making penetration impossible.
It is very important that you visit your GP if you are experiencing pain and penetration problems to check if there are any underlying organic causes that require treatment. The physical causes of pain and penetration problems include skin conditions, such as lichen sclerosis, eczema and psoriasis, general health conditions like diabetes, thyroid problems, lower urinary tract or overactive bladder, and events such as pregnancy, childbirth and menopause.
Medical treatments for pain and penetration problems vary depending on the underlying causes. Skin conditions like lichen sclerosis, eczema and psoriasis are treated with prescription steroid creams. Anaesthetic creams that contain a numbing agent are sometimes used to treat pain and penetration problems. Specialist physiotherapy can be tremendously helpful in releasing pelvic floor tension to reduce pain on penetration. Both specialist pelvic floor physiotherapists and sex therapists may use a guided vaginal dilation programme in the treatment of vaginismus.
There are many psychological causes for pain and penetration problems, including:
A professional sex therapist will complete a full assessment to identify the main psychological causes of your pain and penetration problems and will then support you, through a series of cognitive and behavioural processes, to break the cycle of pain and establish full sexual activity.
Remember, sex therapists are specialist trained counsellors and we talk about sex and sexual issues all day long. Don’t let embarrassment stop you from getting the help that you need and that works.