Experiencing pain instead of pleasure during sex is more common than you may think. Yet many of us struggle to talk about it with our doctors, who may be able to help.
The silence may come from a sense of stigma or shame, a belief that somehow we’re ‘failing’ in the bedroom. But really, none of us needs to suffer in silence.
Here, two doctors who work in the area talk about how to raise the issue with your health professional and get the most from your consultation.
First things first, it’s important to take action and to make an appointment. One of the factors stopping women from seeking treatment is that they worry that the issue is trivial, says Dr Margaret Redelman OAM, a GP and sex therapist.
“We need to empower these women and help them understand that their pain is as valid as any pain,” she explains. “Each person’s experience is as valid as the next.”
“The myth out there is that sex is natural. What’s true is that the instinct is natural, but the performance is a learnt experience.”
In this story, Amanda explains how a painful health condition made it impossible to have sex.
Dr Margaret says that if you’re feeling embarrassed, the best way to raise the issue is to first own it. “Try saying, ‘I’m really embarrassed to be talking about this, but this is what’s happening to me. Are you able to help me?’”
The direct approach is also supported by Dr Karina Severin, a Jean Hailes GP with a special interest in sexual health. “Be open about it,” she suggests. “A useful way to bring it up might be, ‘I’m having some trouble with sex.’
“Even if you feel awkward about bringing it up, the doctor will help you with the conversation.”
Awkwardness is a feeling which, while uncomfortable, will not harm you, adds Dr Margaret.
A useful way to bring up the topic might be, ‘I’m having some trouble with sex.’"
Dr Karina Severin, Jean Hailes for Women's Health GP
When discussing painful sex, knowing some of the medical words and the correct names for body parts can help you and your doctor get on the same page. This list may help:
When it comes to tricky topics, it can be helpful to know what sorts of questions your doctor will ask you. You can then think about your answers beforehand and feel more confident and prepared.
For painful sex, your doctor will likely ask:
You may also be asked questions about your sexual history, sexually transmitted infections, sexual positions that might cause you discomfort, or whether you have ever experienced sexual trauma.
“What the doctor is trying to do is establish if the pain is a medical problem, a psychological problem or a relationship problem,” explains Dr Margaret.
Your doctor may also examine you. This may involve gently touching the vulva and an internal examination to establish the site of the pain. The doctor may also place a speculum – the instrument used during cervical screening – inside the vagina to locate the source of the pain. If you’re uncomfortable at any point, you can ask the doctor to stop.
Learn more about painful vaginal sex, including the symptoms, causes and what you can do.
Painful sex can affect relationships, sometimes even strain them. Dr Severin likes both partners to be involved early in treatment.
If one person is experiencing pain or discomfort, they can withdraw and the other partner thinks they’re the problem, or that there’s an issue with the relationship."
Dr Karina Severin, Jean Hailes for Women's Health GP
“If one person is experiencing pain or discomfort, they can withdraw and the other partner thinks they’re the problem, or that there’s an issue with the relationship.
“It’s important for that person to understand what is really going on.”
To aid the process of involving your partner and inviting them to your appointment, Dr Margaret suggests a conversation opener such as, ‘I love you and want to have a great sex life with you, but I get sore when we have intercourse and that makes me want to avoid it. Would you be open to helping me have pain-free sex by coming to my doctor with me?’
She explains that a partner can’t help if they don’t know you have a problem or don’t understand what is happening.
“In a relationship each person is 50% of the sexual relationship, therefore, both need to be on the same page for best progress. Learning together to achieve your best sex life can be a very intimate experience,” she adds.
We speak to three women about the realities of living with pain, and share insights and advice from the experts.
For women who raise the issue with their doctor but don’t feel heard, Dr Margaret has one final piece of advice: “If you feel the doctor has not understood you, dismissed you or hasn’t provided helpful management, you have some options. One, ask the health professional if this is an interest area for them and, if not, ask for a recommendation to see someone else. Two, try to explain what you are experiencing again. If you still feel dismissed, ask friends for a recommendation to another GP.
“As an adult, it is your duty to yourself to look after your needs and health, and you are worthy of this.”
All reasonable steps have been taken to ensure the information created by Jean Hailes Foundation, and published on this website is accurate as at the time of its creation.
© 2024 Jean Hailes Foundation. All rights reserved. This publication may not be reproduced in whole or in part by any means without written permission of the copyright owner. Contact: licensing@jeanhailes.org.au
