Pain during sex

Symptoms of dyspareunia

Pain during sex is a common concern that can affect all genders, though can be more common in women. As well as the physical pain it causes, it can affect relationships. It may put stress on the relationship or cause you to avoid sex. If you have dyspareunia you may notice symptoms like:

• pain during sexual entry (when someone is penetrating you)
• pain during any form of entry (this can include inserting tampons)
• deep pain during sex
• pain after sex

If you experience pain during sex, you may fall into the following categories:

• Primary pain: This is when you’ve been experiencing pain ever since your first sexual experience.
• Secondary pain: This is when you start to experience pain during sex after a period of time experiencing pain-free sex.
• Complete pain: This is when you always experience pain during sex.
• Situational pain: This is when you only experience pain in certain situations. 

What causes pain during sex?

There can be various reasons why you might be experiencing pain. Sometimes there is a physical reason, sometimes there are psychological factors involved. Often, it is a combination of the two. For example, you might have pain during sex due to a physical reason and then become stressed and fearful of sex which intensifies the pain.

Here are some examples of physical causes:

• Injury or trauma - If you’ve had something happen to your reproductive area (for example, a cut made during childbirth) this can lead to irritation and pain.
• Recent or historic surgery - If you’ve had surgery in this area recently, you may experience post-op complications that cause pain. Sometimes scarring from past surgeries can also affect pain levels.
• Inflammation of the skin - Some skin conditions like eczema can affect this area and make sex painful.
• Illness, infection or disease - This could include endometriosis, fibroids, cystitis, irritable bowel syndrome, pelvic inflammatory disease, vulvodynia and others. Infections like thrush and certain sexually transmitted infections can also cause pain.
• Hormone changes - Certain changes that happen around menopause for example can lead to you having a dry vagina, which can make sex painful.
• Tight foreskin - This is something that can make sex painful for those with penises. 
• Testicle pain and swelling - This can be caused by certain infections, like chlamydia.
  Painful erections. A condition called priapism can make erections painful.

When it comes to psychological causes, here are some to be aware of:

• Mental health concerns - If you have anxiety, depression or struggle with body image, you might find intimacy challenging. This can lead to low arousal which in turn can make sex painful.
• Having a history of sexual abuse - If you’ve been sexually abused in the past, this can have an impact on how you experience sex.
• Increased stress - When we’re stressed, it can cause our pelvic floor muscles to tense up, which can lead to pain.

Working with a doctor can help you identify what might be causing your pain. Once you know which factors are at play, you can find the right treatment approach. 

How to manage and treat pain during sex

Getting a diagnosis can help you understand what treatment may be best for you. In order to get a diagnosis your doctor will likely carry out certain tests. These may include an STI test, physical exams (such as a pelvic exam), blood tests or ultrasound scans. 

If a physical problem is found, your doctor may recommend medications or certain lifestyle changes. For example, they may encourage you to try different positions during sex, embrace longer foreplay or use lubricants. You may also be advised to try desensitisation therapy. This involves trying different vaginal relaxation techniques to help decrease pain.

If your dyspareunia has psychological causes, you may be recommended counselling or sex therapy. Depending on the cause, talk therapies like this can help you understand where your pain is coming from and how you can manage it. For some, hypnotherapy for dyspareunia is an ideal option.

Hypnotherapy for dyspareunia

Hypnotherapy is a tool that works with the subconscious. This means it can make changes to our thinking patterns that may otherwise be tough to change. When it comes to pain during sex, hypnotherapy can help change any fearful thoughts we may have about pain. This can reduce stress and anxiety around sex, which can help lessen pain. 

Visualisation may be used to dial down pain levels too, something that is often used in hypnotherapy for chronic pain. If anxiety, depression or stress is having an impact, hypnotherapy can help here too.

It can also be used to improve self-esteem and confidence, helping you feel better about yourself and sex. This can also help you feel more comfortable in asking for what you want during sex, to increase arousal and lessen pain. Relationship problems can also benefit from hypnotherapy, helping to uproot any behaviours leading to conflict. 

How to find a hypnotherapist

If you’re ready to try hypnotherapy, you can use our site to find a hypnotherapist. You can learn more about them and the way they work by reading through their profiles. Once you’ve found someone you think can help, simply send them a message to find out their availability.

Some hypnotherapists will offer a phone call before you book in, so you can learn more about how they can help. You can ask any questions you might have here and check that you feel comfortable with them as your hypnotherapist. When you’re ready, you can then book your first session, which may be in-person or remote. 

You may need a number of sessions, depending on the cause of your pain. Your hypnotherapist will be able to advise on this and guide you through the process. In time, you should find the pain reduced and easier to manage so you can enjoy your sex life to its fullest.

Further help

• The Vulval Pain Society

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