Q&A with Dr Catalina Lawsin: What Do I Do When Sex Hurts?

Have you been experiencing pain during or after sex?

There’s a lot of reasons why women might experience pain during or after sex. These can be either physical or psychological. One of the most common physical reasons women experience pain during sex is because we experiences changes in our hormones, particularly our estrogen levels.   As we age or if we have a chronic illness, such as cancer and need chemotherapy or perhaps have a gynecological issue which requires either surgery or other medication often times these procedures or treatments can lower our estrogen levels.  Particularly when that happens dramatically women are going to experience a lot of discomfort because when our estrogen levels decrease, we don’t produce as much lubrication in the vaginal area, making our vaginas more dry, shorter and narrow, hence leading to pain during and after sex.  I’ve even had some patients tell me that they experienced so much vaginal dryness particularly in the context of having chemotherapy that they can’t even walk. So when I tell you that this is actually a fairly common thing, it is.   Estimates report between 10 to 30 percent of women will experience pain during sex.  So if you are experiencing this, know that you’re not alone.

Some of the psychological factors that may contribute to women experiencing pain during or after sex can be distress just being stressed in the moment or feeling anxiety or depression during those times we tense up and our body is hyper aroused and constricted then it’s really hard to relax and actually enjoy sexual activities and that can lead to pain.

Another thing is though is that if you’ve experienced some type of trauma in the past, sometimes there’s things that happen in our present lives that actually can trigger that trauma and because sex can be a very intimate and we open ourselves up to be more vulnerable. It can actually be one of those triggers to some of that trauma leading to a bit more pain during sex or discomfort.

So now what do you do about it?

1. One of the first things I tell my clients is first and foremost find out whether or not you have a physical reason for this pain, so start off with either your GP or your general practitioner family doctor or your obstetrician/gynecologist to actually get some tests done and see if there’s any physical reasons you may be experiencing this pain. One of the biggest reasons that a lot of women live with this pain is because they don’t actually seek support. So the first place to start is with your GP or your gynecologist then if it isn’t something physical then perhaps they can refer you to somebody like a clinical psychologist like myself or a sex therapist or even a physical therapist who might give you some exercises that you can actually do to manage that pain but also strengthen the pelvic muscles to actually support yourself during sexual activities.

2. The next thing I recommend is if you are in a relationship to first and foremost talk to your partner about your pain.  Often times women will just endure this pain and sit in and an experience that pain.  Unfortunately over time their sexual satisfaction is going down when women endure this pain or many will avoid sex altogether.  When this happens, unfortunately this can lead to assumptions by your partner that perhaps you’re not interested in sex, which in turn can cause distance.  Silence makes women live in pain alone while talking about the pain can open the door to improving your sexual satisfaction.

3. Once you’ve cleared with your doctor that there isn’t that you’ve addressed any physical concerns or contributing factors I also recommend that women bring in some tools into the bedroom to help in that moment deal with that pain. So using things like lubricant and first trying it out on your own to explore your body and find out what feels more comfortable.   Ofcourse, this is very individual, but I recommend that women try to use lubricant on their own first to really see what does or doesn’t feel comfortable. So take some time to explore this on your own without that pressure of a partner in the room. Then you can ultimately bring the lube out to the bedroom and try that another strategy.

4.  Focus on the foreplay.   Keep in mind foreplay starts way before we enter the bedroom. Some of that can be the way we gently seduce our partner subtly or it can also can include a massage and really getting as relaxed as possible.  I said earlier that oftentimes when were distressed or stressed in general we tense up and so if you are experiencing pain, being relaxed is going to be one of the best things that you can do to actually manage that pain and also feel more comfortable with your body and with your partner during that sexual encounter.

5.  And then finally again, once you’ve done all these other things are tried them also try new or different sexual positions that are less painful and more satisfying.  Use this as a time to explore your sexuality.  In long-term relationships couples tend to kind of have their routine, so this actually can offer an opportunity to spice things up and play around a little bit in the bedroom.  Remember, sex is meant to be fun! So use this as an opportunity particularly with a partner that you trust to actually explore what does feel good.

So I hope these strategies help. If you liked this video, feel free to like it, share it and subscribe to my YouTube Channel.   Keep an eye out for my .weekly videos answering common questions about sex and relationships. Feel free to join my Facebook group Psychotherapy Without Borders or check out my website at www.DrCatalinaLawsin.com.  Cheers!


Related Posts



Subscribe to My Newsletter

Join my mailing list to receive the latest news and updates.