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Have you seen that commercial with the woman at the doctor’s office. She is sitting up on the exam table answering questions that her doctor is asking her. Her answers are short and uncertain. Hovering around her is another her, urging her to speak up, be honest, tell the doctor it hurts! I experience a variation of this in my office all of the time. I will have a couple come to see me because one person has “low desire”. One of the first questions I ask them is: “Do you experience any pain with penetration? During sex? With a tampon?” At least, 75% of the time the answer is “yeah. Sometimes.” Or “kind of”. These responses come with a downward glance and huge amounts of shame. Why?!If I were to go to an orthopedic surgeon for knee pain, I hardly think I would feel ashamed to report this pain. Unfortunately, due to the stigma around expectations of what sex is supposed to be, there is an immense amount of shame and embarrassment surrounding all things sex and genitals. This has to change.


“If it hurts, stop doing it,” says me, all of the time. The thing about painful sex is that if we try and push through the pain it will almost always get worse. The repetitive pain compounds things- meaning you can develop psychosomatic symptoms in addition to the initial pain. Sometimes, vaginal muscles will begin to tighten in apprehension of any impending penetration (this could be symptoms of vaginismus), which causes more pain. If you are experiencing burning or rawness in the genital area (this could be symptoms of vulvodynia), continued friction can worsen the pain. These are just 2 of may possible diagnoses. This is why it is important to go to a knowledgeable, skilled doctor. A correct diagnosis is imperative. In the meantime, stop doing any activity that hurts. Do not resume until you have seen your doctor and received a correct diagnosis. Once you have completed treatment for your pain and the pain has gone away (and your doctor clears you!) you can gently and slowly begin to resume penetrative activities.


What should you do if you are experiencing painful sex? I will often have potential clients call me to set up an initial appointment for painful sex. And while I would never turn them away, I always suggest that they go get checked out by their gynecologist (extra credit if the gyn has sex medicine credentials!) Oftentimes, painful sex can be symptoms of emotional, as well as, physical issues. Having your medical doctor rule out physical cause, give you a correct diagnosis and begin treatment is necessary to relieve physical pain. If there is an emotional layer to the pain we can work on that while or after the physical symptoms have been addressed. 


If you take one thing away from this post let it be this: there is nothing to be ashamed of! Many women experience pain during sex. This doesn’t mean they are broken. For the most part, painful sex is very treatable. But it has to be reported. As women, we have become accustomed to keeping quiet and this has to change. What would happen if you were to become more involved in your exams at the gynecologist? Did you know that you can ask the doctor to hold up a mirror so you can see what is happening while you’re being examined? How do you think this would change your experience? Get involved. Learn about your body. And take care of yourself!


If you or someone you know experiences painful sex have them contact me: www.christyhaas.com