Why Does Sex Hurt?

Hey crew! 👋

Here’s your 5 minute read on how to have a healthy, confident and pleasurable life. This week’s topic impacts ~1 in 3 women in our community: chronic pain during sex. As for next week? We’ll flip it and focus on pleasure. I’ll share a step-by-step guide on touching techniques.

Also for those that missed sign up, we’ve got our new Sexual Communication Masterclass next week. We’ll be teaching 3 techniques to help you identify your needs and feel more confident talking about sex. Spots are limited, sign up below.

A Glossary of Sex & Pain

If you’re a long-time reader, you’ll have heard me emphasize the importance of language for gender equality, body autonomy and wellbeing. Without it, it can be really tough to understand and describe our experiences.

There are a lot of conditions related to painful sex. To narrow ‘em down, here are some of the most common ones amongst our community members:

• Dyspareunia is a broad term that refers to pain during or after sex. The pain can be superficial (e.g. the entrance of the vagina) or deep (e.g. in the pelvis). Vulvodynia, Provoked Vestibulodynia (PVD), and Vaginismus are all medical conditions that can cause Dyspareunia.

• Vulvodynia refers to unexplained chronic pain in the vulva. This condition is defined by pain lasting 3+ months and is not due to a specific recognized cause.

• Provoked Vestibulodynia (PVD) is a subset of vulvodynia, where the pain is triggered by touch or pressure to the vestibule, the area surrounding the entrance to the vagina.

• Vaginismus is characterized by involuntary contractions of the pelvic floor muscles that surround the vagina, which can make penetration painful or even impossible (e.g. sex, tampons, etc.). The contraction is often associated with anxiety or fear of penetration. And yes, it is possible to develop vaginismus even if previously penetration was painless, e.g. post birth.

The Role of the Brain

In her book Better Sex Through Mindfulness, Ferly Advisor, Dr. Brotto explores the links between pain and the brain:

“Imagine a house alarm that is triggered when the wind blows as opposed to when an intruder breaks in. This analogy is helpful for understanding how a woman experiences vulvar pain when only a slight touch (or sometimes even no touch at all) is applied to the vulva - a stimulus that most women would not perceive as painful, and some may not even notice at all.

But the brain of a woman with [dyspareunia] registers the light touch as a painful stimulus… In other words, the brain reacts to the light touch [or penetration] as if it were a sharp object.”

This happens because of ‘central sensitization’, which is when our central nervous system becomes ‘hyperreactive’ and less able to differentiate pain types. Over time, these conditions can have major impacts on feelings of shame, our sense of self, and our relationships.

It doesn’t have to be your ‘normal’

This is also why traditional treatments like topical creams and oral medication are not solutions on their own. They don’t actually tackle the psychological factors that often drive these conditions in the first place. Instead, many researchers are advocating the use of mindfulness, CBT and physiotherapy to help navigate pain.

Interesting find - within our community, we see higher rates of PVD & vaginismus amongst women from more traditional/conservative upbringings and/or traumatic backgrounds.

1 Thing to Try This Week

The not-so-simple ‘Itch Meditation’. It helps you train how to override discomfort and regulate the brain’s reactivity.

Find a comfortable seated position and close your eyes. Take 5 slow deep breaths in. Identify an itch (or imagine one). Instead of scratching it, observe it. Breathe into it, imagining your breath soothing it. Stay here for 5 breaths and open your eyes.

2 Questions to Ponder

• What sensations, textures, types of touch etc. do I enjoy/not enjoy and under what circumstances?

• How might I communicate/share my preferences with others?

3 Read/Watch/Listens

👀 TED: What Young Women Believe About Their Own Sexual Pleasure by Peggy Orenstein

📚 When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain (note: from 2011 so bit older)

👥 The Vaginismus Network: A Community for People with Vaginismus

Remember, sex isn’t meant to hurt (unless you consensually want it to!). The more we know about our bodies and the bodies of others, the better able we are to cultivate the sex lives we both want and deserve.

Stay tuned for next week’s dive into pleasure! ⚡️

p.s. don’t forget to sign up for next week’s free Sexual Communication Masterclass Here

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