You haven’t just given birth, over-limbered at the gym, or attempted to show your girlfriends that yes, you can still do a split, on a recent night out. But for some reason, your lady parts are causing discomfort during sex.
“Painful sex, medically known as dyspareunia, is a common problem,” says Dr Kelly Loi, gynaecologist, obstetrician and medical director at the Health and Fertility Centre for Women. “I see around two to three patients a month about it.”
The difficulty is pinpointing why sex is painful is that it may not be just physical – there could be psychological reasons, too.
“This is why communication is paramount,” adds Dr Loi. “The couple must seek help sooner rather than later because if the issue manifests, cracks could start appearing in the entire relationship.”
There are number of reasons why lovemaking can suddenly become unbearable and the majority can be diagnosed. Read on so you can understand your body better, and provide only the right kind of screams in the heat of the moment.
If there’s any sexual move that’s easily mastered, it’s the one that involves us just, well, lying on our back. However, Dr Christopher Chong, urogynaecologist and gynaecologist at Gleneagles Hospital, says around 20 per cent of women have a retroverted uterus – their womb is tipped backwards and points towards the rectum, making the missionary position painful.
“A retroverted uterus also comes with ovaries and fallopian tubes that are tipped backwards, and can get ‘butted’ by the head of the penis during intercourse,” Dr Chong explains. Two words: Passion killer.
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Your gynaecologists can determine whether you have a retroverted uterus. During sex with your man, give alternative positions, such rear-entry, a whirl. “These tend to cause no pain for those with a retroverted uterus,” says Dr Chong.
“The vagina is a stretchy organ,” says Dr Chong. “If a baby can exit it, there’s little chance a penis will have trouble entering it.” But only as long as you’re stimulated enough prior to entry, he adds.
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“Go slow,” suggests Dr Chong. “Ensure that you’re lubricated, have had sufficient foreplay and you’re not stressed, as this can cause the vaginal muscles to cramp up. Take your time, don’t concentrate on his manhood but how your body feels, and be patient.” Importantly, talk to your husband. He needs to know he must be gentle and loving. “Deep continuous movements can only happen once you’ve relaxed into things,” says Dr Chong.
IBS is a condition that can include symptoms like abdominal pain, bloat, and constipation or diarrhoea. These symptoms can contribute to painful sex. “The intestines are very close to the pelvic area,” says Dr Chong. “Having sex when you have IBS can cause friction due to the movement during intercourse, and cause further inflammation to the intestines.”
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Start by treating your IBS – talk to your doctor about ways to reduce symptoms, including diet, medication and managing stress. Meditation techniques and longer foreplay can reduce your anxiety and make you feel more relaxed during intercourse.
How can parts up there affect parts down there? Pain during sex is common in breastfeeding women due to hormones, not your actual bits. “Oestrogen is the hormone that helps keep the vagina lubricated and flexible,” explains Dr Loi. “But when women are breastfeeding, their oestrogen levels are lower than usual, which in turn hampers the production of natural lubrication.”
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Oestrogen pessaries or creams can help reduce dryness and vaginal lubricants can also help. Both are available from pharmacies.
This condition – where the lining of the uterus starts growing in other areas –can cause sensitivity and pain, especially if the growth is near the vaginal wall. Sex can become painful due to inflammation and friction during lovemaking.
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“A biopsy of cells can decipher whether you’re a sufferer and where the growth is happening,” says Dr Chong. “Certain contraceptive pills can lessen the symptoms of endometriosis, and Panadol can help reduce pain.” Couples can also benefit from positions that avoid deep moves, like spooning, where Hubby lies behind you. This creates less pressure on sensitive areas.
Urine and yeast infections, as well as genital herpes, can turn sex into a chore, too. “It depends on the infection and how far it has spread, but herpes can cause blisters which are tender when touched,” warns Dr Chong. “Also, small scrapes or cuts at the entrance to the vagina can feel torturous upon friction.”
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Most genital infections can be cleared with a course of antibiotics. “See your doctor immediately and avoid sex altogether until the issue is solved,” says Dr Chong. “Many infections are not only contractable, but they’ll worsen if you continue making love when your body is unwell.” Also, check with your doctor about whether your husband will also need tests.
Vaginismus is the involuntary tightening of the pelvic floor muscles. Spasms then start to occur inside the vagina, effectively shutting it down completely. “When this happens, penetration will hurt,” explains Dr Loi. Some causes for it are stress, fear, or not being physically or emotionally in the right headspace for sex at that time.
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All is not lost. See your gynaecologist, who can carry out an internal examination. Also, says Dr Loi, “Practise kegel exercises once a day. Pull the muscles that you use to stop yourself going to the toilet tight, and hold for 10 seconds.” Do this twice a day, holding for 10 seconds at a time.