Pain experienced during sex - How sex therapy can help
Perth, Western Australia
Painful sex is distressing and can lead to a loss of sexual interest, relationship problems, and affect your mood and well-being. There are two terms which are generally used by medical professionals and sex therapists to categorise painful sexual experiences for women which I will outline below:
This refers to pain experienced during foreplay, sexual intercourse, and after intercourse.
In this condition sexual intercourse is either impossible or extremely painful as there is persistent and involuntary spasming or tightening of muscles around the vagina whenever penetration is attempted.
There are many potential physical and psychological causes of Dyspareunia and Vaginismus including:
- A lack of arousal, vaginal dryness, or insufficient lubrication
- Recurrent vaginal infections or urinary tract infections
- Physical illnesses or conditions such as Endometriosis, Pelvic Inflammatory Disease, Irritable Bowel Syndrome, Ovarian Cysts
- Inflammation or skin infections such as eczema, dermatitis, lichen sclerosis
- Trauma or complications during childbirth or pelvic examinations/surgery
- Tight pelvic floor muscles
- Past sexual abuse or other traumatic experiences
- Mental health conditions such as stress, anxiety, or depression
- A lack of adequate sex education, body awareness, or distorted ideas about genitals
- Relationship issues
- Some medications may have related side effects
- Age related changes such as menopause
If you are experiencing pain or discomfort during sexual activity the first step would be to consult your GP or a Gynaecologist to conduct a detailed assessment and gynaecological examination. Through this process physical factors can either be ruled out or considered in regards to the treatment plan moving forward.
The role of sex therapy
If a physical cause is identified a combined approach of medical intervention and sex therapy may be appropriate. The sex therapist would assess the impact of the physical issue and how it contributes to the pain experienced during sexual activity. The treatment may involve medication or management of the physical symptoms in combination with talking therapy and sex therapy techniques.
If no physical cause is identified then sex therapy would focus on addressing and talking through the psychological or relationship issues which are having a negative impact on the individual or couple's sexual experience. In conjunction with this, the therapist will set specific tasks and exercises for you to complete at home which aim to reduce anxiety and avoidance, and build trust and intimacy. These are based around Sensate Focus which is a term used to describe a series of graded touching exercises in sex therapy that aim to encourage the couple to learn more about themselves and each other; encourage the couple to be more present during sexual experiences while focusing on positive feelings; enhance communication in the couple about what they like, don't like, or want more of; reduce anxiety, fear of failure, and built up pressure that is associated with sexual activity; and reduce avoidance and negative reactions.
Some other specific techniques may include:
- Providing advice about ways to enhance and lengthen foreplay, different sexual positions which may reduce or alleviate pain, and the use of personal lubricants
- Exploring ways to increase or enhance sexual arousal
- Couples therapy to resolve relationship issues
- Improving communication around sexual issues and preferences
- Using cognitive-behavioural techniques to reduce anxiety and avoidance
- Using mindfulness and relaxation to encourage the individual/couple to be more present in sexual interactions
- Providing psycho-education
- Practicing kegel exercises to obtain control over the pelvic floor muscles
- Using vaginal dilators or trainers to help relax the pelvic floor muscles to enable pain free penetration
If you are in a relationship it is a good idea to involve your partner and attend sex therapy as a couple. You can also attend sex therapy if you are not in a relationship. In this situation the exercises will focus more on body awareness and self-focus.
There is plenty of evidence available to demonstrate that sex therapy works and can be effective in treating Dyspareunia or Vaginismus. If you would like to discuss this further or have any questions please contact Jessica and she will be happy to offer advice about how sex therapy may benefit your situation.
Phone: 0450 688 221
Mt Lawley Counselling Centre
13 Alvan Street
Mt Lawley Western Australia 6050