When your oooooohhhh yes, yes, yes, turns into an ooohhh no, no, stop, you may be feeling as if your body has let you down.
Sex is supposed to be about exploring pleasure and not unwanted pain.
There are times in our lives when we may notice sex feels different or even uncomfortable such as when stress is elevated, during hormonal shifts, post baby, and thats ok, if its short lived. No need to freak out about every little change our body goes through on a day to day basis. That could make any person narotic.
Its when pain becomes persistent that you should explore why.
Not all painful sex is created equal. Some people have pain upon insertion, others with deep penetration. Sometimes its the orgasm that hurts or even pain after the deed is done. No matter when it hurts, its a Debbie Downer and may cause you to loose interest in sex all together.
Sometimes just the thought of sexy time causes pain. {Say what?}
Yup. Our thoughts influence our brain's decision making. The brain is constantly taking a whole lot of information in such as temperature, stretches, smells, tastes, your surroundings and your beliefs about things. With this information, in regards to pain, the brain then decides if your body is in danger. It's usually not just one thing that causes pain, but many inputs that lead the brain to decipher if you need protecting. If there are not enough signals that lead toward danger, the brain will let it pass until it reaches its threshold (which is always changing). Pretty smart, right.
Back to painful sex.
Maybe you have heard of these terms: vaginismus and vulvodynia. These are diagnosises similar to 'back pain'. They tell you where the pain is, but not why it's there to begin with. So, don't get hung up on the diagnosis.
Remember, pain is your brain's way of protecting you and sometimes it gets a little overprotective like a teenager's parent. Protection is good, without it we may get into trouble, but too much protection stops 'viva la vida' in its tracks.
I know, pain with sex sucks, big time. I suffered with it for years (but can happily say not anymore). There is hope for you too. Don't worry, I got you. We are in this together.
First thing you need to explore is why sex may be painful for you.
Here are a few reasons sex may hurt:
Chronic infections: Bacterial vaginosis, UTIs and yeast infections, oh my. These are few things that may go wrong down below that will require intervention. Yes, there are creams and medications to treat these bullies, but when they keep showing up, its a sign your vaginal biome is out of whack (think more bad bugs than good bugs). This may be a cause of your vaginal pain with sex. When dealing with chronic vulvovaginal pains, it helps to think outside of the box, literally.
Take your focus away from your vagina and look at your gut. Your gut houses a lot of your immune system (the army that fights off these infections). Are you also having any abdominal bloating, IBS, constipation? Have you taken antibiotics (they kill the good and bad bugs...we want the good guys there). Do you also have an inflammatory disease?
If you answered yes to any of those Q's, you need to investigate your gut. I am not going to go into detail here, but giving you the heads up, we can't just blame the vagina.
Allergies or sensitivies: Vaginal tissues are sensitive. They like to be at a nice acidic pH level. Sometimes the vagina doesn't agree with various lubes or even your partners semen. This is a less common reason, but don't totally throw it out as an option to explore.
Conditioned pain response: Sex is supposed to feel good and when it doesn't, your body will try to protect you. The pelvic floor muscles will tense up to guard the sensitive area from harm. This is a normal response.
Your body means well, but when pain with sex persists without resolution, your body becomes more sensitive to the possible threat of sexy time. Your muscles will tense up and "guard" you with even the thought of intimacy.
Vaginal dryness: This can occur when our hormones are not in harmony. Estrogen is the main hormone that lubricates the vagina. When it is low, moisture is low. When moisture is low, friction is high. This can make sex feel like a rug burn, ouch.
Estrogen may be low for a multitude of reasons, but some common ones are birth control, post baby, and menopause
Hormones work in harmony, so it may also be that another player in the orchestra is not in tune and it throws off the whole symphony. So, I advise getting not only estrogen levels checked, but also progesterone, testosterone, thyoid, and adrenals to name a few.
Overactive muscles: This can happen as a conditioned pain response. Our muscles are trying to protect us, but for some reason became the helicopter parent that won't back off.
Stress: Stess hijacks your desire for sex. It increases your cortisol hormones which robs your body of its sex hormones (estrogen, progesterone, testosterone). It also makes your bodies more sensitive to the chemicals that send messages to your brain telling it to protect you from danger. And the cycle of pain continues.
Constipation: The rectum lives behind the vaginal canal. They are neighbors living in close quarters. This means that overflow in one passage will push into the other. If your full of poo, the rectum will stretch and keep knocking on the vagina's wall. It's like having a really annoying roommate and that can definitely wreak havoc on your sex life.
Once you know why sex is painful, it times to start taking the steps towards painfree sex. Stay tuned for a few simple steps you can take to enjoy sex again.
In wellness,
Dr. Ashley