Imagine feeling unbearable pain every time you tried to have sex. It sounds awful, but it is an unspoken reality for many women — according to the American College of Obstetricians and Gynecologists,75 percent of women will have pain during intercourse at some point in their lives. For many, this pain will be temporary, but for others it is an ongoing problem that profoundly impacts their sex lives, relationships, and self-esteem. This week in Sex Talk Realness, Cosmopolitan.com spoke with three twentysomething women about their experiences with painful sex.
How old are you?
Woman A: Twenty-eight.
Woman B: Twenty-two.
Woman C: Twenty-six.
When (and how) did you realize sex was painful for you?
Woman A: The first time I had intercourse, it was painful. I figured that was normal, but then it hurt the second, and third, and fourteenth time too.
Woman B: When I first started having sex at 18, it was only painful occasionally. My boyfriend is on the larger side and I have sensitive skin, so after sex I would be raw and puffy. This wasn’t a huge issue for me, and I was really enjoying sex. However, during the summer of 2012, I had recurrent yeast infections every month for about five months in a row. During the infections, sex was impossible, but the pain lasted in between and beyond the infections.
Woman C: I first had sex when I was 20 with a boyfriend I’d been with for about seven months at that point. As soon as he pushed into me, I experienced a pain unlike anything I’d ever felt before and there was also a lot of blood. I wasn’t sure if it was normal, as I’d been told that first times could be painful. But it was excruciating.
How did you feel at the time?
Woman A: I spent 10 years feeling like there was something wrong with me and just willing that problem away. I felt lucky that I could experience sexual pleasure from acts other than intercourse, but I also grew up in a culture that glorifies penis-in-vagina sex as the be all and end all of sex. I felt like I was denying my partners something they wanted more than anything else. So I had a lot of painful sex, after which I still felt broken and defective. Intellectually, I understood that intercourse was something that lots of people enjoyed, but based on my experience, I just didn’t understand how.
Woman B: At first, I was convinced I just had another infection. When the doctor told me that I did not have an infection, I felt like I was going crazy. How could I not be infected? I felt pain!
Woman C: I was extremely traumatized and ran into the bathroom and cried for a very long time, while wiping the blood away from my vagina. I felt embarrassed and ashamed and scared.
How do you feel about it now?
Woman A: I feel so much empathy for my past self, because she was so confused and felt so inadequate. I want her to do things differently so she doesn’t have to suffer for a decade. And I also feel a lot of disappointment in some of my past partners, who, when push came to shove, put their own pleasure before my pain.
Woman B: I am happy that I finally found the cause and was able to overcome my painful sex.
Woman C: Looking back now, I’m not sure if I was ready to have sex, and I definitely don’t think the relationship I was in was a very healthy one. I’m unsure if I would have had the same experience had it been with someone else. Mostly now when I think back on that first time, I feel a lot of sympathy for my 20-year-old self, and if I could go back and tell her all the things I know now — about sex, men, relationships — I think it would help her a great deal.
Do you know what causes your pain?
Woman A: I have either vulvodynia or vaginismus or both — it’s never been made totally clear to me. Whatever it is, it makes insertion of any kind painful, so annual exams suck even more than they usually would, and until recently, tampons weren’t an option. Having my IUD inserted was one of the most excruciating things I’ve ever experienced. Over the course of years, the muscle memory builds up, and my body now expects insertion to be painful, which is a self-fulfilling prophecy.
Woman B: I went to a urologist and he told me that I had vulvodynia, which is when a woman’s vulva is in pain for no identifiable cause, but which may have been caused by my fear of contracting another infection.
Woman C: I have vaginismus, which basically means that my pelvic floor muscles instinctively clam up in anticipation of pain whenever anything goes near there. It’s similar to if you burn yourself on a flame — next time you go near one, you’ll pull back by default. After the first time I had sex and the pain I experienced, I came to expect pain every single time and my body just shut down and refused to accept it.
How has it affected your sex life?
Woman A: I’ve had a lot less intercourse than I otherwise would have had, and fewer partners than I might otherwise have had. Intercourse was always emotional, because I was always anxious about how it was going to go, and then I was disappointed and angry at myself when it hurt and I had to stop midway through, or couldn’t do it at all. It has totally shaped my sex life, and in darker moments, my feelings about my body and my viability as a romantic partner. When you can’t give the person you love something they really want and reasonably expect in a relationship, it makes you feel terribly inadequate.
Woman B: For a good part of a year, it was touch and go. First, my partner and I couldn’t have sex due to the infections, and then we couldn’t due to my fear. When I was diagnosed with vulvodynia, we worked to reduce my stress and went slow. I feel like this experience has brought us closer and we are now more attuned with each other’s bodies.
Woman C: In that first relationship, there was a lot of built-up resentment. He never really explicitly told me that it bothered him, but it was pretty obvious from the way he’d act during sex, and eventually we stopped trying altogether. He told me once that he’d considered breaking up with me because I was “bad at sex.” It’s been over six years since that happened now and we’re on good terms again, but I haven’t forgotten how it made me feel. Since then I’ve slept with a few people, with varying degrees of success — I’ve managed to have completely pain-free sex with one partner, but there have been issues with others. It seems that with every partner I have, the issues become less and less, and I’m able to enjoy myself a lot more, which I think is a by-product of accepting my condition.
How have your partner(s) responded?
Woman A: It’s been a mixed bag. I had a series of partners who did their best to be patient, but for men in their late teens and early 20s, patience around sex is a finite resource. I didn’t truly realize the importance of a supportive partner until I had one say, “If you’re in pain, I want to stop.” As opposed to what all the previous guys had said, which was, “If you want to stop, that’s OK.” Those are two completely different sentiments, and I didn’t realize until I heard the former how much of a burden the latter had put on me.
Woman B: He was very supportive and nothing but loving. I am very lucky to have such a patient partner.
Woman C: As I mentioned, my first boyfriend wasn’t great about it, but we were both very young and naïve, and I think he had unrealistic expectations of sex. My second boyfriend, who I was with for five years, was always very supportive and never pressured me into anything. He was also the person who encouraged me to eventually seek professional help for it, and I’m incredibly grateful to him for that. After we broke up I was extremely nervous about telling new partners about it, but I’ve been really pleasantly surprised that it’s hardly been an issue at all. I’ve dated three people since my breakup last year, and not one of them had a negative thing to say about it.
Have you spoken to a doctor about it? What did they say?
Woman A: I spoke to numerous NPs and ob-gyns about it. They were largely mystified, though one suggested using more lube, and another gave me a prescription numbing cream, which would have stopped me from feeling pain, but also would have prevented me from feeling, uh, anything. To me, the point was never just to have sex, it was to have good sex. Finally I went to an ob-gyn who referred me to a physical therapy center, who were able to help me.
Woman C: I went to a doctor about it in the middle of 2013, after putting it off for almost five years. I’d done some reading online and suspected that I had vaginismus, and the doctor confirmed this. I was then sent to a physiotherapist who specializes in pelvic floor pain. She told me that it’s actually extremely common for women to experience vaginismus and pain during sex, even though it’s really not talked about all that often, and that it’s absolutely curable with physical therapy.
What tools, techniques, or treatments have you tried to alleviate the pain? Did they work?
Woman A: I went to a physical therapy center that specializes in pelvic pain, and they were great. There’s a cocktail of behavioral changes and exercises — it’s different for everyone — but none of them worked until I made the decision to invest the time and energy and patience. Physical therapy isn’t a drug and it’s not a magic wand. But I found it to be really effective, and I wish more doctors and nurses knew about pelvic pain disorders and could refer people to effective treatment.
Woman B: Immediately after the vulvodynia diagnosis I learned to do pelvic floor stretches, which helps loosen the vaginal muscles. During the pain disorder, they become rigid and react strongly to touches. I slowly massaged them and then had my partner massage them until I could resume having sex. To combat the yeast infections during the summer, I proactively take boric acid suppositories, which is like a vagina vitamin!
Woman C: I’m probably not as diligent with my physical therapy as I should be, but I use dilators — basically plastic tubes that increase in size — to work on relaxing my pelvic floor muscles. My physiotherapist has also suggested applying heat packs to my stomach to relax those muscles, as well as kegel exercises to get my vagina used to clenching and letting go. I’ve noticed some changes down there and the last time I had PIV sex, it wasn’t really much of an issue at all.
Do you spend more time doing sexual stuff other than penetration now?
Woman A: Yes. And while it’s great to have other ways to get off and to get your partner off, pain during sex has a way of casting a pall over the evening — not exactly conducive to giving the world’s best blow job.
Woman B: During the infections, we engaged in more oral sex, but it has not changed since.
Woman C: I was always pretty into other types of sex anyway, but my condition has definitely made me more appreciative of all the other things you can do. I couldn’t be with someone for whom penetrative sex was the be all and end all. I orgasm easily through oral sex, whereas I’ve never orgasmed through PIV (if it’s not painful, it tends not to feel like a whole lot).
Do you have any advice for women who are having painful sex?
Woman A: Be kind to yourself. There is nothing wrong with you. You are not broken or defective or bad at being a human female (also, lots of male people experience pain during sex, and they are not bad at being human males either). You don’t owe sex to anyone. The more painful sex you have, the harder it’s going to be to undo your body and your brain’s totally reasonable association between sex and pain. So don’t do things that hurt, and don’t accept that pain is part of the deal. Find a doctor who takes your pain seriously, and then try any treatment you can find and afford until something works. It’s maddening to have to work at it because it seems like it should be something that just happens naturally, but I promise you it’s worth the effort.
Woman B: You’re not alone! There is always a remedy; you just have to keep trying different routes.
Woman C: Don’t force yourself to have penetrative sex if it’s painful — it will only make it worse. Don’t be ashamed to seek professional help; although I’ve heard plenty of horror stories about doctors not being understanding, I’ve had nothing but great experiences with the medical professionals I’ve seen. Know that it gets better with time and patience and hard work, and even if you never overcome it, there are plenty of other ways to enjoy a really great and fulfilling sex life. Penetrative sex isn’t everything, and once you come to realize and accept that, it really feels like setting yourself free.