Ask Gigi: What Do I Do About Pain During Sex?
Welcome to Ask Gigi, an advice column where sex and relationships writer Gigi Engle answers your most intimate questions. Nothing is off-limits! From threesomes to anal, unrequited love to cheating: we want to hear it all.
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I’ve been with my partner twenty-two years. We’re happy in most aspects of our relationship. We’re best friends and have a happy life together. My only issue is that we don’t have sex much. It’s my fault. For most of my life I have had trouble with sex.
No matter what we do, sex is always painful. My partner gives good oral sex and I can orgasm from it, but when we have regular sex, it hurts so much I can barely stand it. We haven’t had sex in over two months.
Any ideas on what I can do to make this better? I just want to have good sex.
Thank you for your letter. This is a pervasive issue and it deserves attention. Let’s talk a bit about sexual shame, pain during sex, and how we can help get passed it. First things first, I want you to know that you are not broken and you are NOT alone. This is a common issue, we just don’t talk about pain during sex enough. This needs to change as education around sex evolves.
Do not think for one second you are broken. You’re not. I’m proud of you for writing in, but I’m more proud that you’re not giving up. The right to sexual pleasure and fulfillment is a basic human right.
So many of us have had pain during sex. I’d venture to say nearly every woman who has engaged in penetrative sex has experienced some level of pain at one point or another. Pain is also persistent for some. This is an unfortunate reality rooted in sex-negative messaging, a lack of education about anatomy, and the physio-psychological effects of aforementioned shitty messaging.
The reasons for pain during sex are varied. Some include, dryness and/or difficulty with natural lubrication, vaginismus, endometriosis, untreated STIs, pelvic inflammatory disease, vulvodynia, sexual shame, and other vaginal infections. I’m not a doctor and cannot make a diagnosis, but most persistent vaginal pain is rooted in a lack of proper arousal and/or psychological factors like sexual shame (which can lead to physical manifestations of pain).
You need to get to the underlying issues that are plaguing you. This isn’t just a physical problem, it’s a psychological problem. You have to ask yourself the right questions.
When did this pain start? When does it typically begin? What were your early experiences with sexuality like? Were the things you heard positive or negative? How was sex discussed when you were growing up? Was it discussed?
The answers to these questions are what your dyspareunia (vaginal pain) is rooted in. You feel like this is your fault. You want to feel pleasure, but don’t feel like you deserve pleasure. You feel lost. You blame yourself and see yourself as the problem, rather than a person WITH a problem. If you have negative thoughts like this about your body, ability to experience pleasure, and your sex life - you will continue to have painful sex. Your vulva and vagina are manifesting your shame in the form of pain.
When you’re going to have intercourse, you’re inside of your head. You’re expecting pain during sex, so when you experience it, it is a self-fulfilling prophecy that reaffirms shame.
Start with changing the way you talk to yourself. Redirect these negative messages away from self-blame to goal-oriented solutions. You are a human being with a sexual concern and that doesn’t mean you are not the issue here. A proper treatment plan will depend on the level of pain you are experiencing. It can take a lot of work, but with the right mindset, you will get there.
Next, focus on outercourse - foreplay, only named the way it should be: As something in and of itself. Stop putting so much pressure on yourself to have penetrative sex. It’s putting restrictions on your body and brain, making all forms of sex shitty and awful. No one should go through life like that.
Enjoying sex (all sex!) for the sake of pleasure and not performance is key to better experiences. If you’re wrapped up in this idea that only P in the V sex counts as “real,” you’re going to fuck yourself up even more. Take time to have fun with your partner. Sex should not be agonizing. I’m not saying give up on penetration, but recognize that it isn’t the most important thing. What is is the connection with your partner and experiencing intimacy and orgasm -- which you are!
Lastly, I want you seek help on the ground. Whatever your feelings are on therapy, you do need to seek outside help. Many people read articles, ask writers for advice, read books -- among other things -- looking to fix the problems themselves. You have been with your partner for decades (and have been having sex longer than that, I imagine) and have yet to find a solution to this concern. It is time to allow someone else to take the wheel and help guide you.
Even if it doesn’t work, at least you’ve explored that path. We don't have comprehensive sexual education, understanding of pleasure, or shame-free feelings around sex -- all contributing to an environment in which sexual concerns and self-doubt flourish, and communication and seeking assistance falters.
I hope this helps a little bit. At the very least, perhaps it will give you a place to start.
This column originally appeared on Your Sexual PSA, where Gigi is the resident sexuality educator.