Painful sex or “dyspareunia” can happen before, during or after intercourse.

It is a complaint of persistent or recurrent pain or discomfort associated with attempted or successful vaginal penetration. Including the use of tampons.

The pain can be superficial - around the opening of the vagina, or deeper - feeling as if it is within the pelvis itself.

The pain can last beyond the act of intercourse or insertion, causing pain for minutes, to hours, to days after.

The pain can range for each person, with most describing terms such as “sharp”, “stabbing”, “burning”, “dull”, “thudding”, “hitting a wall”

Nearly 75 percent of those AFAB will experience pain during sex at some point in their lives.

Sometimes, this pain will be a one-time thing. Other times, it will be more persistent.

Some people accept painful sex as the norm, but it shouldn’t be. There are circumstances where someone might seek out a level of pain during sex, but there’s a difference between a sexual kink and undesired, severe, or persistent pain with intercourse.

The pelvic floor muscles sit in the base of the pelvis and encircle the vaginal opening.

These muscles can experience spasms or dysfunction in one or more of the layers (superficial, middle or deep)

This can make the size of the vaginal opening smaller causing vaginal insertion painful and/or impossible. If the deeper muscles are the issue, you can also experience deeper pain.

Dyspareunia can be related to a history of sexual trauma or abuse, other pelvic traumas (e.g., car accident, sports accident), or a multitude of emotional and stress related factors. Other pelvic floor disorders like endometriosis, PCOS, dermatitis, vaginismus, vulvodynia, thrush and STI’s can also result in dyspareunia

Poor lubrication is another cause of dyspareunia and can occur with breastfeeding, oral contraception use, and menopause due to lowered estrogen levels.

As we get older, we can experience a general loss of muscle flexibility which can also make penetration painful.

It is common to feel that treatment may be awkward, however at Self we are dedicated to making you feel comfortable and have worked with a large number of patients to help address vaginal pain.

We will take the time to learn about your pain and whether it might be associated with an event or other pelvic floor dysfunction. There is no such thing as TMI.

We are trained in trauma-informed care, so you can expect compassion, non-judgement and support throughout your care. With your consent, we can also remain in touch with your other relevant health professionals to make sure we are all working towards your goals.

Treatment may include:

• Education

• Pelvic floor awareness and retraining

• Pelvic floor muscle tension relaxation techniques

• Manual therapy

• Vaginal dilators/trainers

• TENS