If it hurts, it's not normal: painful sex

In technical terms, it is called dyspareunia, but for those who experience it, it is, much more commonly, painful sex. It is the pain felt during sexual intercourse, affecting far more people than you might imagine. According to official statistics, 12-15% of women suffer from pain during intercourse, with this percentage rising to 44% for those in menopause.

Let's explore the causes and possible solutions.

How, when, and how much

Let's start by trying to understand the different types of pain that can be felt during sexual intercourse.

It's important to first try to localize the pain: most women describe this problem as a sensation of pain that can be acute and mainly related to the moment of penetration, or deep, occurring with full penetration. It is often also felt in the phase following intercourse, when burning, cramps, or muscle spasms may be experienced.

First, ask yourself if the pain you feel affects the vulva and the initial part of the vagina at the moment of penetration, or if it is a pain further "up," which you perceive in the lower abdomen and at the level of the cervix. In the first case, we speak of superficial dyspareunia, while in the second, we speak of deep dyspareunia, and the causes can also differ.

For example, superficial dyspareunia is very often related to vaginal lubrication problems. During phases of a woman's life when estrogen levels in the body decrease, such as during menopause, lubrication may diminish and cause vaginal dryness, which in turn will make penetration difficult, sometimes even leading to micro-lesions and minor bleeding. If what you perceive is dryness, it could also be due to the wrong contraceptive: some hormonal contraceptives can alter lubrication and increase friction during penetration, making intercourse painful. In these cases, it might be enough to change contraceptives or choose a lubricant suitable for our needs to make sex enjoyable and fun again. If you want to start with something gentle and simple, you could try, for example, Intymate Intimate Moisturizing Gel - Water-Based.

Pain could also be caused by genital lesions, infections, or inflammation. In any case, do not wait to talk to a specialist: postponing it could worsen the situation physically, as well as increase your worry and mental load.

Physical problem or psychological barrier?

Let's try to explore an alternative possibility to the biological one, which is what happens when an invisible barrier stands between us and intimate pleasure, limiting our freedom and sexual activity.

Painful sex due to psychological causes is also called acquired dyspareunia because, unlike pain from organic causes, it has its roots in the emotional state and psychological condition of the person suffering from it. It is no coincidence that the pelvic floor is called an "emotional organ" because it is directly connected to mental stimuli and has a direct correlation with any states of anxiety.

Let us explain better: if sexual intercourse creates uneasiness, this activates a reflexive contraction in the muscles, which in turn will reduce lubrication and vaginal space, causing pain during intercourse. It is estimated that in almost half of the cases where pain occurs during sexual intercourse, the origins are psychological. This is a huge number, especially considering the tendency to underestimate the emotional aspect when physical pain appears.

At the root of our emotional distress during sex could be various factors. Perhaps we are experiencing a particularly stressful and worrying period, or we feel we do not have control over an aspect of our lives, which makes us uneasy. However, it could also be a more deeply rooted malaise, for example, undiagnosed depression, which, even if mild, could begin to represent an obstacle in our daily habits.

The case of traumatic experiences is different. Let's start with a fact: in Italy, 31.9% of women between 16 and 75 years old have experienced physical or sexual violence in their lifetime (ISTAT data). This is a huge percentage, and for those who have experienced one or more episodes of abuse, it is easy to imagine how these types of events, among many consequences, also negatively impact how one relates to sex, creating an emotional barrier with long-term consequences in the sphere of sexual pleasure.

If our emotional balance is in difficulty, it is really important to take care of ourselves and, together with a specialized professional, develop an integrated approach to the problem that truly takes our emotions into account.

Vulvodynia and endometriosis: let's start recognizing them

These are two conditions that are more unknown than rare, and only recently have they begun to be investigated in detail scientifically. You've probably heard of them: vulvodynia is a disorder that involves sensations of burning, sharp pains, and shocks, with lesions that are often not visible and therefore difficult to identify and diagnose.

Endometriosis, on the other hand, consists of an excess of endometrial tissue that grows outside the uterus and results in deep pain, especially during the menstrual cycle. What these two conditions have in common is the chronic pelvic pain they cause in women, but above all, the diagnostic delay that almost always characterizes them. Precisely because of their lack of popularity, they are often underestimated and confused with common candidiasis or cystitis, and sometimes a correct diagnosis can even take years.

The pain you experience during sex could have one of these two chronic conditions at its root, especially if you also feel unwell at times when you are not having intercourse. In these cases, it is important not to settle if you receive a diagnosis that seems partial or not thorough. If you feel that the problem has not been truly understood or you feel that you have only been partially listened to, try consulting a gynecologist with a more contemporary and informed approach to these issues, who can avoid minimizing what could be a complex, but treatable, condition.

If painful sex is a problem for you and you still cannot identify the cause, what is truly important is not to give up: the causes could be varied, and it might take some time to find the reason.

Fortunately, today there are numerous possibilities to identify and resolve them, without letting pain during your intercourse become a habit.