No More Pain

Dear Dr. Melanie,

I love my partner, but sex is painful and I don’t want it at all! I just to it because he wants to! It’s starting to put a huge strain on our relationship. I would like to be able to want sex again, it not be painful, and actually enjoy it again! I dread sex! I can go for months or more without it! What is wrong with me? — Dreading Sex

Dear Dreading,

Sexual pain is a real problem for many women, so I’m glad you asked your question. First, you are right to want to avoid sex that hurts! Sex should never hurt either partner. Second, you need to visit your gynecologist for a pelvic exam to check for any physical causes of your pain. If your doc can’t find anything physically wrong, see a sex therapist to explore any psychological issues that may be causing your pain.

There are many reasons for sexual pain. Physical or emotional trauma can cause muscles to clamp shut at the thought of sexual activity. There are also assorted infections, skin conditions, and sexually transmitted infections that can cause pain during sex. Internal conditions like endometriosis (scar tissue) and fibroids (benign tumors) and cysts can cause pain with penetration. Another possible issue might be a lack of sexual desire and/ difficulty getting aroused. If you’re not interested in sex and your partner proceeds to touch you or penetrate you with fingers or a penis, your lack of natural lubrication may make you feel like you’re being rubbed raw.

It’s a good sign that you want to desire sex and that you once enjoyed it. There’s a good chance you can get back your desire, arousal and satisfaction. Schedule a visit with your gynecologist right away. And, if necessary, visit a sex therapist with or without your partner. In the meantime, reconsider what “having sex” means to you both. If you don’t want intercourse but he wants some sexual gratification, consider doing him a favor once in a while by using your hands, mouth, or thighs (he can insert and stroke his penis between them) to please him. If you can comfortably touch yourself, considering masturbating with him watching so he can learn the kind of touch feels good to you, given your restrictions due to pain. Some couples enjoy watching each other masturbate at the same time.