What You Need to Know About Pain During Sex
Did you know that 30% of women experienced pain during their last intercourse ? thirty%! But no matter how frequent it is, sexual pain doesn’t get enough attention. Millions of women suffer in silence, unaware that there are ways to treat their pain. To help me illuminate this important topic, I spoke with Dr. Sonia Bahlani , a pelvic pain specialist based in New York City.
Painful sex is a serious problem
As astonishing as this figure of 30% is, it is possible that even more women are suffering from sexual pain. Dr. Bahlani says: “Sexual pain is underestimated because it has a stigma attached to it. Sex is a difficult topic for most people. They don’t want to talk about it. ” In addition, women are often told that painful sex is okay. My clients said something like, “My doctor told me this is exactly what sex is,” or “My doctor said to have a glass of wine and try not to think about it.” Women are encouraged not to get treatment or even think about what they are facing as a problem.
To complicate matters further, some conditions of sexual pain may diminish or even disappear without treatment. Dr. Bahlani says: “If you look at the evidence and history of vulvodynia, pelvic floor dysfunction, interstitial cystitis, you will see them increasing and decreasing. Sometimes people get better without doing anything. ” Clinicians often ignore a woman’s complaint because they believe she will get better on her own.
So let’s just be clear: it’s not okay to experience pain during sex, and you deserve to find a doctor who will take your pain seriously.
Pain can have several causes, and these causes can interact with each other.
Dr. Bahlani explained to me a number of potential causes of sexual pain, including:
- Pelvic floor muscle problems
- Hormones
- Neuropathy
- Vulvodynia
- Endometriosis
- Bladder pain / interstitial cystitis
- Pelvic inflammatory disease
- Myoma of the uterus
- Psychological reasons
This is by no means an exhaustive list – pelvic pain is a complex problem. Pain can also be present in a number of areas in the pelvis, including various areas of the vulva and vagina, uterus, bladder, and muscles. Dr. Bahlani takes a holistic approach to pelvic pain because she recognizes that pain is often multifaceted. She says: “It’s really important for me to deal with the whole patient, because more often than not, patients have several different generators of pain. Their pain is not because of one thing. It doesn’t feel like a cold when I give them one medicine and they get better. We often have to solve each problem ourselves. “
In addition, as Dr. Bahlani addresses one specific cause of his patient’s pain, another factor often arises. For example, a woman may experience sexual pain due to interstitial cystitis. As she continues to have sex with her partner, she may begin to anticipate this pain. The subsequent anxiety she experiences can make her pain worse. She may even start contracting the pelvic floor muscles in anticipation of pain, leading to pelvic floor dysfunction. Dr. Bahlani says: “It’s like peeling an onion: I often have to heal one thing and then watch what happens and heal another.” Due to the interconnected nature of these factors, Dr. Bahlani recommends seeing a specialist as soon as possible to avoid these secondary causes of pain. Interstitial cystitis is easier to heal on its own without anxiety or pelvic floor problems.
There are not many specialists, but there are many treatment options.
A surprisingly small number of doctors are trained in the diagnosis and treatment of sexual pain. Even obstetrics and gynecology barely touch the surface of sexual pain. Dr. Bahlani says she has clients flying into her New York offices from all over the world. She recently started offering telemedicine services to work with patients who cannot find a pain specialist in their area. (She cautiously adds that she cannot make a medical diagnosis over the phone. But telemedicine treatment can still be extremely valuable and reaffirming.)
Now for the great news. There are many treatment options for sexual pain, including:
- Pelvic floor physiotherapy (topic of next article)
- Neuropathic drugs
- Tricyclic antidepressants
- Topical creams
- Trigger point injections with anesthetics (similar to acupuncture)
- Botox
It’s not your fault and there is hope
I asked Dr. Bahlani what she would say to a woman who is in pain and wants to find a solution, but feels embarrassed and ashamed. “I would say number one: understand that this is not your fault. There is nothing that you have done wrong to cause this. Number two, this is a problem that many women are silently suffering from, but you don’t have to be part of this silent majority. ”
Although sexual pain can be quite difficult, Dr. Bahlani said she is able to find the root of the problem for about 98% of her clients and help them ultimately lead a normal life without pain. She says, “We can fix something. We can help you. It takes time, but there is so much hope. “