Experiencing pain during sex can have a huge impact on quality of life affecting interpersonal relationships, health and wellbeing.
It has been reported that 60 per cent of women have described a time when sex was painful. It is estimated that five to 45 per cent of females experience painful sex on a consistent basis.
Although painful sex is common, experiencing regular and frequent pain during sex should not be considered normal. There are known causes and treatment is available.
Most commonly, women and some transgender individuals report experiencing sexual pain (dyspareunia) at the entrance of the vagina and deep inside the pelvis. Superficial pain, pain at the entrance of the vagina, usually involves the vulva and/or superficial pelvic floor muscles. Deep pain felt inside the pelvis may be caused by the bladder, deeper pelvic floor muscles, uterus and cervix, and cul-de-sac (space between the rectum and back wall of the uterus).
Endometriosis is a frequent cause of deep pain during sex. Over 50 per cent of individuals with endometriosis experience painful sex and it is one of the main reasons patients come to the BC Women’s Centre for Pelvic Pain & Endometriosis.
Some people may experience both superficial and deep pain. Dyspareunia is multifactorial, meaning there are different causes contributing to the pain. Deep pain common among those with endometriosis may be caused by the condition itself along with other conditions such as bladder issues or central sensitization. Central sensitization refers to changes in the brain and spinal cord that result in greater sensitivity to pain.
Sexual pain is complex affecting each person differently; therefore treatment plans should be tailored specifically to the individual. Treatment is often multidisciplinary that may involve pelvic floor physiotherapy, counselling and psychological therapy, pain education and management, surgical and medical therapies. Depending on the cause, an individual may need one of these treatments or all of these treatments.
“Patients are encouraged to have open discussions with their health care provider to determine the root of the problem in order to manage pain,” says Dr. Paul Yong, research director, BC Women’s Centre for Pelvic Pain & Endometriosis.
Learn more about pelvic pain and endometrosis and how to be referred to the Centre for Pelvic Pain & Endometriosis.