What do you do if sex is painful?

Jay Dee

What do you do if sex is painful?

May 13, 2016

Yesterday I wrote a post dealing with a question I’d received from our anonymous Have A Question page.  The post was on whether or not a marriage can survive without sex.  But, there was another question within the one comment that I wanted to address,

What do you do if sex is painful

Yesterday I wrote a post dealing with a question I’d received from our anonymous Have A Question page.  The post was on whether or not a marriage can survive without sex.  But, there was another question within the one comment that I wanted to address, but felt needed a separate post.  Here’s the part in question:

My wife and I had pain issues in every attempt to consummate our relationship. We stopped trying altogether about 12 years into the marriage. We have never fought about this, because we are Christians and understand the difficulties associated with painful intercourse. We have not once talked about sex in many years and frankly, would not know how to or why to bring it up since both of us have significant problems. We have been married for 28 years.

And I think there are a lot of marriages where sex is painful and they’re not getting help.  So, I thought I’d write a brief post listing some of the reasons it might hurt and some of the help you can look into.  Now, I’m not a doctor, therapist, pastor, or anything like that.  This is just some research I did on my own.  It’s only to point you in the direction of some possible solutions, don’t count it as medical advice.  Now, vaginal pain during sex is the most common, so I’m going to be focusing on that.  He mentions they both have significant problems, but I’m not sure what the problems on his side are.  So I’m going to focus on vaginal pain in this post.

You might just need lubricant

There is a common myth out there that if a woman is aroused, then she’s “wet”, or in other words, her vagina (and entrance, or “vestibule”) is lubricated.  But, this isn’t always the case.  There are times when women are lubricated, but not aroused.  Or when they are aroused, but not lubricated.  Or there are times when there is a war going on in their body.

For example, the first time you have sex, you might be aroused and excited, but also nervous and a bit fearful.  These two sets of emotions can interact in some odd ways, and sometimes it can mean you aren’t lubricating.  So, not a small amount of Christians find they have trouble on their wedding night, and it could easily be solved with lubrication.

There are lots of different kinds, and I should really do a post on different lubricants, but our favorite is coconut oil (which may or may not be compatible with condoms, so be aware).

So, if you are experiencing pain during sex, first step would be to try lubricant.

You might just need to relax

I know, that sounds trite.  But, the vagina opening is surrounded by muscles (the pubococcugeus, also known as your pelvic floor).  When you are stressed, these muscles tense up.  And when you’re having pain during sex, then it’s not surprising you might be stressed and might be clenching those muscles.  In some women, these muscles are very strong and can make penetration impossible.

So, some women find that a massage first, going slow, not having pressure to perform, all aid in being able to relax and then sex becomes possible.

You might need to go slow

Sometimes new married couples just jump right into sex and go too fast, and then when things hurt, they just try again.  You might need to slow down, and you might need to work up to penis in vagina sex.  Start by exploring each other, as knowing more can help relax you.  Then go really slow.  Insert a lubricated little finger (pinky finger).  Then try a larger one, then maybe your thumb.  Then maybe two small fingers.  Work you way up.  If the husband’s fingers are too big, start with her fingers.  There’s nothing wrong with exploring together.  Also, there’s no such thing as too much lube in this scenario.  This may take multiple sessions.  Maybe you only get one finger in today.  Count that as progress and then try again another time, or another day.

Go slow, and take your time.  You’re looking for progress, not perfection yet.

You might need a hymenectomy

In some women, their hymen is very thick/strong.  The hymen is a flap of skin that surrounds or partially covers the vagina opening.  Some women stretch/tear/break it earlier in life, often from completely non-sexual activities (riding a bike or a horse, gymnastics, etc).  Many break their during their first penetrative sexual act (be it masturbation or intercourse), which is why virgin often (but not always) bleed the first time they have sex.  But for some, it’s too strong, or too thick, and it’s not easily broken.  Sometimes it’s just the way they are.  Sometimes it was partially torn earlier and grew back stronger or with scar tissue (which doesn’t stretch).

If this is the case, then you might need to see a doctor to have your hymen removed.  It’s not a complicated procedure, they can be done in a doctors office or a hospital (depending on the doctor) under local anesthetic.  They usually use absorb-able sutures just to manage bleeding, so you don’t have to go back to have them removed.

You might need to learn more about sex from a biblical perspective

Some women have learned some awful things about sex, things that are not true.  They’ve grown up being told sex is dirty, that it’s sinful, that it’s wrong, that it’s not pure, that “good girls don’t” and things like that.  The Bible has a very different message. Our course, Becoming More Sexually Engaged, helps break through many of these incorrect messages and teaches you what the Bible has to say about sex, and then follows up with practical advice on how to become more sexually engaged in your marriage.

You might need a therapist

Remember I said some women might just need to relax?  Well, some can’t.  Especially if there is significant trauma in their past, for example, from sexual abuse (or any kind of abuse really).  Some people might need to work through some issues in order to be able to relax.  A massage won’t cut it.  If you are having pain during sex, and you have a history of abuse.  Please see a qualified therapist.

You might need a physiotherapist

For some, the muscles are just too tight.  It’s not a psychological issue, it’s merely physiological (nothing to do with the brain, just the body).  There are physiotherapists who specialize in pelvic floor muscles in every major city, so far as I know.  Just google pelvic floor physiotherapy and the name of the closest city, and you should be able to find one.  They often treat those with incontinence issues (bladder control), which is the exact opposite problem (loose pelvic floor), but of course, they can treat the opposite side of the spectrum as well.  These are the specialists for those muscles, they know the exercises you can do to loosen them up.

You might all of the above

For some, there’s not one issue.  There are many.  There is a clinic in New York that specializes in sexual pain called the Institute for Women in Pain. I have no direct experience or contact with them, but I’ve heard a lot of good things.  Might be something to look into.  Reportedly, they have all the resources you need to get to the bottom of your sexual pain.  If you’re at the end of your rope, these are the guys to call.  It’s not cheap…but it might be worth it for the ability to have sex and gain the benefits I wrote about yesterday.

In the mean time

Just because you can’t have intercourse, doesn’t mean you can’t have sex.  Sex is merely sexual activity between a couple.  There’s still manual sex (women don’t need insertion to have an orgasm, in fact, most can’t from penetration alone).  Learn to touch each other.  Try out some mutual masturbation (you won’t be the only ones).  Or experiment with oral sex.  Or you can use outercourse, which I don’t have a post on yet…  Basically the husband places his penis along the vulva, over the clitoris, and then you slide it up and down in a thrusting motion.  Basically, it’s sex without penetration.  You can potentially both orgasm from this and get the majority of the benefits of sex while your work through the penetration issues.

Did I miss any?  I know there must be some medical professionals reading.   Feel free to comment below and add your thoughts.  You can even comment anonymously if liability is a concern.

If you’ve been through this, please share your experiences and what worked for you below, it might be exactly what someone needs to read.

I think more are dealing with this than we think, and like the above person, I think a lot of them just give up.  Don’t give up.  You can make this work, even if you never manage to have intercourse, it doesn’t mean you can’t have sex and a healthy sexual relationship.  So, please consider sharing this post, because you never know whose marriage you’ll give hope to.  Ever week now I’m seeing people start reading because a friend of theirs shared something and they’re so happy to have finally found some answers to their struggles.  And they probably never tell the person who shared it how much of an impact it made in their lives.  So, consider sharing.  You never know who you might help.

Looking for help?

30 thoughts on “What do you do if sex is painful?”

  1. Keelie Reason says:

    Those that experience pain during sex must really feel discouraged. Sex is so hard to figure out as it and adding pain to the mix must be terrible. I hope that people that experience pain in this area will reach out to their doctor and ask for help. So hard. 🙁

    1. Paul says:

      Thank you for being so sympathetic. You must be a wonderful person to have such a tender heart for those with very difficult marital problems. I spoke to my doctor once about this when, in the course of a physical exam, he inquired about my satisfaction with sex. I told him that I have not had sex, and that my spouse andI are still virgins. He may not have believed me because of rarely, if ever, having heard about this kind of problem or because he had nothing to say in response. I was not surprised. I would not feel comfortable with nore would I be willing to trust a secular specialist. You are so right. This is a hard problem, and one that is not easily or quickly resolved.

  2. Homemaker says:

    The author of the Unveiled Wife dealt with the same thing.

    1. Kay says:

      Was going to say the same thing. Jennifer Smith (Unveiled Wife) had vaginismus that was actually a reaction to the parabens in her face wash, off all things. As soon as she switched to something all natural, she was able to have sex instantly, after four years of misery and near divorce. So for those who struggle with painful sex, make the switch to all natural products and consider getting tested for food sensitivities too. One of my best friends has a gluten sensitivity and didn’t know it, but as long as she is good about her diet she can have sex. Whenever she “cheats” she is unable to have sex because it is too painful.

      1. Anonymous says:

        Most cases of vaginismus are not due to “unnatural” products. In the vast majority of cases, it’s a stress response of the sympathetic nervous system. It has to be treated with a mind-body approach that involves vaginal dilators and overcoming the conscious or unconscious anxiety.

  3. Myself says:

    There is also the post-menopausal time when there are changes in the lady parts and sex is painful.
    Any suggestions for that?

    1. Jay Dee says:

      I’m still working on getting myself up to speed on menopause. I’m afraid I haven’t gotten to post-menopause yet, though I hear some pretty good things about HRT (hormone replacement therapy).

  4. Rachael says:

    Sex has been painful for me since I got maried 8 months ago. I have hypertonic pelvic floor muscle disfunction which is pretty much incurable (there are exersises that reduce the pain but dont eliminate it). I love my husband but he thinks non penatrative sex is “wordly” and gross so I try my best to ignore the pain. Doctors might not be helpful as even gynocologist arent train to deal with cronic vulvar pain. I sugest anyone that has sexual pain read When Sex Hurts by Andrew Goldstein, Caroline Pukall, and Irwin Goldstein before they go to a doctor (none of my doctors were helpful but I was able to diagnos myself with this book). Some forms of chronic sexual pain can be cured with sugery or using dilators or medication can help.

    1. Jay Dee says:

      Would your husband be willing to do the Intimacy Ignited study?

      1. Rachael says:

        I will ask. I have had him read several Christian book on sex and talk to our pastor but he is still not comfortable with other forms of sexual expression.

        1. Jay Dee says:

          Well, I’m going to reference 1 Timothy 5:8 here and say husbands are supposed to provide good sex to their wives, if at all possible, and if he’s not because of some silly made up rules…well, then…let him wrestle with what that verse says.

          1. Rachael says:

            Thank you. I like your blog!

            1. Jay Dee says:

              Thank you! I like people who comment!

  5. JoMama67 says:

    Excellent article. I agree with everything said.
    I put off having sex with my husband because I was embarrassed of my weight. The whole act was painful to me but I wanted to make my man happy so I just grit my teeth and dealt with it. I lost weight but still, sex was painful. (My husband never complained about my weight issue then I have to add)
    What happened was that I needed surgery, a hysterectomy to be exact. My uterus was enlarged, and now I am feeling a lot better and a somewhat happy husband.

  6. anonymous says:

    I had terrible vaginal pain when I was taking deprovera the shot for 3 month birth control. This went on for about a year because I didn’t realize it was causing the pain.

  7. LatterDay Marriage says:

    Here is what you DON’T do:

    Hide the problem from your spouse and just try to avoid having sex
    Do nothing to find a solution.

  8. Anonymous says:

    I really like this quote: “Sex doesn’t have to be just intercourse.” This is so true. My husband, having a somewhat higher sex drive than me, has said that actual intercourse isn’t his favorite part of sex because only he can orgasm that way. He rather enjoys when both of us are enjoying it which involves exploring each others bodies. Get creative!

    On the flip side, after my first pregnancy, up to 8 months postpartum, I had internal pain in my vaginal area that only occurred whenever I became turned on. So even when my husband would just kiss me passionately and I would start to get turned on, I would feel pain. Of this, the Lord healed me.

  9. JaxStyle says:

    I like this quote: “Just because you can’t have intercourse, doesn’t mean you can’t have sex.” This is so true. My husband, having a sightly higher sex drive than myself, says that actual inter course isn’t his favorite part because only he can orgasm that way. He likes it best when we’re both getting equal enjoyment, which is usually when we’re touching and exploring each other. Get creative!

    On the flip side, after my first pregnancy, up to 8 months postpartum, I experienced internal vaginal pain when I became even remotely turned on. Even if my husband just kissed me passionately and I began to get turned on I would feel pain. Of this the Lord healed me. 🙂

  10. Ed says:

    Dear Jay,
    Your observations are pretty sharp. Thanks for your understanding. My wife and I have this problem and we’ve never been able to overcome it, much less even to deal with it. I figured that it would just go away as we engaged in foreplay early in our marriage, but nothing more intimate happened. I was too surprised to know what to do except to be patient and keep waiting for the right timing, the right circumstances, the right set of emotions to be in play, etc.. It has gotten to the point where my wife has lost all interest in sex. Her career is demanding with 15 hour days. That leaves her too tired for any intimacy whatsoever. She has never given me any reason to suspect any unfaithfulness to me. Both of us are virgins. She repeatedly tells me that she loves me but has no interest to do the act. I was stunned when she told me this and did not know what to say. I have tried pastoral counseling but ministers seem completely unable to respond except to encourage me to pray about the matter. Christian counselors are not much better, only prescribing medication for my depression over this. Praying is all that I can do and what I have done from the get-go. I plead for God to intervene. For unknown reasons heaven is silent. I am glad that you have this blog which I discovered. It keeps me from feeling alone.
    Sincerely, Ed

    1. Jay Dee says:

      I’m sorry to hear you’re struggling through this. You are definitely not alone. I’ve gotten a couple emails since publishing this post from men in the same position. I’m saddened that the pastors won’t do anything, but I understand why. It’s pretty scary and risky to confront someone about their sexual relationship. I’m afraid that given that I can only communicate to you, then I have much of the same answer: lean on God and pray for healing. Not only of body, but more importantly, of your wife’s spirit.

      1. Ed says:

        Thanks for being understanding, Jay. You are the best! Pastors are not sexual therapists and have no training on how to deal with this sort of problem. I spoke to two pastors about this, but beyond directing me to pray about the matter, and to pursue professional counseling, their help was quite limited. It isn’t enough to encourage people to be biblical when something physiological is going on in the body I like your counsel to LEAN ON GOD AND PRAY FOR HEALING. I have been doing this for very many years. The best thing that you said was to pray for healing for YOUR WIFE’S SPIRIT. Well said. AMEN.

        1. Jay Dee says:

          Happy to be of service.

  11. Diane says:

    What about chronic pain in nonsexual body parts? The pain doesn’t give us much chance to get in the mood. If we do manage to catch a low pain break and make love the pain can return with a vengeance after the adrenaline wears off. Then we spend 3 or 4 days getting the pain under control again.

    1. Jay Dee says:

      Find the root cause of the pain and deal with that? I’m afraid I’m neither qualified to answer the question, nor do I have enough information to make an unqualified guess. I’d consult with someone who specializes in removing the cause of the chronic pain permanently.

  12. Jon Henry says:

    When we had trouble breaking the hymen, we found what you termed outercourse to be just as good. In fact, after we finally did break it, we still enjoyed outercourse better for a while until we became more adjusted to intercourse. During pregnancy, outercourse is how we made it through when intercourse became extremely difficult.

  13. Sarah Bailey says:

    I realize this is now an older article but I just wanted to add in that having low hormones can cause pain too. Post childbirth I experience what felt like “micro tears” inside during intercourse. Pardon the gross comparison, but where there should have been elasticity, it felt dry rotted and torn. Doctors didn’t have a clue, and I even went to a specialist. No one had a clue.

    Each time it got better when I naturally stoped nursing (usually around 9months when I ran dry). Finally a family friend suggested using estrace cream which I guess is proscribed post menopause? My midwife said it’s rarely used but may help.

    HALLELUJAH. It saved our sexuality. It stopped the pain, and got things back on track. I am rather boyish shaped (barely A cup, no curves, etc.) and I guess I just didn’t produce enough estrogen naturally. Just thought I’d share for any ladies struggling through pregnancy and post childbirth pain!

    1. Jay Dee says:

      I’m glad you decided to share, despite it being an old post!

  14. Lou says:

    I have been married nearly 45 years and do not deny sex to my husband, but I don’t enjoy it. It has been painful nearly every time for all 45 of those years. And yes, I’ve talked to my doctors and use lubricants and estrace cream. My husband hopes to be having sex at 80. I am hoping there is a time when I can say, “Enough.” I don’t find my husband (or anyone else) erotic, and I am disgusted by oral sex. I believe sex is not to be withheld as a weapon between couples, but I also don’t see it as loving to be either dishonest or persistent about a painful activity. Surely, I have made my sacrifice, and there can be a time for him to make his?

    1. Jay Dee says:

      Often pain during sex is related to psychological barriers – I think it’s quite possible that you’re views on sex are impeding your enjoyment of it. I’m sorry that you’ve been struggling with that for 45 years.

  15. Anonymous says:

    Vaginismus is a very common condition among Christian couples, and the risk increases if both of you waited until marriage to have sex. If the woman has vaginismus, most of these suggestions will not work to resolve it. I suffered for years and tried all these suggestions to no avail until I found people who actually understood the condition and could help. If this is you, seek out treatment from the Women’s Therapy Center in NY.

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