If you experience pain during sex, you are certainly not alone. Pain during sex is called dyspareunia, and research shows that about 7% of women experience pain it.[1] Of those 7%, about one-quarter of them reported that the pain had been occurring frequently or every time they had intercourse over at least 6 months. Today, we’d like to look at some of the most common causes so that if you’re experiencing dyspareunia you maybe have a starting point to know how to explore and hopefully resolve this challenge. 

Pain during sexual intercourse is a relatively common issue. Of course, the lifetime prevalence is going to be higher, and I would expect that every person is likely to have at least some discomfort if not some pain during the course of their sexual interactions with their spouse over the lifetime of their marriage. This can be tough to talk about for some people, so we hope that today’s show serves as a bit of an icebreaker and introduction to the subject. 

We’re not sexologists, sex therapists or medical professionals. I am a marriage counselor so we do address sexual issues, but just be reminded that if you are experiencing pain your wisest course of action is first of all to talk to your doctor or gynaecologist, and possibly to book an appointment with a sex therapist.

There are more reasons for pain during sex than what we will cover, for example, we are not going to address urinary tract infections or sexually transmitted infections. But anxiety and menopause are two major causes so we’ll start with them.

Sexual Anxiety

Sexual anxiety (or sexual performance anxiety) is something that affects men and women of all ages, regardless of how much experience they have had with sexual intercourse. There are a variety of possibilities here. A newly married wife may be too self-conscious to tell her husband what she does not enjoy: this could lead to some trepidation or anxiety about having sex which could result in pain during sex.[2] In some cases, the anxiety may be short-lived and go away on its own. In other cases, it may be something that occurs on a regular basis and interferes with a healthy sex life.[3]

According to sex educator Amy Jo Goddard (n.d.), two things are generally the root cause of sexual performance anxiety. She states, "this response is conditioned by the way in which we were brought up to think about certain aspects of sex and our own bodies, and by social expectations that impact our relationship with our own sexuality."[4] This means that messages from your family of origin, your church, or from locker-room discussions or friends at school — all those sources could potentially contribute to anxiety during sex.

Other times it may simply be a lack of sex education: perhaps not that you don’t understand how sex works, but that you’re just not prepared for all the realities of sexual encounters with your husband. Everyone functions differently and has different needs when it comes to sex, and not being well educated can lead you to feel unsure about the techniques of giving, achieving or receiving pleasure. Additionally, you may experience fear because of myths concerning pregnancy, or myths about how your body is supposed to react during sex, and these beliefs can be very anxiety-inducing.[5]

Of course, anxiety impacts arousal, which impacts your body’s ability to prepare itself for penetration and intercourse. It’s also important to note that the anxiety doesn’t have to be sexual performance anxiety. It could be anxiety about anything: how you’re going to pay the bills, your child’s health, the family get-together that’s coming up, whatever. General anxiety can also impact your sexual experience, potentially resulting in discomfort or pain.

What to do About Anxiety

Obviously, with such a wide variety of potential sources for anxiety it is challenging to cover all the possible solutions.