Pain or discomfort during intercourse may be diagnosed as dyspareunia, vaginismus or vulvodynia in women. There is often pain during intercourse for women who have endometriosis, and sometimes with PCOS – Polycystic Ovarian Syndrome, though there are often additional symptoms leading to these diagnoses.

Dyspareunia is more a blanket term for pain in and around the vagina and vulva and may be felt all over the surface. It also encompasses deeper vaginal pain that may include deep pain or pressure against the cervix. This could be caused by the penis actually coming into contact with the cervix – some women experience pain when this occurs, whereas other women may find this pleasurable. Sometimes there may be an infection or other complication with the cervix. However, dyspareunia is often diagnosed by a gynecologist when they are not able to find a physical reason for the pain, such as infection.

Sometimes pain occurs along the outer opening of the vagina. This pain or discomfort may be experienced as burning or stinging. If there isn’t actually any skin or tissue damage seen by your doctor, then you might be experiencing vulvodynia.

Other times, it may feel as though there is “a wall” just inside the opening of the vagina and the penis cannot go beyond this “wall.” This is a very small muscle that is involuntarily contracted or in spasm. This is vaginismus. This muscle will relax when you start to recognize it and actively relax your entire body. Sometimes laughing, talking in a light, playful way during sex can ease this muscle.

If any of these definitions resonate with you on some level, here’s what you do next:

Step #1: Please, Do NOT have painful sex anymore – if you do experience any discomfort during sex, please pause. Change up what you’re doing and have a different kind of sex. Don’t just stop and roll over in frustration. When we do this, then sex isn’t enjoyable at all anymore (and this creates a different kind of negative cycle). Stopping may also lead to feelings of failure and turn sex into a negative experience. Plus, you’ll both feel bad. So, continue having sex, just change from intercourse to oral sex, outercourse, or mutual masturbation (or any other variety of ways to engage sexually and affectionately with your partner).

You simply must detangle the pain from sex. If you continue to suffer to please your partner, or to avoid the conflict, you will continue the anticipatory anxiety response cycle.

More treatment ideas to come…

Kimberly Atwood is a licensed psychotherapist and certified sex therapist specializing in  sexual health, intimacy and relationship issues.  She works in private practice in Princeton, NJ and provides online therapy with clients across the country (IN, MA, NJ, NY, PA).  For more information, please check out her website.