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You are experiencing pain before, during or after having sex. Let’s discuss the reasons why this may be happening & what I would suggest doing about it.

For those of you that don’t know me, my name is Michelle Cooke, Period & Hormone Naturopath, Natural Fertility Educator & Naturopathic Emotional Release Practitioner. I’m the Founder and Director of Reproductive Wellness, a clinic located in Melbourne. I see patients online and face-to-face.

 

ABOUT PAINFUL SEX (DYSPAREUNIA)

 

Painful sex is known as Dyspareunia – which is pain that can take place before, during or after sex. It can impact women of all ages. It is important to remember that it is not normal to experience pain around having sex. It is your body’s not so subtle way of letting you know that something is not quite right.

If the painful sex is not addressed: this can lead to low libido, being afraid of being intimate, loss of interest in sex, fear of sex, emotional issues: guilt, shame, anxiety, stress and relationship issues.

TYPES OF PAINFUL SEX (DYSPAREUNIA)

 

There are two types, and it all comes down to the location where you feel the pain:

  1. Superficial Dyspareunia

Pain that occurs when the penis enters the vagina (occurs at entrance to vagina – vulva)

Due to:

  • Hormonal – Low oestrogen states where there is vulvovaginal atrophy (thinning of the vulva and vaginal walls):

  1. Menopause

  2. Perimenopause where oestrogen starts to decline

  3. Birth control

  4. Breastfeeding

 Remember oestrogen is responsible for a thick, stretchy and strong vaginal wall due to assisting with healthy blood supply & secretions. Low oestrogen > tissues being less stretchy, thinner and less lubricated.

  • Vaginal Dryness

 a)Lack of sexual arousal

Psychological reasons e.g. uncomfortable previous sexual experiences, anxiety, stress, previous sexual trauma etc

b)Sjogren’s Syndrome

 

c) Oral Contraceptives– stop ovulation from happening, stop your natural oestrogen production > vaginal dryness

d) Menopause – due to drop in oestrogen which provides moisture & hydration to the vaginal tissues

  • Skin Issues

  1. Lichen planus

  2. Lichen schlerosis

  3. Dermatitis

  4. Immunobullos Diseases

  • Nervous System Disorders / Damage

  1. Neuroma – thickening of nerve tissue

  2. Spinal nerve injury or compression

  3. Pudendal neuralgia

  4. Herpes neuralgia

  • Vaginal infections

  1. Genital herpes

  2. Trichomonas vaginalis

  3. Candida Albicans

  4. Bacterial Vaginosis

  • Emotional causes

  1. Sexual or emotional abuse

  2. Previous traumatic situation

  • Sexual arousal disorders

  1. Absence or decrease in:

  • Initiation of sex

  • Sexual thoughts

  • Pleasure

  • Interest in having sex

  • Desirable response

  • Lack of arousal: either physically or emotionally

 

  • Abnormal Tissue (Neoplasms) –

  1. Squamous cell carcinoma

  2. Paget Disease

  • Illness due to medical treatment or examination

  1. Pelvic radiation

  2. Chemotherapy

  3. Postoperative

  • Anatomical Issues

  1. Narrow vaginal entrance

  2. Clitoral adhesions

  • Vaginismus – recurrent or persistent involuntary tightening or spasming of the vaginal muscles which impacts the ability to have sex

  • Vulvodynia

There is pain and sensitivity when pressure or touch is applied to the vulva. The nerves in the area are hypersensitive.

  • Intact or thick hymen – membrane that covers some of the vaginal entrance. This will widen after your first sexual experience (after being a virgin).

  • Trauma to the area

  1. Genital mutilation

  2. Vaginal delivery from birth or episiotomy (scar tissue and nerve endings sensitive)

  • Depo usage for an extended time – this impacts the natural production of oestrogen

  • Bartholinitis – A pair of glands known as Bartholin’s glands are located on either side of the vagina These normally produce moisture when you are sexually aroused. Bartholinitis is inflammation of those glands > pain during sex either straight away or as sex continues.

  • Size issues – penis too large for the vaginal opening

   

  1. Deep Dyspareunia

Pain that occurs when the penis is deeper and further into the vagina. Pain can resemble tearing, burning, aching, dull or sharp. It can occur in the genital organs themselves or due to the penis bumping other things located in the pelvic cavity during sex.

Due to:

  • Trauma to the area

  1. Genital mutilation

  2. Vaginal delivery from birth or episiotomy (scar tissue and nerve endings sensitive)

 

  • Vaginal infections

  1. Genital herpes

  2. Trichomonas vaginalis

  3. Candida Albicans

  4. Bacterial Vaginosis

  • Vaginal Dryness

 a)Lack of sexual arousal

Psychological reasons e.g. uncomfortable previous sexual experiences, anxiety, stress, previous sexual trauma etc

b)Sjogren’s Syndrome

 

c) Oral Contraceptives– stop ovulation from happening, stop your natural oestrogen production > vaginal dryness

d) Menopause – due to drop in oestrogen which provides moisture & hydration to the vaginal tissues

  • Hormonal – Low oestrogen states where there is vulvovaginal atrophy (thinning of the vulva and vaginal walls):

  1. Menopause

  2. Perimenopause where oestrogen starts to decline

  3. Birth control

  4. Breastfeeding

 Oestrogen is responsible for a thick, stretchy and strong vaginal wall due to assisting with healthy blood supply & secretions. Low oestrogen > tissues being less stretchy, thinner and less lubricated.

  • Pelvic Inflammatory Disease

From STIs (sexually transmitted infections) Chlamydia or Gonorrhoea. This condition affects the uterus, fallopian tubes and sometimes the ovaries

  • Bladder or Urinary Tract Infections

If the bladder is inflamed due to an infection this can painful during sex because the bladder is a neighbour to your uterus.

  • Bowel Problems

If the bowel is inflamed in conditions such as Ulcerative Colitis, Crohn’s Disease or Irritable Bowel disease and it gets knocked during sex this can be painful. This is also another fellow neighbour of the uterus.

  • Position of your uterus

If your uterus is retroverted or retroflexed in a tipped position

  • Fibroids

Non-cancerous growths in the muscular wall of uterus

  • Ovarian Cysts

Ovaries can be knocked during sex.

  • Endometriosis

Uterine lining like tissue grows on various organs. The whole pelvis can become quite inflamed particularly if there is scar tissue and adhesions binding your organs.

  • Adenomyosis

Uterine lining tissue grows inside the muscular wall of the uterus.

  • Pelvic Disease

What should I do about it?

For Diagnosis & Treatment: See a GP & get a referral to a Gynaecologist

 

For Supportive Treatment: Make an appointment with a Period & Hormone Naturopath like myself

 

Emotional Support: Sex therapist, Couples Counsellor, Psychologist or Naturopathic Emotional Release Practitioner (this is what I do, more info below)

 

If required: Pelvic Physiotherapist to assist with pelvic floor issues, helps with symptoms

The treatment of dyspareunia will be different depending on why it is actually happening for you. As you can see there are several reasons why it may be happening for you.

 

Regardless of the cause of your painful sex, I would always suggest seeking out some type of emotional support. Because there will always be an underlying emotion / stress related to why it is happening for you and just generally the fact that you are unable to have sex or have difficulty having sex with your partner. Something which may have started as a physical issue can arise in emotional issues > impacts emotional wellbeing and your relationship.

 

This alone brings up a lot of emotions such as shame, guilt, fear of failure, depression, anxiety, stress and a fear that you won’t be able to have sex which need to be worked through. Even after the issue has been dealt with on a physical level, there can still be emotional issues that can arise because of an anxiety that you may experience that pain again.

 

Can a Naturopath help with painful sex?

Absolutely! Especially a Naturopath that specialises in periods & hormones which is what I do.

In my clinical practice I use herbal medicine, nutritional medicine, diet & lifestyle advice. I look at your test results differently to a GP because I look at optimum levels within the test range to make sure you are within that range for hormone balance & support. We can address things like stress, anxiety, hormone imbalance, skin support, STI infection support etc (bacially whatever is causing you pain).

I am also a Naturopathic Emotional Release Practitioner. Naturopathic Emotional Release is a technique which helps to identify underlying emotions / stress or sabotages relating to painful sex. This tool uses Muscle testing & Chinese meridian points to identify the emotion & Chinese meridian points & EFT to clear & process the underlying emotion. It taps into the Autonomic Nervous System and works on subconscious beliefs, stress or underlying emotions. If your painful sex is due to a past trauma and it is too difficult to talk about you don’t need to speak about it. The technique is still effective at addressing it and clearing it for you.

I would love to help you, go ahead and book a FREE 15 min discovery call to find out more about how we would work together and if we are a good fit:

If you have any questions or comments please pop them in the box below 🙂