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Painful sex

Penetration, painful sex and panic: When sexual discomfort requires a doctor's appointment

We chatted with Dr McQuade of Dublin’s Well Woman Centre.

DUREX MADE HEADLINES last month when the brand ran a commercial focussed on sexual discomfort.

Durex UK / YouTube

As opposed to an advertisement alluding to explosive orgasms and sexual gratification, the commercial tackled the very real subject of vaginal dryness.

Ladies, we’ve shown the world what we really look like. We’ve let our hair grow out, gone back to work and made our voices heard, so why do we still put up with uncomfortable sex?

While the ad specifically refers to the frequency with which women experience vaginal dryness depending on their menstrual cycle, it also acted as a reminder that for many women, sex and physical discomfort go hand in hand.

While many issues can indeed be remedied with an over-the-counter product, persistent pain during sex is not something which should be ignored.

As such, spoke with Dr Shirley McQuade of Dublin’s Well Woman Centre, who highlighted the signs and symptoms we all need to be aware of.

shutterstock_1174895965 Shutterstock / fizkes Shutterstock / fizkes / fizkes

So, when it comes to pain and penetration, what do we need to consider?

First off, there is no need to panic if you experience it every so often.

“Occasional pain during sex is very common and there is usually no obvious cause,” Dr. Mc Quade explained. “However persistent pain or severe pain warrants a visit to a doctor.”

Now, let’s consider what happens when periods and penetration meet.

Given the fact that very few women are immune to menstrual pain, it’s likely that cramps and intercourse will meet from time to time, but how do we know what’s ‘normal’?

Kicking off the subject, Dr Mc Quade reminds us: “Most women will experience some discomfort during period bleeding. This is due to pain factors released causing cramps as the lining of the womb is shedding.”

Intercourse can cause movement of the womb which can be painful at any time but tends to be worse when the womb is already extra sensitive during a period.

“If you are experiencing pain then avoiding deep penetration may help,” she advises. “If the partner is behind or the woman is on top deep penetration can be reduced.”

So let’s say you have been experiencing pain during sex, what do you need to consider?

Well it’s worth taking a few things into account before you panic; new relationships, family stresses and work pressures, to name just three.

If someone is in a new relationship it can take a little bit of time to get used to a new partner. Lubricants used during sex may be very useful. There are many products easily available from any pharmacy or online. If condoms are being used for contraception make sure that the lubricant you buy is condom friendly otherwise condom failure can happen.

“Equally, if someone is under stress either due to work or family pressures, lubrication can be affected,” Dr Mc Quade added. “It may be that taking measures to deal with stress such as counselling or simply carving out more time to relax may be the answer.”

However, if you are regularly experiencing pain during sex, it’s worth noting whether you experience any other symptoms; bleeding, for example.

“Bleeding during sex can happen for the first two or three times for someone who has not had sex before, but it is not normal for this to happen on a regular basis,” Dr McQuade explained.

“An increase in vaginal discharge could indicate an infection so that would need to be checked out.”

If you are regularly experiencing pain during sex regardless of your cycle, then it’s vital you seek guidance from a medical practitioner. However, given the intimate nature of the subject, it’s understandable that many women shy away from discussing the subject with a professional.

shutterstock_656485612 Shutterstock / NATNN Shutterstock / NATNN / NATNN

With that in mind, we asked Dr McQuade to explain what a patient might expect if they do make the decision to relate their symptoms to a doctor.

“There are several causes for pain during sex so it is important to try to establish when the pain happens,” she said. 

A practitioner will take various things into account, including the location and duration of the pain.

They will, for example, attempt to establish whether pain manifests at the start with initial penetration or whether it’s a deeper pain which can cause a pelvic ache through to the next day.

The following are some conditions they will take into account when considering your symptoms.

  • Thrush (candida) infection or vaginal dryness are common causes of vulval or vaginal pain, particularly in menopausal women.
  • Bladder infections or a vaginal cyst can cause vaginal pain.
  • The viral growth of Human Papilloma Virus – genital warts - may cause a painful area at the entrance to the vagina.
  • Eczema, psoriasis or lichen sclerosis can cause external pain, but this is less common.
  • Irritable Bowel Syndrome (IBS) or long term constipation can cause pain during sex if these conditions have flared up.

Dr McQuade then turned her attention to a condition known as vaginismus which causes the muscles at the entrance to the vagina to tense, so that penetration isn’t possible.

This can happen either when a woman is trying to have sex for the first time or has experienced painful sex previously.

“Sometimes reassurance that all is normal or whatever has caused pain previously has been treated is sufficient to allow the woman to have pain free sex,” she continued.

However there are specialist counsellors who can provide the woman with techniques to stop the involuntary muscle tensing. This therapy tends to be very successful with only a few counselling sessions needed.

“Deeper pain may be due to pelvic inflammatory disease (PID) or endometriosis,” Dr Mc Quade continued. “If PID is suspected a course of antibiotics may be prescribed. Both unresolved PID and endometriosis require follow up with a hospital based gynaecologist.”

So, what’s the takeaway here?

Well, first off, it’s important to note this is not a complete list of causes of painful sex, so if you are experiencing this problem, a visit to your doctor may find a cause with a simple solution.

Secondly, suffering in silence is only going to intensify any concerns you may have. By making an appointment with your practitioner, you will be swiftly advised on the steps you can take to address the issue.

Remember, information is power, people.

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