How to deal with painful sex

Woman lying in bed looking upset

This is the second in a three-part series on how to deal with painful sex.

Last week, I talked about possible causes for the pain. This blog outlines a practical action plan of things you can do to help make sex pleasurable again for you.

But let me make one thing EXTREMELY clear. You absolutely MUST seek medical help. Never attempt to self-medicate with vaginal or pelvic pain.

The first step is always to…

See your doctor. If your doctor is the sort you know will be embarrassed, ask to see another. Believe me, they’ve all seen and heard it all before.

Don’t be fobbed off with the advice that using a good lube is all you need. Lube helps but it’s not going to make a scrap of difference in a lot of cases. If you don’t think your doctor is knowledgeable enough or dismissive, ask for a referral to see a gynaecologist or genital urinary specialist.

A good gynaecologist can change your life. If you’re plagued with problems and can afford it, it’s worth paying to see one that’s private and highly recommended, if the one allotted to you through the public health system isn’t cutting it.

A good sex therapist may also be useful. Medication or another treatment might sort the physical problem, but painful sex impacts your whole relationship. It makes you nervous about having it and makes your partner worry you don’t find them attractive. Some men think women make it up to get out of sex.

Always add lube before penetration. If you’ve run out, don’t do it. It’s an essential, not a luxury. You could try a CBD infused lube – a chemical found naturally in marijuana and hemp plants. It won’t get you high but lots of women find it pleasantly stimulating.

Try a vaginal moisturiser. They’re different from lubes: you use them even when you’re not having sex to keep everything moist and comfortable. Go for one that doesn’t contain parabens or aspartame and insert before bedtime.

The jury’s out on whether they work effectively. Personally, if you think your problem might be related to menopause, I’d ask your GP about using oestrogen (or Estradiol) pessaries (if you’re able to take HRT). They really do work.

Ask what’s available to treat your specific condition. Drug names and treatments change constantly, so there’s no point in me naming specific medications, but there usually is a treatment for most conditions. It might be a pill or cream or vaginal pessary. It might involve doing some ‘homework’, like vaginal massage or using vaginal dilators.

Sometimes, though, the treatment doesn’t work.

In that case, the only option might be to avoid intercourse entirely and redefine sex. That sounds extreme but actually isn’t. Lots of couples enjoy non-penetrative sex sessions more than they did sex that revolved around intercourse.

A vaginal dilator might do the trick. A dilator is a tube-shaped device that you use to stretch the vagina. Often made of plastic, they come in different sizes. You start by using the smallest in the kit and increase the size as you become more comfortable.

Botox has been found effective for vaginismus because it paralyses the muscles.  One doctor claims a 90 per cent success rate but it’s not (yet) readily available and an expensive option.

Use a kegel training kit to build muscle strength in your pelvic floor. Again, start on the lightest weight and build up to the heaviest. Insert high into the vagina and then do your usual kegel exercises – repetitively squeezing and releasing your pelvic floor muscles – around the toner ball. (I do both a training set and toner balls in my supersex range, if you click on the links.)

Take time to relax into sex. Put some lubricant on the head of his penis and use it to stroke the vulva, over the clitoris and around the opening, to get ready for penetration. Don’t rush it, take it slowly. Having an orgasm before penetration also helps to relax the vagina.

Choose positions that don’t allow deep penetration. Any position where you’re in control, rather than him, works (you on top, for instance). Otherwise, choose positions where you’re both lying fairly flat with your own legs quite close together. Spooning sex works well, as does doggy style but with both of you lying flat with his legs on either side of yours.

Sex toys can help. I’ve just released a new sex toy range, designed especially for women who find sex uncomfortable. Regular masturbation and gentle, internal massage helps enormously to relax the vulva. This range is made from body-safe, super-soft silicone which feels great next to the skin.

This is the second in a three part series on painful sex. Part one talked about how to identify the cause if sex is painful for you. Part three reveals the two game-changing, practical things you can do to instantly change things.