Sex and pain

This article was written by Normkritiske Læger ( @normkritiskelaeger ), an association of doctors and other healthcare professionals who work against discrimination in healthcare. They want zero tolerance for sexism, racism, homophobia, transphobia, fatphobia and ableism in healthcare. 

Pain and sex

Pain before, during or after penetration with a toy, finger or penis into the vagina (also called sexual pain) is called dyspareunia. Dyspareunia is a condition that covers persistent and recurring pain when attempting or achieving penetration. Pain can be of different nature depending on the location and is described as burning, stinging, drilling and “throbbing pain”. At the same time, they can be both acute and chronic in nature.

Pain is always experienced and described from a subjective perspective, and it is important to emphasize that pain can be present even if no obvious cause can be seen or found on examination. Studies show that between 8-22% experience regular pain during penetrative sex in the vagina (a single study that exclusively examined trans men found a prevalence of 10% in this group) and that up to 75% of people with a vagina will experience pain during penetrative sex at some point in their lives. Although many people experience pain, it is also important to dispel prejudices and myths that vaginal pain during sex is something “natural” or “normal” and just a part of having penetrative sex in the vagina. This notion is closely related to previous - and partly continuing - notions of a sexual script from a penis perspective, for some called "the female price of male pleasure", where there has been a greater focus on "cis men's" pleasure and this has also been the societal understanding. 

What are the causes of pain during sex?

The causes of the pain are different, and both physical and psychological factors can play a role. Physically, pain can be related to both areas of the vulva and vagina, but the pain can also originate from other organs in relation to the lower abdomen, such as the intestines and from muscles in the pelvic floor. The origins of the pain can be many, for example, they can originate from infections, tears, scar tissue, hormonal influences, birth defects, ovarian cysts, prolapsed uterus, or diseases such as endometriosis and lichen sclerosus, to name just a few. In people with dyspareunia, it can also be an overactive pelvic floor muscle that contributes to the pain. If you have always had pain during penetration, this may indicate an underlying cause, such as a thick mucous membrane (genital ring) at the entrance or other anatomical conditions. Psychologically, there may be a fear of penetration if you have previously experienced pain in this context, for example during transgressive sexual experiences. Some mental disorders can also have an impact on pain and penetrative sex, for example, there is a higher incidence in people who have depression.

Pain during penetration can affect one's sex life and desire and lead to avoidance behavior. It can be a major nuisance in terms of experiencing an enjoyable sex life and if you experience the pain as a nuisance, both acute and chronic pain during vaginal penetration, you should consider having it examined by your doctor or gynecologist in order to clarify the background.

Read also: The myth of virginity - from a queer perspective

Read also: What is a squirting orgasm?