Hey reader,
One of the greatest tragedies of our sex mis-education in which there are countless, is the amount of women, vulva-havers and AFAB folks who endure painful penetrative sex under the assumption that it is normal. This works in tandem with women's pain being swept under the rug and minimised by healthcare professionals, health research, sexual partners and sometimes even ourselves. This ends here.
So while pain during penetration has certainly been normalised, it doesn’t mean it’s normal. Penetration is not supposed to hurt, whether it's with fingers, toys, penises, and anything else that may go inside you. There are a number of reasons why it may be painful, and you can make an initial assessment by first discerning whether it’s entry pain or deep pain. This then also dictates how you'd go about treatment or management with your healthcare team.
Entry pain is exactly what it sounds like - pain at the entrance of your vagina or the surface. The most common reason for entry pain that I see in my practice is lack of sufficient arousal and/or lubrication. Insufficient lubrication is like raw-dogging a playground slide on a hot summer day. Again, this may be a result of rushing the sexual experience, stress or anxiety, but it may also be pelvic floor dysfunction, side effects of medications, hormone fluctuations, childbirth or menopause. The body needs a lot more time than we often give it. On average, vulvas need at least 15-20 minutes before they are fully engorged. Of course don't forget to lube up. Other factors might include existing skin conditions or irritation like eczema or thrush. Skin conditions, hormone and medication management are not my department, so please refer to your physicians or specialists where appropriate.
Deep pain refers to the pain that feels deep within the pelvis. With deep pain, it is almost always connected to a medical condition that will require you to consult a healthcare professional like a gynaecologist or a pelvic floor physio. Some common conditions can include vaginismus, endometriosis, fibroids, PID, prolapse, cysts, UTIs or STIs. Find a physician that will take your pain seriously because it is.
In preparation for your consult, I would suggest taking as many notes as you can in relation to the pain. Where does it hurt? How would you describe the pain? Scale of 0-10? Does it change with certain positions or along with your menstrual cycle? Does it stop hurting immediately after penetration is over or does it linger? This not only helps your physician make a clearer assessment, but it also helps you advocate for your experience and what you need.
Yours,
Sel
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