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Painful sex blog | Dear Desire

Painful sex and how to claim back your sex life (for women)

All too often women struggle with penetrative intercourse and deal with painful sex on a regular basis. Pain during sex, otherwise known as dyspareunia, is a recurrent or persistent pain before, during or after sex. Do not let painful sex take control of your sex life, lets discuss the possible symptoms, causes, solutions and preventative measures you can take to claim back your sex life!


  • Pain with tampon use
  • Pain at entry
  • Deep pain
  • Sharp, burning pain
  • Pain before, during or after intercourse
  • Pain in the vagina, bladder, or the urethra
  • Pain similar to menstrual cramps
  • Stabbing pain


There are two types of causes for dyspareunia: physical and psychological causes.

Physical causes

Vaginal dryness:  

Which could be caused due to lack of fourplay or inadequate lubrication.

Reduction in estrogen caused by childbirth, breast feeding or menopause.

Certain medication such as antidepressants and birth control.


Vaginismus is a condition where the vaginal muscles involuntary tighten up when you try to insert something into it (tampon, penis) and you have no control over this.

Vaginismus can be caused by medical and psychological factors.


Such as yeast infection, urinary tract infection, sexually transmitted infections, etc.


From childbirth, an accident, an episiotomy, a hysterectomy, or pelvic surgery.

Uterine fibroids

Noncancerous growths/tumors that slowly grow along the walls of the uterus. When pressure during intercourse is placed on these tumors, pain can occur.


Inflammation of the bladder.

Ovarian cysts

Pockets or sacs of fluid that form on or inside the ovaries.

Radiation and chemotherapy

Radiation therapy can cause the lining of your vagina to become tender and inflamed, this can cause pain during sex. Chemotherapy can cause a loss of estrogen production which can lead to early symptoms of menopause leading to vaginal dryness.

Psychological causes


Causing your pelvic floor muscles to tense up and become tightened, resulting in pain.

Anxiety and depression

Anxiety and depression contribute to vaginal dryness and vaginismus. Either caused by medication such as antidepressants or fears and concerns of intimacy resulting in discomfort.

Past traumas

Rape, abuse or sexual violence may cause a sense of fear, shame and guilt related to sexual intercourse causing your body to tense up in times of trauma related instances.


There are many types of treatments depending on the cause of the pain.

Vaginal dryness treatments

Vaginal dryness is treated with one of three treatments. An estrogen ring, tablet or cream. While estrogren treatments may help with vaginal dryness it also comes with side effects, vaginal bleeding and breast pain. Estrogen treatments are not advised if you are pregnant or breastfeeding, have breast cancer or a history of endometrial cancer. Always consult your health care practitioner. Make sure you are fully relaxed and aroused before intercourse or use a good water-based lubricant to help lubricate the vagina. Avoid using fragrance soaps, creams, or bubble baths

Vaginismus treatments

Pelvic floor exercises can be done help gain control of the vaginal muscles.

Relaxation techniques to help train the muscles to relax and release from tenseness.

Infection treatments

Infections can be treated with short-course vaginal therapy such as antifungul medication in the form of creams, ointments or tablets. Some are available over the counter and others to be prescribed.

Injury treatments

Some sexual pain does not require medical attention or treatment. If you are recovering from an injury due to surgery or childbirth allow your body enough time to heal properly before diving back into sexual intercourse. Allow for 6 weeks before attempting slow gentle acts of sexual activity. And use lots of lubricant!

Cystitis treatments

There are at home remedies you can try to treat cystitis. Drink plenty of water, apply a hot water bottle on your tummy, use the rest room frequently, avoid intercourse, take ibuprofen or an over the counter painkiller for pain and inflammation.

Ovarian cysts treatments

A birth control contraceptive may be prescribed by your doctor to keep the cyst from recurring. In some cases it may be recommended to remove the larger cysts or growing cysts through surgery.

At home treatments

  • Relax before sex, take a warm bath, destress your body.
  • Take an over the counter pain reliever before sex.
  • Apply a water-based lubricant to the vagina, remember silicone-based lubricants can cause your condom to tear.
  • Communicate your pains and fears with your partner and always keep that communication open.
  • Foreplay, set a side longer time for foreplay to allow your body to secrete its natural lubricants.
  • Empty your bladder before and after sex.
  • If you can't bare the pain of penetration, try other forms of sex. ie. Oral sex.
  • Change positions. Be in control and guide your partner. Communicate your boundaries and what you are comfortable with.
  • Practice safe sex and good hygiene. Go for regular medical check-ups to avoid infection.
  • Apply ice to the vulva after sex to help calm any burning you may incur.
  • Practice regular Kegel exercises to train your muscles. Read our blog on all things Kegel exercises here.

Treatments relating to psychological causes

Not all medical treatments will help with all causes.
  • Sex therapy or counselling can be a great help to rid your mind of past traumas and negative thoughts relating to sex due to past sexual abuse, etc. counselling with your partner is also recommended to help build a strong sense of communication to help improve and restore sexual intimacy.
  • Cognitive behavioral therapy can be a helpful form of therapy to decrease negative behaviors and thought patterns.
  • Desensitization therapy is another form of behavioral therapy used to help treat post-traumatic stress disorder, fears and phobias as well as anxiety. This form of therapy may help with relaxation exercises for the vagina to help decrease pain.


There is not normally anything you can do to reduce the risk or dyspareunia there are however a few things you can do to reduce pain during sex.

  • Practice safe sex and good hygiene measures.
  • Wait at least 6 weeks after childbirth before having sex
  • Use water-based lubricant to avoid vaginal dryness
  • Get proper medical care when necessary


Please note this is not medical advice and we advise you to seek medical help for all and any sex related pains you may occur. 


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