How to talk to your partner about sex pain
Many of our clients are experiencing sex pain, and the idea of talking about it with their partner feels overwhelming.
It doesn’t matter if they’ve been experiencing pain for years or if it’s brand new; the idea of talking to their partner about it is excruciating.
Communicating about sex is complicated, it’s worse when you add communicating about unintended pain. The embarrassment, shame, and discomfort are even more present.
Many avoid the conversation to protect themselves and their partner from uncomfortable or hurt feelings.
You can have this conversation in a way that allows you both to feel heard and safe.
Why is communication about sex pain important
It’s well known that clear communication is important for any healthy relationship. The ability to explain your experience to a partner and have them hear and understand your point of view improves emotional and sexual (for some) intimacy quite a bit.
When both parts of the couple feel safe, seen, and heard when they communicate, it allows each to know the other on a deeper level.
This makes conflict or disagreement less distressing for both members, as each person can see the other’s point of view.
When your relational intimacy is deeper, it is easier to work together to solve problems and see that your partner has positive intent.
This is especially true when it comes to talking about sex in general. Good communication around sexual activity allows for sexual satisfaction between partners.
When one partner is experiencing sexual pain or sexual dysfunction, communication is incredibly important.
Without communication, the pain or other issues may increase because the other partner doesn’t know that there is a problem. On top of that, the associative nature of sexual arousal means that repeated unwanted and unintended pain can make sex less attractive.
When one partner suddenly shows less interest in sex, the other partner may take this personally or become emotionally hurt. This can cause unintended problems in the relationship.
When you hide something like this from your partner, even if it is in an effort to protect them, you end up creating distance between the two of you.
Whereas when you talk to your partner about what’s going on, then both of you know what’s happening. This allows the two of you to face the issue and problem-solve together.
Why sex might hurt
Sex pain has quite a few causes. While some are easily fixable, some take more work to diagnose and treat. Two types of pain can affect sex between you and your partner.
The first type is called dyspareunia, or pain during sexual intercourse or penetration. This vulvovaginal or vulvar pain can be so severe that it can also impact a person’s ability to insert a tampon or a speculum.
The second type of pain is pelvic pain. This pain is different in that, while it can impact sexual functioning, it may or may not prevent penetrative sex. . Pelvic pain also impacts the person in the greater pelvic region and doesn’t just impact the vulvovaginal area (vagina, vestibule, clitoris, or labia).
Some sexual pain disorders or issues that can cause dyspareunia:
Vaginismus or muscle tightness/sexual tension caused by stress or anxiety
Vulvar skin conditions like dermatitis
Sexually transmitted infections (gonorrhea, chlamydia, and genital herpes can all cause localized vulvovaginal irritation/pain)
Other vaginal infections, like bacterial vaginosis
Urinary Tract Infections can cause vestibular pain
vestibulodynia, vaginal atrophy, or vaginal dryness, which can be caused by a variety of different things, including hormonal changes
Some Issues that cause pelvic pain:
Ovarian cysts
Fibroids
Tilted uterus
Pelvic inflammatory disease (occurs in advanced untreated STI’s)
Endometriosis
Adenomyosis
Both pelvic pain and vulvovaginal pain can impact anyone with a vagina, including non-binary or trans people.
Sex pain can also occur in men, but as it is more commonly reported in women (up to 15% vs 5%); we are focusing on the female perspective in this section.
At the same time, the communication tactics we are discussing work no matter who you are or who your partner(s) are. If you are having pain during sex, it’s important to communicate about it.
The fact is that sex shouldn’t hurt. If you’re experiencing unintended and unwanted sex pain with or without a partner, it is important to talk to your doctor.
Check out NPR’s In Good Health for a good overview of sex pain, pelvic pain and vulvovaginal pain. It's available to listen to here if you would like to learn more.
Why do couples avoid talking about sexual pain?
There are a lot of reasons why couples avoid talking about sexual pain and other sexual function disorders. Some are psychological factors, others are cultural.
Here are the main ones:
Discomfort talking about sex
One of the biggest reasons couples avoid talking about the pain one partner is experiencing during sex is because of general discomfort talking about sex in the first place.
They weren’t communicating with their partner before the pain started, and now they don’t know how to communicate about it when there is a problem.
Sexual trauma
A history of sexual trauma, particularly childhood sexual abuse, is associated with difficulty communicating about sexuality.
When there has been a history of secrecy and shame around sex in childhood, this can continue into adulthood. It can also feel more vulnerable communicating about sexual pain with your partner when you have a history of being disbelieved when you bring up sexual topics like abuse.
Fear of hurting their partners
Many people hold back from talking about sexual pain in their intimate relationship because they are worried about hurting their partner.
Sexuality and sexual performance can be vulnerable topics, and if one partner is experiencing pain, the fear is that the unaffected partner might take it personally.
The partner experiencing this pain might be considering their partner’s feelings by avoiding this conversation.
Shame
There is a lot of sexual shame in our culture. This translates into our conversations about sex, as well as our actual sex lives.
When you have negative thoughts and feelings about sex in general, it can be difficult to bring the conversation up. When there is pain, there may be shame about sex in general, but some might experience shame about the pain. Some people feel like the pain is their fault (when it isn’t).
Understanding why you or your partner is avoiding these conversations helps to understand the best way to move forward with these conversations.
How to talk about sex pain with your partner
Bringing up the conversation about sex pain might feel overwhelming. You are worried about being embarrassed, feeling ignored, or being blamed.
Start the conversation by being straightforward. Start gently but don’t beat around the bush. Be clear and specific, and do what you can to not use euphemisms.
It’s okay to couch the conversation in reassurances if you think your partner might take things personally.
Avoid placing blame, whether it is taking it on yourself, placing it on your partner, or something they are doing,
There is a possibility your partner will get upset, no matter how hard you try. Try to recognize and validate your partner’s feelings without getting defensive or shutting down.
If you start feeling heated or it seems like your partner is starting to get upset, feel free to take a break.
If you decide to take a break, give yourselves no less than 20 minutes to cool down. If you need more time, come back to the conversation at least for a check-in within 24 hours.
You can take as many breaks as you need. Sometimes these conversations can be hard, and it’s important that both of you are able to stay calm while you have them.
Focus on the future and problem-solving. What are you doing to take care of the pain? Are you seeing your doctor? Seeking a second opinion? What can the two of you do to make things more comfortable for the foreseeable future?
What else can you do?
Once you get into your doctor and get an accurate diagnosis, there are a variety of treatments they might suggest, like antibiotics, birth control pills, or seeing a pelvic floor practitioner to help the pelvic floor muscles.
It can take quite a while to get in with a good sexual health clinic and get an accurate diagnosis. Here are somespecialists we recommend in the DC metro area.
Some things that you can try in the meantime are lubrication for vaginal dryness and relaxation exercises to help with vaginal tension. You also might want to explore other non-penetrative types of sexual activity, and holding off on any type of touch that feels painful.
A sex therapist in Washington, DC, can help you have the sex pain conversation with your partner and move into the future
If you are struggling with having this conversation with your partner, or if the two of you are having a hard time understanding each other, it might be time to bring a therapist in.
A good sex therapist can help you to have these conversations about sex pain and navigate the pain and its impact on your sex lives.
At the Center for Intimacy and Relationships, we specialize in combining sex therapy with couples therapy. Schedule a free consultation to see how we can help.
