Sexual Pain Glossary

Sexual Pain Glossary:  If you have been experiencing sexual pain for some time now and are beginning a course of treatment, you may hear many different terms to describe your condition and the necessary treatment.  These new terms may be confusing and at times sound like a different language.  In order to put you in control of your body, it is necessary to have an understanding of what each option is that is being presented to you and what exactly your diagnosis is.  This tip is designed to cover the common terms associated with sexual pain and the treatments available and describe them in layperson’s terms.

Causes of Sexual Pain:

Dyspareunia: Dyspareunia is defined as recurrent and persistent genital pain associated with sexual intercourse. It can be experienced by a man or a woman. The pain can be superficial, mild, or sharp.

Interstitial Cystitis?: Interstitial Cystitis is an inflammatory condition of the bladder which causes pain in the pelvic region around the bladder as well as frequent urination.  IC van also cause pain during sexual intercourse.

  Endometriosis: Endometriosis is a female gynecological disorder where the cells that make up the lining of the uterus grow outside the uterus.  These cells grow and belled the same way as those that make up the lining of the uterus and therefore can cause pain during intercourse

  Pelvic Inflammatory Disease: Pelvic Inflammatory Disease is the term for an infection of the uterus lining, fallopian tubes, or ovaries. Common symptoms of Pelvic Inflammatory Disease include fever, pain or tenderness in the pelvis, lower abdomen, or sometimes the lower back, and/or vaginal discharge with abnormal color, texture, or smell.

Post Pregnancy & Intercourse :Typically doctors recommend waiting at least 6 weeks after pregnancy before resuming sexual intercourse so that any incisions or sensitive tissue will have fully healed.  Having sex prior to being fully healed can cause infection and / or pain during intercourse. With this being said, every pregnancy and every birth situation is different, 6 weeks is considered standard practice, but there are always exceptions. Prior to resuming coital relations after the birth of your child, check with your doctor.

  Vaginal Dryness/ Inadequate Lubrication: Some women who experience painful intercourse do so because their bodies are not creating enough natural lubrication during sex.  Without adequate lubrication sex can involve too much friction and will therefore be painful in some cases.

Vaginal Infections & Sexually Transmitted Infections :  Sexually Transmitted Infections such as herpes and genital warts can cause painful intercourse. Vaginal infections such as yeast infections and bacterial vaginosis can also cause pain with intercourse.

Vaginismus Vaginismus is recurrent or persistent involuntary contractions of the muscles surrounding the outer third of the vagina. Sometimes, the muscles tighten and narrow so much that inserting a tampon or having sexual intercourse is impossible.

Vulvar Vestibulitis? : Vulvar Vestibulitis is characterized by pain in the area around the opening of the vagina. This pain typically happens when pressure is applied during sexual intercourse, using tampons, a gynecologic exam, etc.

Vulvodynia: Vulvodynia is chronic pain of the vulva without an identifiable cause. This pain can be experienced in one or multiple places. While descriptions vary, the most common symptom is burning.

Treatment(s) for Sexual Pain

Dilators: Vaginal dilators are used in the treatment of sexual pain.  They typically come in a set of 5-10 dilators ranging in size and width.  The smallest is about the size of a small finger and the largest is approximate to the size and shape of a large penis. Dilators are inserted into the vagina to help women achieve penetration and intercourse pain free. Use of dilators is progressive. Clients begin by learning how to relax the vaginal muscles with the smallest sized dialator. Once this has been achieved, and the client is able to experience sexual pleasure with the smallest size dildo, then the next size up is used and the whole process is repeated until the client is able to have insert a dilator that approximates the size of her partner’s penis.

Estrogen Creams: Estrogen creams and other prescription medications can be used to help treat vaginal dryness, which is often the underlying cause of painful intercourse. Estrogen is needed to keep the skin elastic and soft.  Some women, due to medical problems or the natural aging process (ie menopause) experience increased difficulty naturally producing enough estrogen naturally.  Estrogen creams are typically inserted into the vagina with a special applicator or applied on places like the thigh where they are absorbed transdermally or through the skin.

Kegels: Kegels are exercises, which involve alternating between tensing and relaxing the pubococcygeus (PC) muscles.  These exercises help gain control over PC muscle tension and can reduce painful intercourse.

Lubricants: Painful intercourse can be caused by a lack of natural lubrication.  Without lubrication women can feel like their vaginal canal is getting rubbed raw.  The lack of lubrication can be a result of a medical condition or from poor sexual technique (ie. the woman not being sexually aroused enough).  Applying lubricantion decreases the friction between the penis and the vaginal canal.  While oil based lubricants tend to work the best, most people opt to use water based lubricants. This is because water based lubricants (such as KY) can be used with a condom. Oil causes condoms to break.

PC muscles: The pubococcygeus (PC) muscles are the muscles of your pelvic floor.  For some women with painful intercourse, these muscles are too tense or tight.  Locating and learning to control PC muscles will reduce tension and painful intercourse.

Relaxation Techniques Relaxation techniques are exercises that a therapist may have you do in order to learn to reduce anxiety and tension within your body. Relaxation techniques include progressive muscle relaxation, guided imagery, and mindfulness training.  Without anxiety your mind and body will naturally become more responsive to sexual stimulation   furthermore, when a partner is riddled with anxiety, the anxiety becomes a sexual turnoff.

Sensate Focus: Sensate focus is a common exercise given by sex therapists to couples who are struggling with: sexual pain, arousal problems, male impotence, anxiety and sexual communication problems.  The goal of sensate focus exercise is to shift the focus of sex from orgasm to the actual experience(s) of all your senses and increase sexual communication. Sensate focus exercises are progressive.

Sensate focus exercises have four basic stages.  Stage one is a back massage. Stage two is a chest massage. Stage three is focuses on genital stimulation and stage four is intercourse. Orgasm is never the focus. Throughout each stage, couples are asked to become more mindful of how they are touching and being touched.  What do they enjoy? What makes them comfortable? Aroused etc.  The purpose is to become aware of all the different types of senses beyond orgasm.  In the application of sensate focus exercises each therapists has their own particular style as to how they teach this exercise.

Sex Therapy: Sex therapy is a form of talk therapy that is focused on sexual function and dysfunction. Sex therapists have specific training in this field. During treatment, you will focus on your painful intercourse symptoms, the effect it is having on your relationships, your    sexual history,  values, and behaviors. Sex therapy for painful intercourse will included behavioral exercises for you to complete at home as well as discussing and resolving any underlying psychosocial inhibitors to having good sex. This includes, but is not limited to: addressing the relationship between you and your partner, sexual values you were raised with, overall knowledge / experience (teaching techniques for pleasuring a woman or introducing more effective sexual positionsand setting realistic expectations. Sex therapy is appropriate for both individuals and couples.

Support Groups: Support groups are often recommended to individuals to help them learn how to cope with their condition, understand its effect on one’s sex life, and develop skills that can decrease pain and enhance one’s sex life.  Most importantly, support groups provide individuals support from other people who are coping with a similar situation.  Support groups can be particularly important for women struggling with this issue because female pain is so infrequently discussed. Most women who have this condition suffer in alone and in silence.

We hope that you have enjoyed our sexual pain glossary. Please let us know if there are other terms you would like us to include.