We’ve been writing about sex for more than ten years, and when we started out, the topic that our female readers wanted to hear about most was orgasms — how to have them (either solo or with a partner), how to have them more often, how to have different kinds, how to have them simultaneously with a partner, how to stop faking them, and so on. Well, the Big O is still a favorite topic, but these days it practically ties with another topic: painful sex. (And we’re not talking about the attending heartbreak, though consistent physical pain during intercourse can itself be heartbreaking, of course.) We don’t necessarily think that sex is suddenly more painful for women, but rather that it’s becoming more acceptable to talk about the fact that, for women especially, sometimes sex can hurt like a motherfucker…not to put too fine a point on it. But too many women still fail to speak up. So we were thrilled to hear about a new book that focuses on this topic: When Sex Hurts: A Woman’s Guide to Banishing Sexual Pain, by Andrew Goldstein, MD, Caroline Pukall, PhD, and Irwin Goldstein, MD. We definitely don’t have nearly enough letters after our names to adequately address the issues involved here! The authors were kind enough to allow us to publish an excerpt from the first chapter of their book, which you can read below. Check back in next week for their summary of the various causes of painful sex, and the week after that for a Q&A with the authors, in which they address some of the most common question they hear about painful sex.
“Sex has such an intense impact on how you see yourself and how you relate to other people. It penetrates every relationship….In fact, it is the central issue in any relationship whether the couple is aware of it or not. The nine years of sexual pain I lived through were an emotional hell.”—ANNIE, THIRTY
It’s been ten years, but Annie, now thirty, remembers the doctor’s words as if it were yesterday. She’d gone to her mother’s gynecologist for what she thought was a highly unusual and, truth be told, embarrassing problem: She couldn’t have sex. It simply hurt too much. After examining her, the doctor said, “You have a perfectly normal anatomy, but, sweetheart, if you’re as tense with your boyfriend as you are with me, it’s no wonder it doesn’t work.”
While those words, and the complete lack of empathy they exhibited, did nothing to help with her problem, they made Annie decide to become a doctor so other women could find someone with more compassion. Many other women like Annie, like you—more than 20 million American women alone—will experience painful sex in their lifetime. You’ve been bouncing from doctor to doctor and spending thousands of dollars seeking help to no avail. Even if you have found a doctor to correctly diagnose your condition, chances are you haven’t found much relief from the recommended treatments. Instead, you’ve spent years in agony, with pain so severe it feels as if acid is being poured on your skin or a knife inserted into your vagina.
Annie knows the drill well. From the first time she tried to have intercourse, she had lived in a world of pain, doubt, and frustration. The first time her boyfriend tried to enter her, she told us, she screamed in pain. “It felt like he was stabbing me, like I was being torn apart. It was horrifically painful.”
The two thought maybe Annie just needed to relax. And she tried. But nothing—not alcohol, not Valium, not even her pleas that he just “rape me”—worked. “I wanted to be normal so bad that I kept asking him to do pretty much anything he wanted,” she recalled. “‘Just close your eyes and go in there; it doesn’t matter if I’m in pain,’ I told him. But he was too good a guy to hurt me, and he couldn’t do it.”
It took another nine years—years filled with dozens of doctor visits, ruined relationships, and the certainty that she was crazy—before Annie found me (Andrew), and I diagnosed her with provoked vestibulodynia (PVD), a condition in which the slightest touch to the vulvar area results in excruciating pain. As many as 6 million American women suffer from this syndrome, which may have a dozen or more causes. Nearly 60 percent report visiting three or more health-care providers to obtain a diagnosis, and an astounding 40 percent remain undiagnosed.
In fact, as many as 40 percent of women with sexual pain don’t even seek medical care! They think that some level of pain or discomfort during sex is normal. Others are simply too embarrassed to talk to their doctor or don’t know how to bring the topic up. If this sounds familiar, take heart—our book gives you the tools to get you the help you need and deserve.
The problem is that painful sex doesn’t just occur in the bedroom. It infiltrates every aspect of your life. Many women feel it destroys their very sense of who they are. “I was very shut off physically for three years and am still recovering from that,” says Sheila. “I have a hard time being sexual because I don’t want to lead my fiancé on into thinking we are going to try to have sex when I am just not ready yet. For me, the pain really affected me more emotionally than it did physically.”
The National Vulvodynia Association reports that women like you find the pain of dyspareunia affects far more than your ability to have sex. It affects your ability to function in the everyday world, forcing you to leave careers and to limit physical activities. Some women we’ve met can’t even handle the pain of sitting long enough to drive a car, so they become virtual prisoners in their homes.
“I haven’t had sex since I was forty-two,” says Patty, now forty-nine. “I cannot wear underwear or pants or anything around my vulva. I wear long skirts with no underwear all year. I bought a special bike seat with a hole in the middle so when I ride nothing rubs against my vulva.” Patty used to express her sexuality through salsa dancing. Now that the pain has spread to her entire pelvic floor and hips, it hurts too much to merengue, so the dancing, her last vestige of sensuality after years of sexual pain, is out.
As you can see—and as you may well know—such pain soon becomes the focus of a woman’s life. No wonder a study published in 2007 found that 42 percent of women with dyspareunia felt they had no control over their lives and 60 percent felt they had no control over their bodies.
MORE ON PAINFUL SEX FROM EM & LO:
- Dr. Kate on Female Sexual Dysfunction: Pain Problems
- When Some Sex Positions Hurt
- Sex Starts Out Fine, Then Becomes Painful
- When Your G-Spot Hurts
- Why Am I Sore After Sex?
- How to Make First-Time Sex Less Painful
- Is Painful Sex Ever an Issue for Guys?
- Swollen Vulva & Painful Urination Post-Sex
- Painful Sex After a C-Section