Painful Penetration

Owowowowowow! Vaginal penetration hurts me!

This condition is called dyspareunia, which means "painful intercourse." An old doctor's joke has it that "dyspareunia is better than no pareunia at all," which has one of your authors grumbling humorlessly about institutionalized misogyny and the other one looking nervously away. We don't want anything dys- in our sex lives at all, thank you. Or in yours.

A lot of things can cause dyspareunia, and a lot of doctors don't know much about it. A standard traditional explanation is vaginismus, or involuntary spasm of the vaginal muscles—however, some interesting new research suggests that vaginismus may not exist. (Experienced gynecologists performing pelvic exams couldn't tell the difference when examining women with supposed vaginismus and "non-vaginismus" women.)

Other possible causes include vulvadynia and vulvar vestibulitis, atrophic vaginitis, pelvic vasocongestion, allergies to latex and lubricants, yeast infections, STDs like trichomonas and chlamydia, pelvic inflammatory disease, contact allergies to douching solutions and detergents, razor burn, bowel problems, endometriosis, skin diseases, and a few others that don't even have names.

If this is a new problem, it might be temporary or no bog deal. Try a change of position, changing your lubricant or adding more, or simply stopping what you're doing and doing something (or having your partner do something) to get yourself more aroused. If the problem seems to be whatever your partner is trying to insert into you is too big, back off and go slower, building up over many sessions, using fingers, vegetables, sex toys, or a medical instrument.

If this is an ongoing problem for you, it's time for a visit to your doctor, who will want to know where it hurts (your vulva, your cervix, the area behind your cervix?) and what kinds of stimuli cause pain. He or she will do their best to prescribe medication and/or surgery to help, and if he or she doesn't care or can't, find a doctor who will. "Eupareunia" would be "pleasurable intercourse," and that's what we want you to have.

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Thank you for posting this. I

Thank you for posting this. I have suffered for 8 years, 5 1/2 of them in the UK where there were NO doctors who cared. The whole time, I didn't even get an internal digital examination!

Here, I was lucky enough to land in Kaiser's chronic pelvic pain department. They see patients from all over California and are perhaps the country's leading center for this problem. If your doctor doesn't care, go see them.

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October 2nd, 2009
Charles Moser and Janet Hardy's picture

Charles Moser, Ph.D., M.D., received his doctorate from the Institute for Advanced Study in Human Sexuality, where he is now a Professor of Sexology and Dean of Professional Studies. He went on to earn his medical degree from Hahnemann University School of Medicine in Philadelphia in 1991. He is board certified in internal medicine, and he is also a board-certified sexologist. He maintains a private internal medicine practice in San Francisco, with a focus on sexual concerns and the medical problems of sexual minorities.

Janet W. Hardy (aka Catherine A. Liszt and Lady Green) is a writer, perv, girlfag, pain slut, and educator. The author or co-author of ten books about alternative sexuality, she has spoken at hundreds of conferences and workshops around the world.

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