It’s estimated that nearly 80 percent of women will experience painful sex (dyspareunia) at some point. This is described as burning, throbbing, and aching before, during, or after intercourse.
The underlying reasons vary, but range from the involuntary contraction of vaginal muscles during penetration, to vaginal dryness caused by a drop in estrogen during menopause.
Painful sex sometimes resolves on its own. When the condition persists or interferes with sexual health, it’s time to have a conversation with your doctor.
It’s understandable if you feel uncomfortable addressing this topic with your doctor. Rather than live with pain, here are a few tips for discussing this sensitive topic (and others) with your doctor.
1. Be honest with your doctor
You might hesitate to start a conversation about painful sex with your friends or loved ones because you’re embarrassed or feel they won’t understand.
While you might not bring up the topic with friends or family, it’s a subject you should discuss with your doctor. Your doctor is here to help and not judge you. Don’t ever feel embarrassed or ashamed to bring up a health issue with your doctor.
2. Talk to a doctor you’re comfortable with
You may have more than one doctor. For instance, you may see a family doctor or general practitioner for annual physicals and other illnesses that come up. You may also have a gynecologist for issues specific to women’s health.
A gynecologist is an excellent choice to discuss the topic with, but feel free to consult your general practitioner if you have a better relationship with them. If you’re embarrassed about painful sex, it might help to discuss the issue with the doctor you’re most comfortable around.
Some general practitioners have considerable training in women’s health, so they can make recommendations and prescribe medication to make sex less painful.
3. Use online messaging portals before your appointment
After you schedule your appointment, you can usually find an online messaging portal to provide more information about why you’re scheduling an appointment. For instance, you can message the nurse or doctor to let them know about your painful sex symptoms.
Messaging your concerns ahead of time rather than discussing them at your appointment might make you feel more comfortable. And, with this advance information, your doctor can come to the appointment prepared to help you.
4. Rehearse what to say
If an online messaging portal isn’t available, rehearse what you want to say before your appointment. This can help ease nervousness. You’ll get the most out of your appointment if you’re able to explain yourself clearly and thoroughly to your doctor.
5. Let your doctor know you’re nervous
It’s OK to be nervous about opening up to your doctor, especially with a sensitive issue like painful sex. It’s also OK to admit that you’re nervous and uncomfortable with the topic.
You could start the discussion by telling your doctor, “I’m a little embarrassed to say this,” or “I’ve never shared this with anyone before.”
Letting your doctor know this is a sensitive topic will help them guide you to open up. The more comfortable you feel with your doctor, the better conversation you’ll have. Being at ease also makes it easier to explain issues with your sexual health.
6. Be prepared to answer personal questions
Getting to the bottom of what’s causing painful sex requires some personal information. Be prepared to answer questions at your appointment that relate to your sex life and other personal issues.
You need to be open and honest with your doctor so they can give you the correct treatment.
Your doctor might ask you about when it hurts. Does pain start before, during, or after sex? Do you only experience pain at the start of penetration, or does the pain become more severe with thrusting?
Your doctor may even ask your feelings about sex. Do you like it? Does it make you scared or nervous? These questions can determine whether painful sex is due to a condition like vaginismus, which is the involuntary contraction of vaginal muscles often caused by fear of intimacy.
If the problem recently started, your doctor may ask questions to assess whether you’ve experienced any injury, trauma, or infection in this area.
Your doctor might inquire about your menstrual cycle if you’re in your 40s or 50s. If your cycles have become irregular or stopped completely, painful sex could be caused by a condition associated with menopause known as vulvar and vaginal atrophy. This causes dryness and thinning of the vaginal walls, triggering painful sex.
7. Bring up the topic early in the appointment
If you’re uncomfortable talking about painful sex, you might put off discussing. However, bringing up the topic early in the appointment will give your doctor more time to ask you questions about your symptoms.
Bring up the topic early to ensure your doctor has time to evaluate your issue and offer the right treatment.
8. Bring emotional support
Starting the conversation with your doctor about painful sex can be more comfortable when you have support. If you’ve discussed this problem with your partner, sibling, or a close friend, ask this person to accompany you to your appointment.
Having a familiar face in the room could put you at ease. Plus, this person can ask their own questions about the condition and take notes for you.
Pain, burning, or throbbing with penetration can become so intense that you avoid intimacy. If painful sex doesn’t improve with over-the-counter (OTC) lubrication or at-home remedies, talk with your doctor. Sexual problems can be hard to talk about, but you’ll need to identify the underlying cause so it can be treated.