By: Mary Schroeder, ND, LAC

Pain with sex is very common and yet can be difficult to talk about. We have such a strong stigma in our culture around sexual pleasure that many people avoid seeking help from their healthcare providers. If you fall into this category, we want you to know that you are not alone, and that there are many options for treatment.

The first step in finding an effective treatment strategy is to get an accurate diagnosis. If you are having pain with clitoral stimulation, penetration or orgasm, here are some things that may be happening:*

Pelvic floor tension. The pelvic floor is a hammock of muscles that cradles the pelvic organs and serves as a “core” muscle group. Trauma and long-term tension in this area can cause many symptoms, including pain with sex, hip pain, and issues with urination.
Vaginismus. This is a tight contraction of the pelvic floor muscles that makes penetration very painful or impossible.

​Painful bladder syndrome (PBS). With PBS, the bladder lining becomes inflamed and causes pain when your bladder is full and when you are exposed to certain irritants like coffee, alcohol, spicy food, acidic foods and carbonated beverages.
Vaginal infections (yeast infections, bacterial vaginosis, and sexually transmitted infections). Disruptions to our beneficial vaginal microbes can cause vaginal and vulvar pain in addition to itchiness, redness and changes in discharge.

​Vulvodynia or clitoridynia. This is a condition in which “outerbits,” including the vulva and clitoris become painful to touch. This can be caused by pinched nerves and nerve sensitivity.
Irritable Bowel Syndrome (IBS). With IBS, patients have long-term diarrhea and/or constipation and pain with bowel movements. This may seem unrelated, but it can cause pain and discomfort with penetration.

If you are pre-menopausal…
Endometriosis. This is a condition in which tissue from the lining of the uterus grows in the pelvic area and causes pain with menses. It affects an estimated 10% of people with periods, and yet very few people know what the term refers to! This can cause pain with sex at any time of the month.
Ovarian cysts. This is also very common and can cause discomfort in your pelvic region and pain with sex mid-cycle.

If you are post-menopausal…
Atrophic vaginitis. After menopause, low estrogen can cause thinning of the vaginal wall, which can lead to irritation and a burning, tearing sensation with penetration. A loss of vaginal elasticity can also can also cause shrinkage of the vaginal opening and consequent difficulty with intercourse.

If you are struggling with painful sex, you deserve to know your options. Treatment can involve acupuncture, pelvic floor therapy, herbal medicine, dietary strategies, hormone support, vaginal probiotics, lubricants, and much more.
Reach out today for a free consultation to discuss options for comprehensive naturopathic diagnosis and treatment.

Note: this is not an exhaustive list. Reach out for medical care to get a full evaluation.