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Painful Sex, Thoughts, & Intimacy

by Dr. Sonia Wright, MD

As a sex coach, it’s my job to help women think outside the box as it relates to sex and sexuality. I help women reframe sexual difficulties and realize that difficulties do not mean the end of sexual intimacy. In fact, I like to think of it as just the opposite. It can actually mean the beginning of the best intimacy ever! In my mind...the greater the sexual problem, the greater the opportunity for enhanced intimacy. One of the issues that I have personally seen the most improvement is around the issue of painful sex, also known as dyspareunia.

I want to specifically address the issue of dyspareunia and maintaining sexual intimacy when dealing with painful sex because it is a topic which is not often discussed. Although, up to 75% of women have experienced painful sex at some point in their lives, women remain reluctant to discuss the topic.

So many women don’t feel comfortable talking about painful sex. This leads to a feeling of isolation and women thinking they have no one to turn to. Women often come to the conclusion that there are only two options available to them. They think they either have to “suck it up” and tolerate the pain or they decide to “close up shop all together” and stop having sexual intimacy forever.

I’ve personally coached several women who have been experiencing pain with sex for 20-30 years. They think it’s their “wifely duty” so they just lie down and hope that penetration ends quickly. I’ve also coached many women who have not had sex in over 10 years because of dyspareunia. Well, I’m here to tell you, it’s not an either/or situation. You DO have options and your options are basically tied to the way you think about the situation.

Let’s look at what might be going on in a woman’s mind when she is dealing with vulvovaginal pain and/or pain with sex.

Women are so hard on themselves. They are in physical pain and on top of that, they are beating themselves up emotionally about having the painful condition.

I’ve coached many women dealing with pain and here is a list of the most common thoughts that are going through their mind ...

  • “I’m broken. there’s something wrong with me.”

  • “No one else is talking about painful sex, I must be the only one experiencing pain.”

  • “I guess this is just what happens as I get older...I lose lubrication and sex becomes painful”

  • “It’s all my fault.”

  • “My partner is going to leave me if I don’t have sex.”

  • “I’ll just have to suck it up and bear the pain. My partner needs Sex. Or this close second… it’s my duty as a wife to provide sex.”

  • “If I do it quickly, maybe it won’t hurt so much.”

  • “It’s probably all in my head...the doctor said it is.”

  • “If I avoid my partner or avoid any touch then they won’t want sex and I won’t experience any pain.”

Whatever the thought, usually leads to a visit from one of our frenemies… what I call the “emotional bullies”.

You know...shame, guilt, sadness, embarrassment, anger, resentment and/or self judgment. We may feel comfortable with them… but they are not helpful in any way. They usually make us feel worse about ourselves.

If we take it even further, we see that these thoughts and feelings lead to actions which are very isolating such as avoiding intimacy, avoiding partners, decreased communication, isolating from friends and family, ignoring the pain signals from our bodies, not prioritizing our health, and resenting or hating our bodies.

Ultimately, the results are decreased intimacy, worsened isolation and disconnection from our bodies and our authentic selves.

If this scenario sounds familiar and you have been dealing with pain, I want you to know that you matter and this situation can get better.

You deserve to be pain free.

You deserve better than this! But it’s a decision that you have to make that you are worthy of more in life.

You deserve to have amazing intimacy and to be connected to your partners and friends.

You deserve to get the treatment you need and be pain free.

But right now, it's important to recognize what is blocking you from getting the help you need. I want to focus on your thoughts because that’s what is stopping you. I’m going to ask you some questions. I want you to get your journals out and write down your answers to these questions.

  • What are all the reasons that are stopping you from getting the help that you need?

  • What is stopping you from prioritizing your health?

  • What is stopping you from putting your needs first?

Ultimately, it may be an issue of not valuing yourself enough to get the help that you need. But I want you to understand it’s not your fault.

Women are conditioned from a young age to tolerate pain and to ignore their own needs. When we first learn about menstrual periods, we are also introduced to the idea that pain is a part of a woman’s life. In addition, we are taught from a young age that our needs are not a priority. Basically, we are taught that a good woman puts the needs of her children and partner before her own needs.

So where does that leave women? It leaves women tolerating pain and not advocating for themselves.

We often need our Wise One to advocate on our behalf. The Wise One is our inner guide who acknowledges our needs. The Wise One gives us permission to take care of ourselves. She says “Hell No!” to tolerating pain and decreased intimacy in our lives. Others may call her the “Selfish Bitch”, so if you hear that name, nothing has gone wrong. It means you are advocating for yourself. The wise one is the one person that rides in on the horse and saves you. Let’s be clear, the only one that can choose the pain free path and save you, is yourself. You get to make the decision to keep advocating for yourself and get the treatment that you need to heal your body.

And while you are investigating different treatment options, you get to create the amazing intimacy that you deserve.

This choice of either tolerating pain with sex or no intimacy at all is built on the belief that sexual intimacy equates only to penetrative sex.

This is not true…

Sexual intimacy is so much more than penetration. As I like to say it’s about Dr. Sonia’s Triad of Sexual Intimacy…connection and satisfaction and pleasure. None of these factors require penetration. What is required is communication and creativity. Remember, you get to define sexual intimacy for yourself, whatever way you like. If you are partnered, you and your partner get to define it for yourselves.

Maybe it’s a matter of committing to maintaining the touching and the pleasure no matter what.

Maybe it’s about getting creative with sexual acts. How can you and your partner preserve the pleasure and the intimacy, while taking the focus off penetration?

Maybe you incorporate oral sex, maybe utilize masturbation sleeves, maybe you try different positions without penetration. Perhaps you incorporate mutual masturbation or have some fun with role playing.

There is no limit to your creativity. You get to have fun with this. This can open up years of fun and enjoyment if you are willing to shift your mindset. Sexual intimacy does not equate with penetration. Take the penetration off the table while treating the pain and take the opportunity to get back to the touch, the intimacy and the love. Pleasure can be yours if you give yourself permission to think outside of the box.

So again I ask you…

  • What do you need to think in order to give yourself permission to experience pleasure without the pain?

  • What do you need to think to put yourself first?

  • What do you need to think to redefine sexual intimacy for you and your partner?

Let me remind you that you only have one life…

Find your Wise One and make the choice…

Choose sustained intimacy.

Choose pleasure.

Choose touch.

Choose the most amazing experiences of your life.

But most of all,

Choose you.

Cause you are 100% worth it.

Sending you all lots of love.

Dr. Sonia
The Midlife Sex Coach For Women


Learn more about Sex Coaching and how to book a session here!

Dr. Sonia is a medical doctor, a trained sexual counselor and an experienced life coach. She combines all of her training, knowledge and skill as The Midlife Sex Coach For Women. She's on a mission to end the emotional pain and isolation associated with sexual issues and help women create the sex lives of their dreams!