There Is Nothing Normal About Pain During Sex

by | Jul 6, 2023 | Sexual Health

First-time sex is supposed to be painful due to the hymen (a thin piece of tissue located at the opening of the vagina) tearing. Most of us grew up hearing this statement. We held on to it as the gospel and waited our turn to feel this ‘natural’ pain. 

There’s no bigger lie, believes psychosexual therapist Catriona Boffard, who has been in the game for well over 13 years and is particularly passionate about this subject. She believes that young women being taught that first-time sex is painful creates more long-term damage than we let on and it’s something that should never be normalised.

“One of the biggest issues is that when women expect something to hurt, or if there has been some physical sexual trauma, chemotherapy treatment or a skin condition, they aren’t going to be sufficiently aroused physically and psychologically – and that will automatically lead to pain. There are many reasons why a woman has unwanted pain during sex, but her first time is not one of them. A woman’s first time shouldn’t hurt.”

Catriona Boffard

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Why you could be experiencing sexual pain

There are various health and psychological reasons that cause pain during sex – and these should be treated with the utmost urgency. “One of the most common reasons why women experience pain during sex is that they’re not sufficiently aroused. Also, because society tells us that sex first-time sex is going to hurt, that also switches off the probability of being physically and mentally aroused. Her vaginal muscles tense up leading to sexual pain,” explains Boffard. 

Another reason could be due to sexual pain disorders. “It’s usually a psychosomatic issue that a woman experiences where there is a fear-pain cycle that perpetuates in the brain. It could be that she’s experienced psychological and physical trauma before when inserting a tampon or a finger, being examined by a gynaecologist or when a penis penetrates,” shares Boffard. 

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The third reason is due to dermatological conditions such as lichen sclerosis which affects the tissue in the vulva area or recurring vaginal infections, adds Boffard. Then there’s also the effects of ageing, menopause or chemotherapy which causes shrinking and atrophy (skin condition demonstrated by thin shiny-appearing skin, small readily visible blood vessels, bruises, stretch marks, increased hair, redness, and pigmentation changes) in the vaginal tissue, particularly in the labia. 

Possible treatments

Should you decide to consult a psychosexual therapist for your pain during sex, they are likely to first refer you to a sexual health doctor for a full examination and assessment to rule out the possibility of the pain being caused by clinical reasons. “The treatment usually depends on what it is that she’s experiencing. There is no one-size-fits-all model. Every woman needs to be treated differently depending on what her concerns are,” says Boffard. 

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One of the most common causes of unwanted sexual pain in women, from a psychological perspective, is negative messaging around sex. “A woman living with vaginismus (the tightening of the muscles on the vagina) may need sessions with a physiotherapist to manage the movement of their pelvis and another may need some psychological therapy sessions. Ideally, a woman experiencing unwanted sexual pain needs a team made up of a sexual health doctor, a sexologist like myself and a physiotherapist,” she says.

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