Pain during sex: Suffering in silence?

If sex gives you pain instead of pleasure, something's wrong.

Half of all women under 25 say they sometimes or always have pain during intercourse.

Why do they put up with it? In most cases there's no medical cause, says Dutch psychologist Ellen Laan. Instead of relaxing and enjoying sex, the women get anxious and tense up their pelvic muscles. The result is pain instead of pleasure. "But pleasure is not a bonus, it's a necessity!"

More than one in ten Dutch women regularly experience pain during sex because of this 'pelvic floor hyperactivity', Ellen Laan's research at the University of Amsterdam shows.

Pain during penetration

So why do women tense up in this way? There are several reasons. Some may have had a trauma in their past which makes them anxious about intimacy. Others may simply have had a bad first sexual experience, and now they're wary of new ones. In both cases the women have no control over their pelvic muscles -- they just seize up and ruin the moment.

The women have a number of different things in common. First of all, they have little say over what happens in the bedroom. They don't really know what arouses them and they don't know how to communicate their desires to their partner.

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Secondly, the women don't have sex for pleasure. Many say they do it "as a duty" or "because "he needs to have intercourse". They don't want to lose their partners so they put up with penetration.

The sad truth is that most men Laan speaks with say, "I don't necessarily need penetration, I just want us to be close." But many women who have pain during sex worry that if they get close it will lead to intercourse. So they avoid all kissing or cuddling, all the things that give you comfort.

The partner's attitude towards the pain is also a factor. If the partner reacts negatively (with anger or impatience), unsurprisingly, this makes the pain worse over time.

This problem is compounded in places where sex is considered taboo. In these societies women are told over and over that first time sex will be painful. They're so anxious on their first night with their partner that their muscles remain tense -- and that causes pain and a bad experience.

"What you need to do to have painless sex," says Ellen Laan, " is to relax your pelvic floor muscles and make sure you're very sexually aroused. First-time sex really doesn't need to be painful."

Arousal is the answer to solving this problem of painful sex. "When you're aroused, these pelvic muscles relax and expand and you produce lubrication," says Laan.

"So I tell women they need to approach sex like a man! Men are protected by their genitals. They can only have penetrative sex when they're aroused. Women should behave the same way. Women need to explore their bodies and figure out what gives them pleasure -- pleasure is not a bonus, it's a necessity!"

Ellen Laan also has some advice for men. "Encourage your partner to discover herself and what gives her pleasure. But when it comes to arousing her, be gentle when you touch her genitals! Don't do it the way you would want your genitals touched. Women's genitals need a very soft touch."

Over the years, Laan has successfully treated women with chronic pain. "A grey mouse walks in the door -- two or three years later she leaves as a strong independent woman. Often they get a new job and a new partner."

It doesn't always mean the end of a relationship, though! Laan has also helped couples to learn to share sexual pleasure. "It's possible, it just takes a little more time".