When intercourse is painful it can be devastating to a relationship. Chronic pain can be a trigger to be avoidant of situations that can lead to sex such as kissing, touching or even going to bed at the same time. As a Certified Sex Therapist and Marriage Counselor I help couples negotiate how to deal with pain issues in their relationships so everyone understands how to handle the pain, and what the plan is to keep intimacy alive in the relationship.

Action Item 1. Negotiate a Plan 

Having a plan to deal with the problem is the smartest thing a couple can do. When sex hurts getting a proper diagnosis and even a second or third opinion is very important. Understand your condition; it could be Dyspareunia, Vulvodynia, Vestibulitis or another pain disorder. Understanding what the problem is advances what solutions are available.

Once the diagnosis is made, you and your partner need to construct a plan for how to deal with intimacy. Avoidance of the subject will only contribute to damage so a clear plan is the best way. A clear plan might sound something like this...” We have agreed that twice a week we will make time for intimacy. During this time we want to kiss, touch, massage, shower together and have oral and genital manual stimulation on one another. We will make effort to communicate what feels good and what hurts as a way to know what to do that is pleasurable.”

Action Item 2. Plan Time to Talk About the Feelings

When sex is painful, people need to feel like time is made to discuss those feelings. Not talking about what is happening leads to disappointment, hurt and anger all which can contribute to a breakdown in the relationship. Get some counseling, preferable couple’s therapy with a Certified Sex Therapist who is skilled in painful sex and the issues it causes in relationships. Talk about keeping intimacy important in the relationship even if intercourse is off the table. Communicate that pleasing your partner is a priority to you and you want to see them satisfied in ways other than intercourse.

Action Item 3. When is Sex Good 

Often when pain is associated with sex, pleasurable sexual activity feels like a foreign concept. Make sure you think about exceptions to the norm or times when sex or lovemaking felt good. It may be that sex hurts all of the time and if so then make note of when lovemaking was pleasurable such as kissing feels good or I like when he rubs my back and my thighs, I like when we hold each other or dance together. Make sure you can list at least 10 things that you like about intimacy that can be used when you guys are sexual together.

Action Item 4. Educate Yourself about Lubrication and Sex Toys

If sex is painful and you want to keep intimacy alive then you need to bring in some alternative ideas. First, lubrication can be extremely helpful in slicking up genitals and not adding problems that could be caused by dryness including irritation and tearing. Find brands that are natural or use natural ingredients to make your own lubricants. Next, try experimenting with some sex toys. Use of a vibrator can be very beneficial in continuing to be sexual together and still being orgasmic with each other. Many sex toys are not made for internal use so finding items that can be used on the outside of the vagina can be a relief to your lovemaking experience. Also, identify toys that can be used on him such as a masturbation sleeve you can use with him. Think in terms of finding solutions and try and find ways to be sexual that avoid pain and contribute to pleasure and fun.

Action Item 5. Keep Trying

No matter what your medical diagnosis is, you never want to completely give up on the idea of having intercourse. You should talk with your partner about the idea of “trying sex” every so often (monthly, quarterly) and set up conditions that may contribute to it being successful. These conditions could include using liberal lubrication, having woman on top position so she can control things, making sure everything is relaxed (no kids at home, ect), having the relationship be a good place, use of medications to ease pain, using a vibrator for clitoral stimulation while simultaneously penetrating to see if its distracting from the pain and finally talking about feelings that may still be a barrier to good sex in the relationship.

When sex hurts it can be devastating to a relationship. Taking charge of the problem can help the couple suffer significantly less and understanding how to deal with the problem of pain can help the couple set their relationship up for success. Contact me directly for resources and ideas through my website at www.OnlineCouch.com

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