Sex Became The Painful Routine of Being a Girlfriend
Around 75% of women will experience sexual pain in their lives. Men can suffer it too. But what happens when this pain becomes chronic? A personal essay + important facts and resources.
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Today’s newsletter is a personal share about sexual pain.
I wrote this essay ten years ago. At the time, I published it on my small personal blog which felt like a huge step in my long healing process. A decade later, I’ve decided to revisit this piece, revamp it and bring it here, hoping it will bring much needed awareness, light and hope to many, on a still-taboo topic for society.
At the end of this post, you will find a Resources section with informative links. Feel free to share around…you might just transform someone’s life.
July 2014 - 6:00pm | Barcelona, Spain
It hurt.
During eight years it hurt. Physically and emotionally. Beyond my understanding and anyone else’s. To the point of doubting my own self, my sexuality, my body, my desires, my confidence, my anatomy, my functionality, my relationships.
It hurt every single time, for eight years.
My vagina was too narrow; and the pain ever-present in my life.
I never knew anything different. I never asked. We didn’t talk among friends about sex, intimacy or naughty adolescent experiences. We never talked about any of it.
I grew up in the 1980’s in a middle-class, hard-working, Catholic family in Latin American. We had good study opportunities, a private education, a supportive, loving family and a religion-based social structure and mentality.
As I grew older, I experienced my first sexual encounters — shy, ingenuous, naive. But what I remember the most is fear. Fear of the terribly threatening menace of an unwanted pregnancy, along with the life-ruining concept of this event at a young age. I’m grateful for the teachings on the importance of not getting pregnant too young, but the fear behind all of it seemed so unfair, so exaggerated…
I don’t blame religion for this problem, but I understand how it has a major impact on people’s lives. It did with mine, making me feel dirty and a sinner, constantly scared in my thoughts since early age.
I became used to feeling guilty and not worthy of my own body.
Then uni came along and with it, a meaningful relationship. The kind of relationship that felt loving, filled with acceptance, making you wonder if this person will be your partner for life. Oh magical thinking. It felt indeed magical and socially acceptable, so I allowed myself to go along for the ride.
After several years, despite the friendship-like love, the laughter and the good times, I was never able to fully enjoy sex. Things that I had timidly heard among other people’s conversations - the rush, the desire, the passion, the excitement, the heated moments of lust and love - were all things I never came to fully experience or understand.
Above all, fear, to the point it killed desire.
Reading or watching sexual content somewhere on magazines or the web felt so wrong. Even when sapping channels on a Friday night and finding by mistake an erotic scene felt wrong. The whole room turned into a complete bubble of discomfort even if I was on my own. I felt curious, but also guilty and frightened.
My fear wasn’t something I asked for, or something that was planted in me on purpose. But there it was, and it was real. It paralysed me for as long as I’ve known about sex.
I remember that first time, booking nervously into a hotel room with my partner-in-crime. All I was concerned about was being seen and what that would mean. About the terrible terrible girl I’d be, and the scary consequences of my unacceptable behaviour. I feared constantly during the whole time.
We made it inside. The experience was far from pleasurable. Instead, it became a therapy session on something I couldn’t really understand.
I was afraid. He wasn’t.
I couldn’t do it. And I cried, hopelessly and confused.
I’ve always been grateful for my then partner for being understanding and respectful about my feelings at the time. What if he hadn’t been? I’m not a fatalist, but my thoughts were always dominated by worst-case scenarios, some of them extreme.
The possibility of having being raped in some unremembered past offered itself as an explanation of my deeply-rooted fear, an idea that stuck with me for a long time. Thanks to therapy, I realised this was never the case, but then again…more fear, of what I didn’t know, what I might have blanked out.
The Facts Banished My Fears.
After several years of gynaecological controls, I learned that my vagina was too narrow, more than the average.
The usual smear test had always been the most painful experience. Not even the tiniest vaginal speculum would fit me, to the point of surprise on my own doctor’s face.
I had so many questions…
But I never asked. And I never shared this with anyone. At 24 years old and one year away from finishing med-school, no academic learning would give me an answer either. All I knew was fear.
A fear that weaves deep in between the fibres of your skin, your body and your mind. Deeper than the love for your people or your own self. Deeper into a dark and almost unreachable layer, into a place where despite being unable to see or touch this thing, you know it’s there. Making it all harder to understand, probably more so at a young age.
I wondered about a few things every time this issue came to the front of my mind:
“What are the flaws in our system?
Is this an occidental thing? A Latin American thing?
Is this happening in other religious dogmas and not just the one I was raised in?
Are girls/women in other countries and continents as inhibited and shy when talking about sex?
Was it just me? Was it my personality? Why so much fear?
Are families actually talking about sex with their children?”
But time kept passing by and those questions were never really answered or cleared up in my head.
My relationship was still alive, but I remained apprehensive, fearing every possible touch, even a kiss, because in my mind a kiss would automatically translate into sex.
Into pain.
I grasped the bed sheets after looking for the best position where pain was slightly tolerable. I then closed my eyes and took a deep breath, trying to master my mind into a few seconds of zen as the waves of pain went through my body.
My thoughts would ramble with every back-n-forth movement, trying to desperately find a quiet place where I could get any sense of relaxation. This way my vagina would relax and open up, I thought as he penetrated me. Maybe, just maybe, the pain would diminish by doing this every time. It never did.
Sex became the painful routine of being a girlfriend.
I was never forced into doing anything, but I kept trying, for the sake of love and what was supposed to be normal. After all, my narrow vagina was never going to become any wider on its own, was it?
In 2008 I decided to get a second Gynaecologist’s opinion. To my surprise, this understanding, calming and open-minded physician was the first person in years of deep and constant struggle, to mention the possibility of a small surgery that could fix this narrowness and make the pain go away. A narrowness called Vaginal Stenosis.
Absolute disbelief took over me. I cried.
I cried in anxiety, in fear and in happiness. Was this possible? Was this even real? Turned out that he performs this surgery at least four to six times per month. I was far — so far — from being alone.
It was now 2009 and I was about to get married and move abroad, which made it difficult to consider surgery right away, as I needed at least a month to go through surgery and recovery. He offered me some advice and suggested a few last therapeutic resources before putting my genitals through the knife.
I learned how this was far from normal, and how it was slowly and silently affecting my relationship. But suddenly there was some light at the end of the tunnel. I kept high hopes in the distance with my new doctor.
Four years passed. I kept building this new married life abroad. New possibilities showed up in our new home. A good friend and pelvic floor specialist offered some help. After several months without success, she referred me to a therapist. Eventually, another year had passed without better results and I just knew. I had to fly home and finally get that surgery done.
I needed to do this, for myself in the first place - for peace of mind, sexual health and my entire future. Then for our relationship, which had been slowly crumbling down for a very long time.
January 22nd, 2013–6:00 pm | San Jose, Costa Rica
I’m lying on my Mum’s bed, sleepy, unable to move. The pain, oh the pain! Wait…this is a different kind of pain.
I’ve spent the last three hours sleeping after I went into surgery. The last thing I remember was lying at the surgical bed, wearing a white thin robe with no clothes underneath, legs up and opened resting on the footrests, genitals properly sterilised and watching my doctor prepare the injection that would put me to sleep for the next two hours.
I had never gone through surgery before. I’ve seen countless surgeries during my med school years: open-heart surgeries, kidney surgeries, broken hips and oncologic ones too. I have accompanied so many patients into that cold green room before they went anaesthetised into a blurry dream. But I have never been on that table spot myself.
Until this day.
April 2013 ~ Florence, Italy
It’s now been three months since surgery.
We’re in Florence on a weekend getaway and we just had an emotional crisis. We should try having sex sometime soon but I keep avoiding it. Fear still haunts me. What if it doesn’t work? I’ve been doing physiotherapy diligently at home as recommended by my doctor, with a specific post-surgery recovery dildo. I’m afraid to try but the next step has to be given. And so we did.
April arrived with some pure tears of joy. The surgery proved successful!
After ten years of endless sexual pain, psychotherapy, pelvic physiotherapy, and a life of deep frustration and low self-confidence, there was light on the other side of that tunnel.
I discovered my pain-free sexuality at age 32.
A journey of self-discovery followed, and I was never the same again.
My mind changed, my thoughts changed. My whole world changed, inside and out. The way I felt towards many things in society changed. I became a version of myself I had never met before.
So often, the facts we know about life are just based on the education and social patterns we were raised in. However, those facts can be misguiding or misleading if we’re not offered an expanded view as we move through life.
Dyspareunia is the medical term for painful intercourse. It can happen before, during or after sex, and it’s most commonly seen in women. It is said that over 75% of women will experience some kind of sexual pain in their lives, whereas only a 1-5% of men will.
There are many reasons that can cause painful intercourse:
Vaginal dryness
Skin disorders
Vaginal, urinary or sexually transmitted infections (STI)
Endometriosis
Pelvic Inflammatory Disease
Radiation and Chemotherapy
Psychological distress
Foreskin damage
Penis deformities
There is so much work we can do to help alleviate these.
And still, in 2023 a study suggests:
“It is debatable whether this condition can be classified as a sexual disorder or pain disorder as identifying a specific etiology can prove challenging.” Full study here.
This is serious.
This affects people’s lives.
This affects relationships, trust and pleasure.
But most of all, it affects self-confidence in the first place.
And without self-confidence, without the ability to face your fears and see them for the destructive lies that they really are…
All you can do is hurt.
Resources For Sexual Pain Awareness & Prevention
It’s true that many sex-related topics still remain a taboo in parts of our society and even among many healthcare providers, but thanks to this era of accessible information, and the empathy being shared by so many professionals nowadays, we can now provide more light on these topics for everyone to learn and prevent.
In this Resources section you will find:
Medical Terms
General Info on Sexual Pain
Sexual Pain in Women
Sexual Pain in Men
Substacks Talking About Sexual Health
You’ll find that many of these informative links don’t mention surgery as a therapeutic option, however, I want to encourage anyone struggling to properly comment your pain and symptoms with your doctor. Surgery was eventually my solution, and even though it might not be for everyone, it’s important that you ask, get well informed, and feel understood by your treating physician.
I hope this curated selection of resources can be of profound help.
Medical Terms
Dyspareunia: genital pain during intercourse.
Vagina: muscular canal that goes from the uterus to the outside female sex organs.
Vaginal: relating to the vagina.
Vaginismus: involuntary tensing of the vagina.
Vulva: outer part of the female genitalia, which includes labia, vaginal opening, clitoris and urethra.
Vulvodynia: pain in the vulvar area, lasting at least 3 months and with no apparent cause.
Pelvis: basin-shaped complex of bones (between the hips) that connects the trunk and the legs, supports the trunk, and contains the intestines, the bladder, and the internal sex organs.
Pelvic: relating to, or located in or near the pelvis.
Phimosis: tightening of the penis foreskin, making it difficult to pull back; common in babies and toddlers.
Symptoms: sensations experienced by a person may indicate that they have a disease or condition. Symptoms can only be reported by the person experiencing them. They cannot be observed by a health care provider. (Subjective)
Signs: something found during a physical exam or as a result of a laboratory or imaging test that shows that a person may have a condition or disease. (Objective)
Ob-Gyn: stands for obstetrics and gynaecology. These branch of medicine specialises in the care of women during pregnancy, childbirth, and the female reproductive system’s health.
Urologist: doctor who specialises in treating diseases and conditions of the urinary tract, and the male reproductive system.
Sexual health clinic: clinics specialised in the prevention and treatment of sexually transmitted infections. Some of the most common services include STI screenings, contraception consultations and provision, pregnancy tests and advice. Not all clinics are the same, so check in advance what services your local clinic offers.
General Info on Sexual Pain (Dyspareunia)
Cleveland Clinic on Dyspareunia
NHS Department of Medical Psychology on Dyspareunia
Healthline - What You Need to Know About Dyspareunia
National Library of Medicine - Scientific Paper on Dyspareunia
Sexual Pain in Women ♀
Jean Hailes for Women’s Health
When Sexual Intercourse Hurts by Ob-Gyn Dr. Paul Carter
Center for Vascular Medicine - 13 Causes of Pain During Sex
Sexual Pain in Men ♂
Male Dyspareunia by Practo Care
WebMD - Understanding Male Sexual Problems
Pain During Intercourse in Men by Lybrate
Why Do Men Feel Pain During Intercourse? By Emedicine Health
7 Reasons Men Have Pain After Sex by Orlando Health
Substacks Talking About Sexual Health
The Science of Saving Your Sex Life
How do we build a new understanding of what constitutes “good” sex?
You Deserve to Feel Fine About Your Pelvic Floor
Genitourinary Syndrome of Menopause
Final Note: If you know of someone who might be struggling with this or similar issues, please share this with them. You might just change someone’s life. I know someone changed mine back then, and for it, I’ll be forever grateful. ❤️
Image Credit: Right as Rain by UW Women
Bravely told, congratulations on getting this piece out there (again, revised!) into the world - I just know it will help others. I, for one, learned a lot here. Thank goodness you were able to voice your discomfort and had a competent and caring doctor able to help you.
I’m so grateful to you, doc. It takes a lot of guts to put something like this out to the world, but it breaks the shame cycle and that is so necessary! I’ll share this in my next roundup.