Study: a quarter of women will experience chronic pain during sex

A new study out of the University of Michigan Medical School found that around 8% of women suffer from vulvodynia, a frustratingly mysterious condition whose symptoms include pain during sex. It’s estimated that 25% of women will have vulvodynia at some point in their lives.

I’ve written about the condition in the past, and have bemoaned the difficulty of getting an accurate diagnosis and effective treatment for vulvodynia. There are cultural barriers to diagnosis – women don’t seek treatment because they think their pain is normal and that sex is just sometimes meant to be painful, or they know their pain is abnormal but feel so ashamed that their sexual experience doesn’t match up to the one the culture tells them they should expect – and medical ones – many doctors don’t know about chronic pelvic pain conditions like vulvodynia and vaginismus, so even when women do seek treatment, they’re unlikely to get an accurate diagnosis.

Barriers to treatment are similarly cultural, medical and financial. There hasn’t been a whole lot of research (surprise, surprise!) into how we can make sex less painful and more pleasurable for women. Funding is hard to come by for such studies, and that makes it harder for doctors and sufferers to find out about diagnoses and treatments. While makes me mad as all hell: if there were a sexual condition that affected as many as 1 in 4 men, we’d know every goddamn thing about it.

I’ve written about the effectiveness of physical therapy and laser therapy (it’s like Star Wars! For your vagina!), and about the frustration that women feel when confronted by this mysterious and misunderstood chronic condition.And it really is poorly understood. This study revealed the woeful state of knowledge about vulvodynia, among patients and doctors alike. In a study of 2, 269 women in the Detroit area:

Around 200 women met the criteria for vulvodynia. The average age of onset was 30. The condition was about as common among women aged 18 to 70, after which the prevalence declined. Experiencing vulvodynia often did not prevent women from having sex.

It also found accurate diagnoses were very rare: 200 women were diagnosed, by these researchers, with vulvodynia, but only 2% of them had been told so outside of the study. More upsettingly still:

Only a quarter of those who sought treatment for their pain were given any diagnosis at all. Some were diagnosed with yeast infections or estrogen deficiency, and while both these conditions can cause vaginal pain, the researchers suspect some women instead had vulvodynia.

Women who talked to a doctor about their pain were no more likely to see their symptoms resolve than those who did not see a doctor, which suggests the treatments the doctors are prescribing often aren’t working, the researchers said.

There are treatments that work, though sadly this article omits one of them, which is physical therapy (and lasers! Did I mention the lasers?!). You can read more about that in this awesome book, Ending Female Pain.

Sex is not supposed to hurt. Really. Really. If sex is physically painful for you, do something about it. This study found that only about half of the women who experienced chronic pain during sex had sought treatment, even though the average period of pain was 12-and-a-half years. Those two numbers make me want to cry.

If you’re experiencing pain during sex, go talk to a doctor and raise the possibility of vulvodynia. And if he or she gives you a blank stare, I suggest you get yourself a new doctor.

Update: As one of our commenters noted, this study didn’t include trans folks, who can also suffer from chronic vaginal pain. Neither did my blog post, and they both should have.

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13 Comments

  1. Posted September 22, 2011 at 1:25 pm | Permalink

    Or, we could question the mandate that heterosexual women must have penis-in-vagina sex. Perhaps we should re-define sex in ways that celebrate female pleasure, rather than male.

    Chloe, thank you for bringing attention to this issue. Your article goes some way towards addressing female pleasure in intimate encounters, but I believe that you can take this analysis further by recognizing that het sex does not always have to involve PIV. If it hurts her to do it (or if it isn’t fun for her), that doesn’t always mean she needs lasers. Maybe she needs an instead-of PIV sex option that works for both her and her partner.

    I appreciate your allowing me to share my thoughts in this space.

    • Posted September 22, 2011 at 4:42 pm | Permalink

      I’m all for celebrating female pleasure and I really don’t feel I need to be treated right now, but I DO receive pleasure during penis-in-vagina sex. There were times when oral worked, when fingering worked, when my vibrator worked, when a mix of those did. I’ve wanted and needed different things at different points in my sex life. PIV is not the only sex that triggers pain for me. I think you’re right that we should celebrate the full palette of sexual options, but please don’t assume that other sex acts would be pain-free or that PIV is more pleasurable for a man than it can be for a woman.

  2. Posted September 22, 2011 at 1:33 pm | Permalink

    I have vaginismus and I can’t tell you utterly frustrating it is. I’m 23 and still a virgin because of it. It seems like the whole damn world is having awesome sex and big loud orgasms on the top of a dresser, but I have to do breathing exercises and take anxiety meds to get something the size of a tampon in me.

    Thank you for writing about this – I had yet to see a post on vaginismus or vulvodynia in any of the non-medical feminist blogs I read, so I’m really glad you’re shedding some light on it.

    I would also like to plug this site, which myself and many women with the condition may find extremely helpful: http://www.vaginismus-awareness-network.org/

    -L

    • Posted September 23, 2011 at 4:08 am | Permalink

      I have gone through the exact same thing. I am 21 and still a virgin and it seems like no one gets it, its not through lack of trying, anymore it has just become embarassing and frustrating to even admitt to it. And the thing that is really difficult about it is even when I went to what I had thought to a very good gyno they made me feel like I was tensing my vagina and could control the impulse, I left the office crying and have yet to return for a pelvic exam because of this. I feel your pain and it sucks.

  3. Posted September 22, 2011 at 1:35 pm | Permalink

    I experienced a lot of pain having sex with a guy the first time. The next day he told me he had been researching on the internet and thought I had vaginismus. He wanted me to get treatment but I thought I could handle it on my own. For me, the fear of pain was causing me to seize up which caused actual pain. However, all I had to do was get more comfortable with myself. As I figured out the layout of this body part I had very little experience with, I could figure out how it worked and stop worrying about pain. I think problems with pain during sex can have a large mental component.

    I definitely think people who can’t make the pain go away should be able to seek treatment. Maybe we need more doctors who specialize in things like this. I think it’s frustrating to go to a general practitioner with an “unusual” ailment because there’s no way they can know everything and a lot of time they have no clue what’s wrong.

  4. Posted September 22, 2011 at 3:13 pm | Permalink

    Wow. I had no idea until just now, but I absolutely have vulvodynia and to some extent vaginismus. (Also, my spell checker just suggested I change “vaginismus” to chauvinism. Haha. I’ve experienced that too.) I thought pain was normal. I figured it made sense. Something inside you hurts.

    I have felt so limited and like a failure when, after or even before sex if enough foreplay and touching is involved, my skin gets so irritated that I can’t bare to continue with my partner. I have trained myself to do a mini breathing exercise and consciously relax myself. To deal with the vulvodynia that I didn’t even know was a thing, we use certain positions or switch around. I have found ways of dealing with my pain and I don’t know that I want any lasers going near Senorita so maybe I won’t be running to the doctor, but mentally it’s such a huge relief to know that I’m not broken or that this isn’t just what sex is.

  5. Posted September 22, 2011 at 3:21 pm | Permalink

    I am a bit uncomfortable with the assertion that “if this happened to 1 out of 4 men, we’d know all about it”. ED, for example, has only really come into the limelight in the past few years due to Viagra. ED, though, still creates a strong sense of shame for younger men who are experiencing it. ED jokes are still used in pop culture as a means of emasculation. Not to mention men who experience pain in anal sex or pain on their penis due to tight foreskin.

    The issue is that sexuality is dominated by cultural norms and shame. Silence is expected if your experience deviates by the norm in any way. Through an open and healthy discussion of sexuality for all genders, perhaps this silencing of women who are experiencing vulvodynia wouldn’t exist.

  6. Posted September 22, 2011 at 5:14 pm | Permalink

    I registered here just so I could post this comment – I’m a longtime lurker but I figured this might help someone.

    I used to have vulvodynia. The specialist who examined me made it clear that she thought I was completely overacting (so helpful), but she prescribed an anaesthetic gel that I never used, and some pills that I did take. I am sorry that I don’t remember what they were!

    I think they went some way towards relaxing me. But another thing that helped me after it got a bit better was, counterintuitively, a menstrual cup. I’d suggest that anyone interested check out the liverjournal page on menstrual cups, e.g.: http://menstrual-cups.livejournal.com/2118383.html#comments

    Good luck!

  7. Posted September 22, 2011 at 5:16 pm | Permalink

    There’s a new book coming out this fall: Healing Painful Sex. I’ve read an advance copy and it’s amazing. Full of great info on almost every kind of medically-related pelvic pain issue that people with vaginas can experience. If you’re dealing with pelvic pain, I highly recommend it.

  8. Posted September 22, 2011 at 6:42 pm | Permalink

    I was diagnosed with vulvodynia and vaginisimus five years ago. All I can say is that pelvic physical therapy is a god send (as is the University of Michigan’s chronic pain clinic). After five years, I can finally have happy, pain-free sex almost every time. It can get better. Don’t give up, don’t listen to people who tell you you just need to get over it, and don’t accept partners who refuse to work with you and be patient.

  9. Posted September 23, 2011 at 1:21 am | Permalink

    I told my doctor that I experienced pain during sex and got no enjoyment from it. She said that’s how it is for some women. End of story. No tips, no compassion, no further questions. This was at the medical clinic of my women’s college during my annual gynecological exam. She expressed more concern over my skin irritation from cheap TP. How frustrating! Glad that this issue is being researched. Also, I began using the UK Mooncup for my menstrual needs and would never go back to pads or tampons. Since I began using the cup, I experience less pain during sex. Still no enjoyment, but it’s a step in the right direction.

  10. Posted September 28, 2011 at 7:30 pm | Permalink

    Although I’ve read and appreciated several articles here on feministing before, I signed up today so I could comment to this one, in particular.

    Thank you Chloe for writing it, feministing for publishing it, and thanks to everyone who comments for being willing to talk about your experience with this all-too private pain.

    My long-term partner suffered from vulvodinia, in some form, during our entire relationship. Today, we are no longer together. While I don’t attribute our break-up to the condition, over time she clearly came to associate negative feelings with our sexual life. This was despite our enjoying various forms of non-penetrative sex, and my attempts (if you will believe me) not to pressure her for anything else.

    What complicated the matter was that she had previously not had any kind of sex, while I had, and had always enjoyed it. While I knew many women experienced pain during intercourse, I naively assumed that it was usually due to lack of care and patience. Our experienced seemed to suggest otherwise.

    One of our problems, as SMASH and anyadnight highlight, is that expectations of hetoro-normative penetrative sex are all-too-common. On the other hand, this pain isn’t always associated only with penetrative sex, but with other kinds of contact, too (from masturbation to using a tampon). I think it is difficult for even the most well-meaning couples to escape their own internalized expectations about what is “normal” and “healthy,” and to resolve their own active desire for pleasure.

    I’m not sure if this adds anything particularly new to the conversation, but I hope my comments fall on kind ears. I learned a lot going through this experience, and hope my partner can find a solution that makes her happy.

    One final caveat, and one may not be addressed sufficiently in the literature (such as “Enduring Female Pain” and “Healing Painful Sex”): I am both wary of and sympathetic to the medicalization of this condition. This article’s author assures us that “Sex is not supposed to hurt. Really. Really.,” but that seems to suggest that women who feel otherwise are unhealthy, and should be treated as such (with surgery, anesthetics, or maybe just yoga, and other forms of therapy). That’s great for women who find therapy (and can afford it), and more information and care should be widely available, but for anyone who has talked to a doctor and not found a solution (or a solution they were comfortable with) it may just reinforce the stigma of having a body which doesn’t conform to “real, normal, healthy sex.” We are born with the bodies we have, and while I’m not in any way against people choosing to eliminate their pain, medicine can’t always solve everything. We should work towards a culture and a society that makes positive medical options freely available, but doesn’t shame people who don’t have sex, either.

    • Posted September 29, 2011 at 11:58 am | Permalink

      [Btw, by "lack of care and patience" I mean from one's partner, mostly. I never thought it was a woman's' fault for experiencing pain].

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