Suffering in Silence? Time to Get Loud About Pain During Sex

When working with people coping with pain, I am often reminded of the ways that many of us have been socialized. We may have been taught to facilitate a conflict-free environment or to prioritize the well-being of others over ourselves.

These are not inherently troublesome values, there is much to celebrate in generous kindness, but I’ve seen that the ways these values show up with pain—particularly pain in sexual relationships—can lead to some difficulties.

When suppressing our sexual suffering, we may see increased shame, higher rates of dissociation, continued physical discomfort, emotional distress, and a negative impact on overall well-being.

Interconnected Self

Our emotions and our physical feelings are interconnected. This connection between mood and bodily sensations can muddle the experience of physical pain. When feelings like confusion, hopelessness, depression, or fear are present, as they often are, pain can take on a different quality. The intensity of these feelings can make the pain even more challenging.

Pain with sex, or dyspareunia, remains a matter kept silent for many. Those coping with dyspareunia are often also living with pelvic and genital conditions contributing to consistent pain. This type of pain often makes sex, arousal, and orgasm feel different. When sex feels different, so do we.

Pelvic Pain and Pain With Sex

This type of pain has been shown to have surprisingly significant impacts on a person. It has been shown¹ to:

• Increase psychological pain. Studies show higher rates of psychological conditions such as anxiety, depression, and PTSD in those coping with chronic pelvic pain.
• Decrease quality of life. Study participants report an overall change in their quality of life, encompassing relationship satisfaction and sense of hope.
• Complicate our sense of identity. Increased dissociation (the process of disconnecting from ourselves as protection from discomfort, pain, and suffering) and persistent agony can change the way we see ourselves and the ways we feel pleasure.

Dismissed and Silenced

Unfortunately, there are some barriers to accessing support for this type of pain. Our current paradigm grapples with a history of systematized discrimination and dismissal of people’s medical concerns—especially those of women, LGBTQ+, and BIPOC people². This means that for many people, articulating this pain to a provider may not have been met with attention and care. They may have been dismissed entirely.

When our pain is dismissed by those around us, we might learn to dismiss it ourselves. When others take away the power of our language, when they don’t hear our pain, we might learn to stop using that language even when speaking to ourselves. Without the words to describe it and without the space to tell others how we feel, we can lose our voice.

A Pathway

Although it may feel daunting to approach this type of pain, a powerful step forward is validating how challenging it can be to live with it and articulate just how much of life it can impact. Finding words to describe this pain to ourselves first can facilitate future communication with others.

By giving ourselves the space to take our pain seriously, we are allowing room for options within sexual relationships to exist.

By listening to your body and affirming your own experiences, you gain the power to find the best treatment for you, to find collaborators, and to know that you are not alone, and that you don’t have to be silent.