Making love is an experience between two people which should bring intimacy on both a physical and emotional level.

But many women suffer with pain during or after sex and are too embarrassed to seek help.

The pain robs them of the pleasure that both parties are meant to experience while love making.

The taboo around speaking about pain during sex prevents many women from even the knowledge of how to get help.

If this is you, it may help to know that you are not alone.

Three out of four women experience sexual pain at least once in their lifetime, according to the American College of Obstetrics and Gynaecology.

While the problem may be common it should not be ignored or endured.

Causes for painful sex are multi-faceted and can be affected by physical, emotional and social factors. A few reasons why sex may be painful are:

• Vaginal dryness: common in menopause, after childbirth and during breastfeeding.
• Gynaecological problems such as endometriosis, ovarian cysts, pelvic organ prolapse, pelvic inflammatory disease and vaginismus.
• Medication: some medications can reduce sexual desire. Please consult your doctor.
• Pelvic floor muscle tightness: as a result of stress, pregnancy or birth trauma (episiotomy or a tear) and poor posture.
• Trauma to the pelvis: an injury or fall, traumatic delivery of a baby via natural or Caesarian section, surgery or abuse.
• Infections: bladder infections, uterine or vaginal infections, STDs and thrush.
• State of mind: stress, anxiety and fear.
• Relationship issues.

Pain disturbs the sexual cycle of desire/arousal and sexual response: When the body anticipates pain it causes the unconscious tightening of the vaginal muscles, which in itself makes sex painful. This pain reinforces the body’s reflex response causing it to happen more. This may lead to the avoidance of intimacy and reduced desire.

What can you do?

Should you experience frequent or severe pain during or after sex consult a healthcare professional (GP, gynaecologist, a women’s or pelvic health physiotherapist or psychologist).

A few tips that can help:

• Use a lubricant. Water-soluble lubricants are a good choice if you experience vaginal irritation or sensitivity. Silicone-based lubricants last longer and tend to be more slippery than water-soluble lubricants. Do not use Vaseline, baby oil, or mineral oil with condoms as these can dissolve the latex and cause the condom to break.
• Make time for sex. Set aside a time when neither you nor your partner is tired or anxious. Take it slow!
• Talk to your partner.
• Try sexual activities that do not cause pain.
• Try sensual, nonsexual activities such as massage.
• Take pain-relieving steps before sex: empty your bladder, take a warm bath, or take an over-the-counter pain reliever.
• To relieve burning after intercourse, apply ice wrapped in a small towel to the perineal area.

Salt Rock resident Tarryn Graham has a BSc in Physiotherapy from Stellenbosch University, and has a special interest in and further training in women’s health physiotherapy. She has 10 years’ experience in women’s health and pelvic floor physiotherapy.