Pain During Intercourse: Common Concerns for Women - Obstetrics and Gynecology

Dr. Chen Fuhao reply Obstetrics and Gynecology

---

Sexual dysfunction, specifically sexual aversion or lack of sexual response in women during sexual activity, is a complex issue.
The true prevalence of sexual aversion among women remains a mystery, as many may feel too embarrassed to speak about it.
However, medical professionals believe that experiencing a lack of sexual response occasionally is common among women, while long-term sexual aversion that requires psychological intervention is less frequent.
The causes of sexual aversion can be categorized into physical and psychological factors.

Physical issues such as a thick or overly resilient hymen can lead to painful intercourse, preventing women from experiencing orgasm.
Additionally, certain medical conditions affecting the genitalia, such as incomplete hymenal closure, inflammation, or tumors, can also result in painful intercourse and sexual aversion.
Fortunately, accurate diagnosis can lead to effective treatment.

Research indicates that psychological factors account for the majority of sexual aversion cases.
Among 100 women experiencing sexual aversion, over 80 are believed to have psychological issues at the root.
Interviews with these women often reveal past traumas or psychological conflicts during their development.
Understanding a woman's early life experiences, sexual history, and her attitudes towards her partner and pregnancy can be crucial in addressing sexual aversion.
Sexual psychologists have noted that many women with orgasmic disorders often come from backgrounds lacking warmth and affection.
Women raised in broken or dysfunctional families may struggle with self-confidence and have a tendency to be suspicious, which can negatively impact their sexual responses.
Premarital sexual aversion is not uncommon, influenced by societal moral standards, fear of pregnancy, concerns about sexually transmitted infections, and feelings of guilt associated with engaging in sexual activity.
Interestingly, many women are aware that premarital sexual activity is not socially endorsed, yet they succumb to sexual temptation.
Consequently, their subconscious may delegate the final decision to their vagina, leading them to engage in trendy sexual behaviors without experiencing orgasm or pleasure.
The absence of pleasure may reduce feelings of guilt.

Theoretically, the moment of sexual union between partners should be the most euphoric and beautiful experience.
However, sexual activity is a complex "mechanism" that requires both partners to be psychologically and physically in optimal condition to achieve perfect harmony.
Unfortunately, many couples do not experience this seamless connection, which is not something that can be achieved overnight.
It is rare for women to fully enjoy orgasm on their wedding night, especially if their partners are overly aggressive, which can lead to unpleasant experiences and misconceptions about sex.
The dissemination of accurate sexual knowledge is the best strategy to combat sexual issues, including sexual aversion.
Promoting proper sexual education can serve as an effective remedy.
However, discussions about sexual education often face backlash from moral guardians.
In reality, accurate and appropriate sexual knowledge does not lead to promiscuity; rather, it can resolve many sexual issues, including sexual aversion.

Sexual education can begin as early as preschool age (around four or five years old), but discussing the anatomy and function of the clitoris with young children is impractical.
Similarly, explaining sexual responses to seven or eight-year-old girls may confuse them.
Therefore, sexual education must be age-appropriate and timely.
Women must have a thorough understanding of their own anatomy and physiology.
Recognizing the differences in sexual responses between genders can lead to a more harmonious sexual life, reducing instances where a husband feels satisfied while a wife does not.
Emotional education is a key factor in addressing sexual aversion.
Emotional communication between sexual partners is another important aspect of sexual activity.
Pleasure is not the sole purpose of sexual intercourse.
If human sexual behavior were solely for immediate gratification, masturbation would be a more efficient sexual practice—clean, economical, time-saving, and convenient, without the risk of pregnancy or sexually transmitted infections.

If human sexuality were merely for procreation, then scientists could replicate this function through artificial means.
Freud's notion that human sexual relations are on the verge of regression is questionable.
With proper emotional education, sexual relationships can thrive and sexual aversion can diminish.
A spiritually and emotionally grounded sexual relationship is inherently filled with love; how could a loving relationship lead to sexual aversion?
In modern industrial societies, people lead busy and stressful lives, often experiencing mental and physical fatigue.
In such circumstances, how can one find the tranquility to enjoy sexual pleasure? Therefore, maintaining mental peace and health, along with cultivating a relaxed attitude toward life, is essential for pursuing a fulfilling sexual life.
The causes of painful intercourse are similar to those of sexual aversion.
Physical abnormalities, trauma, inflammation, tumors, or hormonal deficiencies in postmenopausal women can all contribute to physiological issues.
However, like sexual aversion, over 80% of cases of painful intercourse are also attributed to psychological factors.
Anxiety or fear can lead to vaginal spasms, making penetration difficult and painful for women.

Many women experience painful intercourse due to dissatisfaction with their partners.
Unpleasant childhood experiences, lack of warmth in family life, or exposure to male violence can lead women to harbor resentment or fear towards men, which may manifest in painful sexual encounters.
A woman who has undergone psychological treatment shared, "I really love my husband.
But what can I do? Whenever he wants to engage in intimacy, I remember the ugly man's face who violently took my virginity when I was just sixteen.
I only feel heart-wrenching pain and cannot experience the boundless pleasure described in books."
Her husband is unjustly accused; his character and appearance are worlds apart from that ugly man, yet they share one commonality—they are both men, possessing an aggressive instrument that once deeply hurt her emotionally, causing her physical pain.

Women may experience slight discomfort during their first sexual encounter when the hymen is broken and the vagina is stretched.
However, in a mutually affectionate context, this mild pain is often negligible and can even carry a sense of comfort and pleasure.
Women suffering from painful intercourse should seek help from a gynecologist early on.
Medications, hormonal treatments, or surgical interventions can address underlying genital issues.
With medical assistance, women can also resolve their emotional burdens.

Do not let past shadows overshadow your present.
If you are willing, you can overcome past discomfort and enjoy a fulfilling sexual life like anyone else.
The term "painful bed partner" in Greek describes painful intercourse; you need not be this "painful bed partner" now or in the future—provided you are determined to overcome it.

---

Reply Date: 2003/03/11