by Marta Milkowska
My name is Marta Milkowska and I am a graduate student at the Harvard Kennedy School of Government. I am working on a project aimed to better understand the problem of pain during sex – something experienced by many women. This summer, with support from Our Bodies Ourselves and the Harvard Kennedy School’s Women in Public Policy Program, I am seeking interviews with individuals who fall into one of the following three categories:
- Women ages 16 to 35 who experience pain during sex
- Women who have successfully reduced or eliminated pain during sex
- Physical therapists and medical clinicians (such as ob/gyns, family practice physicians, and internists) with experience diagnosing and treating pain during sex
If you are in one of these groups and are willing to take part in a 45 minute interview, please fill out this sign up form and I will contact you by email to set up an interview.
75% of women experience pain with sex
Although most women experiencing painful sex feel alone, the problem is sadly common. According to the American College of Obstetrics and Gynecology 75% of women experience pain with intercourse or penetration at some point in their lives. Chronic and persistent pain affects up to 22% of women. In fact, according to the NY Times, “pain with sex is up there in prevalence with migraine and low back pain, and yet it is woefully understudied and rarely discussed.” Many women told us they don’t discuss their pain with close friends and family or even with their sexual partners. They may be embarrassed and overwhelmed, or they may think that silence will somehow “protect” their partners. This silence understandably further exacerbates the emotional and psychological stress.
Depending on the root cause and severity of the pain, it may be addressed by measures such as adequate use of lubrication, better understanding of the sexual arousal process, more open communication with a partner, and/or simple relaxation home-based exercises or pelvic floor physical therapy.
The first step in the healing journey is to accept that the pain is not something women must learn to “tolerate,” and that sometimes there are solutions that can help. The second is to figure out, if possible, what is at the root of the problem. An excellent place to begin educating yourself is with texts like “Our Bodies, Ourselves.” The OBOS website includes articles on Pain During Intercourse or Penetration and Vulvodynia, as well as multiple articles on female anatomy. Many therapists suggest self-help protocols with low-risk and easy relaxation and stretching exercises. We will be building a compendium of those as we move forward in our research.
If a woman is experiencing conditions such as vaginismus, the pain sometimes can be successfully treated with physical therapy. (See this article by a SF-based physical therapist, Rachel Gelman). Many women have tried approaches that appear to pose minimal risk, and sometimes these approaches have offered significant relief, although a strong evidence-base is still lacking. Certified physical therapists who have had considerable success in helping women with pain during sex exist, but sadly, are still are not widely available, and absent in many countries. A comprehensive list of certified pelvic floor physical therapists does not seem to exist, but the Section on Women’s Health of the American Physical Therapy Association does offer some resources.
Regardless of the root cause, one of the key steps towards healing can begin with more open conversation. For example, we started monthly Women Sharing Circles – a safe space where women can come together to discuss their sexuality. If you would like to start a similar group, let me know.
If you, or any of your female friends are suffering from pain during sex, or have found treatments that alleviate their pain, I would like to talk to you whether or not you have already sought medical care and whether or not you already have received a diagnosis (for example, vaginismus or vulvodynia). Please sign up here, and I will be in touch with you soon. Thank you!