Let’s talk about sex.
Many of us think about it, lots of us do it, yet, for some reason, discussing sex with your partner can feel daunting. Aside from not addressing any issues you and your partner might have, oftentimes avoiding the subject can create an unspoken wall between the two of you. Everyone has the right to a fulfilling and comfortable sex life, and to have good sex – and keep having good sex – you must be comfortable talking about it.
Talking about sex doesn’t come naturally to a lot of us, but for those who experience pelvic health conditions such as vaginismus, vulvodynia, and dyspareunia, the act of communicating your needs to your partner can take on an added layer of complexity. The conversation becomes about much more than which positions are your favourite, and what sexual fantasies you’d like to try. It's important to remember that there are many ways to ensure an exciting sex life even when dealing with the challenges of pelvic pain.
We understand that broaching this conversation can be difficult for you, and that’s why we’re here to help guide you through this journey towards meeting your sexual wants and regaining control over your body.
The Power of Talking
Treatment options for pelvic conditions will vary depending on your specific needs, however there are many solutions to choose from. Breathing techniques, pelvic floor down-training exercises and vaginal dilator therapy are just a few choices that can help you along your pelvic health journey. Nevertheless, whilst these are all fantastic paths to follow and engage with, it is imperative to never forget the importance of simply talking. After all, it can’t be that hard, right?
The truth is, talking about sex can be notoriously hard, so there’s no need to fret if you often find yourself stumbling over your words, frozen with a big lump in your throat or avoiding the conversation entirely. Research suggests that even in long-term relationships, people know only about 60% of what their partner likes sexually, and only about 25% of what they don’t like i.
Sex is often surrounded by cultural taboos and personal insecurities, making it difficult to discuss openly and transparently - and the fear of being judged by your partner can heighten this discomfort. Additionally, vaginismus, or other causes of painful sex, are a very private aspect of your health, which can make you feel vulnerable when discussing them.
That said, there are steps you can take to soften the conversation and reframe it as a positive step in not only bringing you and your partner closer, but also helping to establish and maintain what works for you in the bedroom whilst respecting your own boundaries. Discussing your needs and your condition is pivotal in overcoming any challenges you may be facing and gives your partner an opportunity to talk about how they feel as well.
Finding the words
It may be possible to temper the fear that often accompanies these conversations if you approach them sensitively. Here are some tips for communicating your needs to your partner:
Avoid ‘We need to talk’
When a partner says those ominous words “We need to talk” it’s a sure-fire way to trigger anxiety. We’ve all been there and know how horrible it can feel. So, one big step you can take in making these conversations more comfortable is to focus on solving the problem, not shining a spotlight on it with anxiety-inducing language.
Look for more inviting ways to broach the conversation. Phrases like “I know how difficult this is for us to talk about, but I really think we can tackle this together” or “I understand this conversation could be awkward, but I think if we brave it, we will become stronger”, can really aid in creating a safe space for you and your partner where you can positively discuss any problems.
Also, it’s a good idea to bring in some positives as well. Telling your partner what they do well can go a long way. No need to get too explicit if you don’t want to! Just a little nod to what you both do well can allow you to more easily discuss what you’d like to do in the future.
Embrace the awkwardness
Embracing the awkwardness of these conversations can actually be a game-changer! Picture this: you both acknowledge the elephant in the room, have a laugh about how weird and uncomfortable it feels, and then dive into the talk with a bit of humour and, most importantly, a lot of honesty.
By not taking yourselves too seriously, you create a safe and relaxed space where you can openly share your feelings and needs. More often than not, the thought of a conversation is far worse than the actual chat. This approach not only eases the tension but also strengthens your bond, showing that you can tackle even the most uncomfortable topics together. Awkwardness often stems from vulnerability, and so in accepting the awkward moments, you’re also accepting each other’s vulnerabilities and learning about one another on a deeper, more authentic level.
Be mindful of timing
Being thoughtful of your timing when discussing sensitive topics like painful sex is crucial, but it's equally important to recognise that this isn't a one-off conversation, it’s a malleable discussion. Just imagine trying to cram a delicate talk into a busy, stressful day—it just won't work and could result in an unnecessary argument!
It's sometimes best to choose a time when you are both relaxed and can give each other your full attention, like over a cozy weekend breakfast or during a quiet evening. By picking the right moment, you create a calm and supportive environment that invites openness.
Just as with intimacy, you don’t want to rush this talk, or you could miss out on all the important parts. This conversation is the start of an ongoing dialogue where you both learn to understand and support each other better. It's about building a greater connection and finding ways to make your intimate life more enjoyable.
How to start the conversation
Here’s a guide to help you introduce this topic with your partner. It’s important to remember that your partner will want to help you be as settled as possible. Feel free to adjust these segments to fit your personal style and relationship dynamic:
Broaching the subject:
“Hey [Partner’s Name], can we chat for a bit? There’s no need to worry, it’s nothing bad. I just want to talk about something important to me, and I think it could really benefit us in the future.”
Explaining the situation:
“So, you know how sometimes sex has been really painful for me? I’ve been trying to understand why, and I found out it’s because of a condition called vaginismus. Basically, it means my pelvic muscles tense up involuntarily, making penetration really painful or even impossible. I really value our intimacy, and I think discussing this openly can help us find ways to make our experiences more comfortable and enjoyable for both of us.”
Seeking support and looking forward:
“Thanks for understanding. First off, just knowing you’re supportive helps a lot. There are a few things we can try that might make things better for both of us. One thing that might help is spending more time on foreplay, really focusing on relaxing and enjoying each other without rushing.”
Communicating needs:
“Another thing is communication. If something hurts or feels uncomfortable, I’ll let you know right away. It’s not about you doing anything wrong; it's just my body reacting. And if something feels good, I'll let you know that too.”
Exploring alternatives:
“We can also explore other forms of intimacy that don’t involve penetration, like oral sex or using our hands. There are plenty of ways to be intimate that can be really satisfying for both of us.”
Closing the conversation:
“I really appreciate you taking the time to talk to me about this. It means a lot to me. We’ll figure this out together, and I’m hopeful that things will get better with time and patience. Thanks for being so understanding. I feel better already just talking about it with you.”
Understanding Pelvic Conditions: Vaginismus, Vulvodynia and Dyspareunia
If you experience pelvic pain, you are not alone. Painful sex is more common than you might think. The pain can result from infection or illness and can also be physical or psychological, but any kind of discomfort during penetrative intercourse or a vaginal examination means your body is telling you that something needs addressing. Vaginismus is an example of this – although recorded cases are usually low, doctors believe the issue is more common with about 1-6% of women worldwide living with the condition ii.
Vaginismus is described as the involuntary cramping, tensing or contracting of the pelvic floor muscles around the vagina iii. The muscle tightening is an automatic reaction from the body which stems from a stress response in relation to partial or full penetration. These contractions can become very painful and often happen before or during a clinical vaginal examination, when a partner attempts penetration, the insertion of a tampon, menstrual cup, sex toy or when the area near the vagina is touched. Common symptoms involve painful intercourse and sometimes the inability to have sex entirely, which can lead to additional symptoms including fear of vaginal penetration and decreased sexual desire iv.
Pain during sex, or dyspareunia, is persistent or recurring pain just before, during or after sex v. Pain can be felt externally in the vulvar region — to the labia (lips of the vagina) or at the opening to the vagina. Some feel the pain internally—in the cervix, uterus or lower abdomen. Other conditions such as dyspareunia, which has a different set of causes but can co-exist with vaginismus, mean identifying the issue isn’t always straightforward.
Vulvodynia is a type of long-term pain or discomfort around the vulva. The pain, burning or irritation linked with vulvodynia can make you so uncomfortable that sitting for a long time or having sex becomes unthinkable vi.
Whilst these conditions can seem intimidating at a first glance, there is plenty you can do to overcome challenges you are experiencing and regain comfort during sex. Taking the first steps to learn more about what you can do is a huge milestone in your journey of self-empowerment.
Conclusion
Talking to your partner about pelvic pain might seem intimidating, but it’s a crucial step towards a fulfilling sex life. By understanding your condition, communicating openly, and respecting each other’s needs, you can navigate this journey together. Remember, your pleasure and comfort matter, and with the right approach, you can achieve a loving and satisfying intimate relationship.
[i] Supplemental Material for Dimensions of Couples’ Sexual Communication, Relationship Satisfaction, and Sexual Satisfaction: A Meta-Analysis. (2021). Journal of Family Psychology. doi:https://doi.org/10.1037/fam0000946.supp.
[ii] Armstrong, C. (2011) ACOG guideline on sexual dysfunction in women, American Family Physician. Available at: https://www.aafp.org/pubs/afp/issues/2011/0915/p705.html (Accessed: May 13, 2024).
[iii] Siang, D.Y.W. (2022) How do I know if I have vaginismus?, DTAP Clinic. Available at: https://dtapclinic.com.my/how-do-i-know-if-i-have-vaginismus/ (Accessed: May 18, 2024).
[1v] Cleveland Clinic. (2020) Vaginismus: Dyspareunia, causes, symptoms, treatment. Available at: https://my.clevelandclinic.org/health/diseases/15723-vaginismus#symptoms-and-causes (Accessed: May 18, 2024).
[v] professional, C.C. medical, Dyspareunia (painful intercourse): Causes, diagnosis & treatment, Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse (Accessed: May 13 2023)
[vi] Vulvodynia (2023) Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423 (Accessed: May 13 2024).
