‘It feels like someone is ripping your insides open.’ The side of sex no one talks about.

Behind bedroom doors, there’s a private battle going on. One so private, that many women aren’t even telling their partners about it, let alone seeking much-needed medical attention. Instead, they’re determined to literally grin and bear it. 

“It’s something I can ‘tough out’ for a few minutes a week.”

“I can sort of ignore it enough to be bearable.” 

“It’s hard to ask him to stop when it hurts so I don’t say anything and then cry in private afterwards because I don’t want him to feel bad.” 

“I need alcohol each time to try to relax.”

“My husband doesn’t know that making our second baby was some of the most painful sex we’ve ever had.”

But while they may try to hide it, for the one in five women who suffer from pain during or after sex — called dyspareunia — the experience is very real. 

So, in an attempt to paint an honest picture of what women are really going through in the bedroom and break taboos around it, we asked the Mamamia community to talk to us, anonymously, about what their sex lives are really like. 

And the results of our survey are truly heartbreaking. 

Decades of suffering in silence.

More than a hundred women who’d experienced pain during sex responded to our poll. 

Of those, 48 per cent were in their 30s, 38 per cent were between 40 and 69, and the remaining 14 per cent were in their 20s. But Laura Hill, a Sydney-based women’s health physio, believes the younger population may be severely under-reported.

“I think there is definitely a chunk missing in that younger demographic,” she told Mamamia, “which could be because they’re not comfortable in answering questions about it.”

And it is this — this discomfort and feelings of “shame, frustration and embarrassment” — that is stopping a lot of women from speaking up, and leaving them suffering in silence for decades. Because for many of those we spoke to, they’ve been in agony since puberty.

“I’ve been in pain since I was a teenager and tried to use tampons and nearly passed out.”

“It started in my 20s and I never sought treatment until my marriage ended at 39.”

“The pain has been there for as long as I can remember.”

View this post on Instagram

A post shared by Laura Hill (@physiohilly)

Beyond feeling uncomfortable, Laura said another reason why so many women don’t talk about it is that they might not know any different. “They think that’s just what sex is,” she said. 

And the Mamamia survey proved that. Of those who responded, almost four in 10 had never sought help.

“I’ve had pain every time since losing my virginity. I thought it was normal.”

“I didn’t ever seek treatment because I just thought it was a result of deeper penetration.”

“I’d experienced the pain since becoming sexually active at around 19. I didn’t realise there was a specific reason for the pain until I needed to seek treatment for extremely heavy bleeding when I was 41.”

Doctors who don’t listen.

While for the women who do speak up and attempt to get help, they’re often met with brick walls by their GP.

“I’ve always had painful sex but was told it was normal.”

“I had pain for 12 years and was often dismissed by doctors.”

“I was about 19 when I first experienced pain during sex. My doctor told me it was most likely a sexually transmitted infection (STI) and tested for everything. When it came back negative, I felt like they just brushed me off, like I would have to deal with it.” 

Beyond being let down by doctors, Laura said some women just “get lost in the pipeline”.

Listen to Chantelle Otten discuss the one part of sex we don't talk about enough. Post continues after podcast.

“They might get tested for an STI and thrush and if these results come back normal, they’re like, ‘Oh, well, everything’s okay’,” she explained. 

“Well, actually, it’s not, they’re still in pain. Yes, they don’t have an infection, but clearly that’s not the issue. And that connection of, ‘this might be muscular or this might be coming from somewhere else and you need to see this person to help with that’, is sometimes a little bit hard.” 

But as for doctors who tell women to “just have a glass of wine and relax”, sadly, that’s still happening.

“Don't get me wrong, relaxation is usually an important part in treating pain but it's not as simple as having a glass of wine and you'll be fine,” the physio said, “otherwise women wouldn't be presenting to us.”

“It’s so painful, she sees stars.”

From the 100 women who filled in Mamamia’s survey, more than 82 per cent said they were currently experiencing pain during sex and 53 per cent said it had happened, or was still happening, every single time they had intercourse.

While 71 per cent said they felt that pain internally (in the cervix, uterus or lower abdomen) almost 25 per cent said the pain was external (in the labia or opening to the vagina). But as for exactly what the pain felt like, it was different for every woman. 

“It felt like my cervix was being stabbed.” 

“The pain can vary from feeling like someone is ripping your insides open to uncomfortable pain.”

“It felt like a stabbing/dryness pain no matter how much lube we used.”

“The pain is deep, like a pulled muscle being triggered.”

“It feels like a sharp, sort of burning pain all the way from the vulva, up inside the vagina. I’d call it an 8/10 at its peak. It hurts more as the penis goes in.”

“It feels like getting punched in my lower abdomen.” 

“I would feel sore internally for about a day afterwards.”

Laura explained that the pain feels different depending on where it is located. 

“Deep pain is sometimes described as a deep thudding, like the penis is hitting a brick wall and it can’t go anywhere,” she told Mamamia. “While entry pain is often described as a burning sensation, or like there’s not enough space or it’s too tight, or some people feel an intense pressure. 

“I’ve had one patient describe a certain spot where it's so painful that she sees stars.” 

What causes painful sex?

Just like the multitude of descriptions for how the pain feels, the Mamamia survey revealed a countless number of reasons why some women experience pain during sex. 

Because while three in 10 are still in the dark about what causes their agony, almost 70 per cent know why. Of those, almost 19 per cent say it’s due to endometriosis (a disease in which tissue similar to the lining of the uterus grows elsewhere in the body) and 18 per cent say it’s a result of vaginismus (when the muscles around the vagina tighten involuntarily).

While nearly nine per cent said it was because of another medical condition.

“It’s related to endometriosis and goes after the removal of the endometrial tissue, however it returns within 12 months.” 

“It turned out that I had adenomyosis [when endometrial tissue grows into the muscular wall of the uterus] and I ended up having a hysterectomy.”

“The doctors suspect that it’s vaginismus or vulvodynia [a chronic pain in the vulva without any identifiable cause] but I also suffer from endometriosis and anxiety.”

Watch: What is vaginismus? Post continues after video.

While many said their pain started after childbirth — even when they’d had a caesarean section — others cited that it was psychological, which can cause them to “tense up before sex which makes the pain even worse”. 

Laura added that the wide variety of reasons for painful sex also included skin conditions, thrush, STIs, urinary tract infections, scar tissue from episiotomies or vaginal tears and menopause which — due to the lack of oestrogen — can reduce lubrication in the area and cause discomfort.

“Our sex life has completely diminished.”

What is sadly not a surprise, almost eight in 10 women who responded to the survey said that pain during sex had affected their relationship with their partner. 

“From someone who loved having sex with my husband and was able to be turned on easily, I now have zero sex drive, no natural lubrication and penetration hurts. I feel so guilty even though my husband has been great. I really miss being intimate but I can’t enjoy it when I’m grimacing.”

“Our sex life has completely diminished.”

“I don’t talk to my husband about it as it’s too embarrassing, so we just avoid it altogether.”

“This has been going on for several years now and the anxiety around having sex means it doesn’t happen because I’m afraid of the pain.”

“In 15 years of marriage, I’ve probably had sex a dozen times and not enjoyed it one bit.”

Pain during sex also impacts the relationship women have with themselves. 

“I have vulvodynia and was always made to feel like I was a freak and this was very uncommon.”

“I blamed myself for not trying hard enough to relax and enjoy sex.”

How can a physio help? 

For women who experience pain during sex, Laura insisted that there is light at the end of the tunnel — and she desperately wants them to feel heard and understood. 

“When you come to see a women's health physio, we will sit you down and have a really good chat to try to understand your story,” she said. 

“We want to know when the pain started or whether sex has always been painful, and if there are any triggers or potential underlying causes in your body. So we would ask about your menstrual cycle, whether you might have a condition like endometriosis, whether you’re on any medications and what exercise you do, because they can all contribute to what might be happening.” 

Laura said she would then look at the body as a whole, including the abdominal wall, and how women move, before conducting a pelvic floor assessment — which is an internal exam. 

View this post on Instagram

A post shared by Laura Hill (@physiohilly)

“So we will go through and assess the deep pelvic floor muscles in how well they can contract and relax, before assessing each little part of the muscle, looking for trigger points,” she said.

“That starts to give us a little bit of an indication of where their pain might be coming from and what's going on in these muscles, and then usually I will try some pelvic floor release and try to work on pelvic floor relaxation.”

With there being so many potential reasons for pain during or after sex, the process to diagnosis can be long and difficult — both mentally and physically — but no matter the result, it’s crucial to understand that there are treatments available. 

“The main thing is just knowing that it’s not normal,” Laura said, “and that there is something that can be done about it.” 

Image: Getty + Mamamia.