Ask a Prof: Why is painful sex more common in younger women?

Sometimes sex hurts, but often people don’t talk about it.

A recently-released British study found that one in 10 women find sex consistently painful. For women between ages 16 and 24, the rates are even higher. To find out more about how sex can hurt, we sat down with Dr. Jonathan Tankel, and obstetrician/gynaecologist at the University Health Centre. The majority of Dr. Tankel’s patients are students. Treating dyspareunia, also known as painful sex, is a large part of his practice. For anyone experiencing painful sex, Dr. Tankel recommends seeing a healthcare provider, and also suggests reading When Sex Hurts by Andrew Goldstein — a book “for a non-medical audience.”

 

The Gateway: What is the biological basis for why women might find sex painful? 

Dr. Jonathan Tankel: There’s two types of painful intercourse you can have — superficial pain and deep pain. The deep pain can be due to a number of biological reasons, such as position of the uterus, or a condition called endometriosis. The superficial pain is much more common, and it’s a lot more complicated. The most common cause in the patient population that I see on campus is provoked localized pain. There can be increased sensitivity, but we don’t necessarily know why.

Pain becomes more complicated because psychological factors affect it as well. The interplay is difficult; when people are having painful sex that will lead to less enjoyment, that will lead to dryness, that will lead to more pain, that will lead to relationship problems which will exasperate the pain.

Why is this more common in younger women?  

We don’t know why this is more common in younger women. I do think that’s true, and certainly here on campus it’s a big part of the work that I do.  A lot of people will have pain initially, and a lot of people don’t seek help, because it’s not talked about. The risk of stress and mental health issues is high in the younger age group — people are often sort of starting out their lives, they’re starting out their careers, they’re studying; that stress could be a factor as well.

What do you recommend for women who are experiencing dyspareunia?

I recommend that people see their healthcare provider. People need to know that painful intercourse is not normal. A lot of people won’t seek help because of negative experiences with treatment. This is not a well-known condition; the average person sees five physicians before a diagnosis is made, and only 1.4 per cent of people are actually given a diagnosis. I think it’s really important that patients get the care that they need, meaning that they are treated respectfully, they get a proper diagnosis, and they get a treatment plan. With a lot of forms of dyspareunia there isn’t a magic cure. It’s a work in progress. Go to your primary care physician, if you’ve got access to a gynecologist, see a gynecologist. They need to get help, and here on campus it’s pretty easy.