The impact of sexual problems on a relationship can be significant. Painful sex (dyspareunia), problems with libido, physical changes such as menopause can all impact on your sex life and your relationship. 

Consider having an open discussion with your partner and/or a health professional about how you feel. If you’ve been avoiding sex this can be especially difficult. But if you do find support, it can build intimacy and help you to manage your sexual relationship more honestly. The good news is there are strategies to help you.

Relationships and painful sex

Feeling stressed, self-conscious about your body, depressed or anxious about intimacy can make sex uncomfortable, and even painful.

Sometimes dyspareunia (painful sex) begins as a physical problem, but then has a flow-on effect to your psychological wellbeing and relationships, causing stress and anxiety.

A vicious cycle can develop where past experiences of painful sex cause anticipatory fear of more pain. This fear creates stress, tension and reduces libido and arousal and as a result, sex becomes painful. For some women their past experiences may include sexual or emotional abuse, which can a be a trigger for experiencing painful sex, even in good relationships with an understanding partner.

There are many ways two people can be sexual, or sensual, with each other that do not involve vaginal penetrative sex. Think of all the things you did before you had sex for the first time. We sometimes call this ‘outercourse’, and refers to kissing, hugging, fondling, touching etc.

Treatment

The right treatment depends on the cause of the pain, but almost all treatment options will include a combination of individual and couples sexual and relationship counselling. If you are in a relationship, encourage your partner to be involved in your treatment, particularly the counselling sessions.

Women and their partners often experience feelings of rejection, confusion, helplessness and frustration and the sooner these feelings are discussed the better the outcome for all concerned.

It can also help if both partners read relevant books and seek out other resources together. It’s okay (and a good idea!) to have some fun with sexual exploration. Sometimes couples get into a ‘routine’ for sex that’s no longer working for one or both partners. Self-help books can be easily bought over the internet, so there’s no need to be shy.

Relationships and libido

It is quite common for women to experience a decline in spontaneous sexual desire with age, or when you have been in a long-term relationship (hello marriage!).

Chronic low libido can sneak up on you. Initially, you may feel like it’s just another dip in your sexual interest and manage it the way you have in the past; explaining it away as a normal response to the stresses of life. But, if low libido has been happening for a long time and it is distressing, or causing relationship disharmony, you should examine your real reasons for not wanting to have sex. Is it about short-term or recent events, or is it beginning to look like a way of life? Is it a way of life you want or is it distressing you? How does it impact on your partner?

For couples, differences in sexual desire can create significant problems. A pattern of avoidance and resentment can build up especially if sex is initiated by one partner and refused by the other over and over again. The partner with lower libido may feel bothered by sexual overtures and the partner with higher libido may feel frustrated, rejected and unloved. Some couples stop being affectionate and loving with each other and negative feelings become more and more overwhelming. These difficult feelings, if not talked through, can impact negatively on the relationship.

What can you do about desire discrepancy?

Solving the problem of desire difference in a relationship can be challenging. There is no magic wand (or pill, potion or cream) that will create sexual desire. And it’s not about just having sex whenever your partner wants.

Good sex can give a well-grounded relationship a really positive boost, but it won’t solve serious relationship problems. Relationship counselling might be an important first step in building trust and communication before working on a sexual problem. More complicated personal reasons can also underlie low libido, so seek counselling if you think this is the case.

Stress

Stress is part of life. It may be related to day-to-day ‘busyness’ with too much to do, and never enough time. Or it may be a more serious and recent event such as job loss, illness or death of a loved one.

It is not always reasonable for some people to feel like having sex around the time of serious stress. But if normal day-to-day stress is getting on top of you, it’s probably worth considering some strategies that might help you get on top of it.

Think about the sort of things that make you feel tense or stressed and not sexual. Can you make a decision to give yourself some time each day where you will make the effort to relax and not focus on the stressful things?

Letting go of stress may not be easy, but if you can find a way to relax, it may give you the energy and the focus you need to enjoy life and maybe sex as well.

Pain during sex

Physical pain is a good reason not to desire sex.If you anticipate pain during sex, you will be anxious and this will reduce libido and arousal. Talk about the pain with your partner so they know how you are feeling.

You should not experience pain during sex so don’t ignore it if you do. 

Talk with your partner

Frightening as it can seem, consider having an open discussion with your partner about how you feel. If you’ve been avoiding sex this can be especially difficult. But if you do it well, it will build intimacy and help you to manage your sexual relationship more honestly.

The aim of this is not to have you swinging from the chandelier every night of the week. It’s to enhance honesty, intimacy, fun and pleasure in your relationship and hopefully help you manage differences in sexual desire instead of using excuses to avoid the issue.

It’s also not to encourage you to have sex when you don’t want to. Use it as a pathway to understanding each other and finding a middle ground that is more satisfying to both of you.

Don’t forget that it will take ongoing commitment and revisiting the discussion to keep it working in the long-term. And if you get stuck, talk to a trained sex therapist.

For more information visit www.jeanhailes.org.au/health-a-z/sex-sexual-health

Published with the permission of Jean Hailes for Women’s Health.

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