Women should enjoy sex. And while we wish this went without saying, it doesn’t. 75% of women will experience painful intercourse at some point in their lifetime, and 7% to 22% of women experience pain during every encounter. These statistics don’t account for those of us who feel numb, uncomfortable, or just unfulfilled during sex.
Sometimes, our pain or lack of pleasure from sex warps into a belief that there’s something wrong with us—there isn’t. What’s wrong is how badly we’ve been educated about our own sexual health and the agency that we have over it. But adjustments to your body care, nutrition, and mindsets, as well as educating your partner, can build your sexual confidence and create the best conditions for you to experience pleasure.
Arousal and desire aren’t the same thing
The whole “arousal, plateau, orgasm, resolution” model of sex you probably learned in health class is just that—a model that doesn’t account for the huge array of sexual variables and patterns that both women and men can experience. When this model fails to describe our own sexual life, we tend to instead think that we’ve failed to behave in a healthy way—and that’s when we (wrongly) begin to label our sexual patterns as “dysfunctional”. Differentiating between arousal and desire is an important first step in reclaiming your sexual health.
Arousal is a set of body processes that occur in response to a sexual prompt, whether or not you actually find that prompt appealing. This usually involves lubrication and increased blood flow to the genitals (which you may or may not notice).
Contrary to popular belief, for many women desire actually doesn’t set in until after arousal, if she does, in fact, find a sexual situation appealing. It indicates wanting sex (getting turned on) rather than only being physically prepared for it. In other words, your body (lubrication, blood flow) and your mind (anticipation, excitement) need to be in agreement for you to enjoy sex. When they aren’t, sex can be painful or tedious.
Researchers call this mismatch of body and mind states, non-concordance, and it’s normal and common, especially in women. In fact, a woman’s genital response rarely reflects whether or not she’s turned on—her body and mind may only be aligned as little as 10% of the time. That means that the other 90% of the time you may be lubricated without being turned on, turned on without being lubricated, or interested in initiating sex for emotional reasons but unable to feel stimulated.
Don’t power through painful sex
Painful intercourse (a.k.a. dyspareunia [dis-puh-ROO-nee-ah] ) can happen if your body isn’t sufficiently aroused or lubricated, or if you feel low on desire. One of the problems with powering through painful sex for your partner’s sake is that it trains your mind and body to anticipate pain with penetration. This can cause the muscles in your pelvic floor to tense involuntarily, leading to more pain and more tension.
This feedback loop is a form of pelvic floor dysfunction (PFD) that can lead to vaginismus, the painful tightening or spasm of the vaginal wall muscles. When pelvic floor dysfunction irritates nerves, women may also develop vulvodynia, a chronic sharp or stinging pain in the vulva without any apparent underlying disease. Vulvodynia can also begin in response to infection, injury, or vaginal atrophy—tissue thinning and inflammation due to low estrogen from menopause or hormonal birth control.
Pelvic floor physical therapy is an excellent option if you frequently experience painful sex, despite feeling turned on, or if you have chronic vulvar or vaginal pain. Pelvic floor physical therapists can help you retrain your muscles and calm your pain responses, as well as teach you exercises to maintain pelvic floor health. Find a pelvic floor physical therapist near you with this directory.
If you want to want more sex
Many people have what researchers call a responsive desire pattern, meaning they don’t often get turned on out of the blue. If you’re not in the mood as often as you’d like and want to initiate more or feel more receptive to a partner, you can learn how to trigger responsive desire.
Since desire often comes after arousal in women, you can start by looking at erotic images, or reading erotic books to encourage your body to get aroused. These activities may lead to a desire to have sex on their own, but if they don’t consider adding in a partner to engage in low-pressure, non-sexual touching of your choosing.
Take your time to figure out what sequence of images, thoughts, or touch arouses you and turns on your mind. Once you have that information, use it. There’s nothing wrong with relying on a prompt or two to get you started.
Having trouble getting aroused?
Any rigorous exercise can be incredibly effective in boosting your arousal, including for women on prescription antidepressants, or who have had hysterectomies. One study found that yoga can improve arousal, lubrication, desire, and orgasm in women, with women over 45 showing the most marked improvements.
Herbs like Tribulus terrestris and ginseng professionally blended with supporting herbs can also help. One small 2014 study found that an extract of Tribulus terrestris improved women’s arousal, lubrication, and satisfaction, and ginseng is a staple of Chinese Medicine that may enhance women’s libido.
If you struggle with vaginal dryness, look for herbal blends that capitalize on phytoestrogens like licorice root. And while there isn’t enough evidence or product testing to recommend topical royal jelly, research shows that it may also have estrogen-like effects and could be a promising alternative to synthetic hormones. One study found that when diluted in a lubricant base, royal jelly was more effective than topical estrogen cream or vaginal moisturizer in treating sexual problems in menopausal women.
Aroused but not turned on?
If you can get aroused but not turned on (i.e. your body is ready but you feel no desire), it’s worth examining the overall context of your life. Are you sleeping enough? Stressed at work? Feeling distant from your partner, or your body? All of these life factors can disrupt your ability to feel desire. Try making a list of what might be inhibiting you, then pick two or three that you can influence, like improving your sleep hygiene or spending quality time with a partner.
Mindfulness practices can also help boost your desire. One 2016 study found that mindfulness-based sex therapy improved alignment between genital response and feelings of desire, and another 2018 study concluded that women who meditated reported better sexual function and desire than non-meditators. If you’re new to meditation, try a free guided podcast for just five minutes a day.
Let go of “should”
From a young age, women are bombarded with media that shape our idea of what a healthy sexual relationship with our partners and ourselves should look like. We’re supposed to be spontaneous and enthusiastic and accommodating; we’re supposed to be pleasing at the expense of feeling pleasure.
It takes effort and time to break free of these thought patterns. Try writing out what your ideal sex life will look and feel like along with a list of turn-ons, which can help you become aware of your needs and communicate them to your partner. It can also help you develop a definition of sexual wellness that reflects who and how you are right now, rather than how you think you should be.
If you aren’t seeing improvement with your new self-care practices and remedies, don’t hesitate to reach out to your health care provider. Your pleasure matters, and the right gynecologists and physical and sex therapists can help you navigate the disconnections between your mind and body.