Types of Sexual Pain

性疼痛的分类

Vulvodynia

外阴痛

A chronic pain condition affecting the vulva, often without a clear cause. It may feel like burning, stinging, or irritation.

一种慢性外阴疼痛综合症，常常找不到明确原因。常见症状包括灼痛、刺痛或持续不适

Vaginismus

阴道痉挛

An involuntary tightening of the pelvic floor muscles during penetration, making insertion painful or nearly impossible.

插入时盆底肌肉不自主收缩，使插入变得疼痛甚至几乎不可能

Dyspareunia

性交疼痛

Pain during intercourse. It can affect both women and men and may occur at the entrance of the vagina or deeper in the pelvis.

性交过程中产生疼痛。男女都可能经历，疼痛可能发生在阴道口或骨盆深处

There are also cases caused by vaginal dryness, infection, or hormonal changes, which require medical assessment.

另外还有因阴道干燥、感染或荷尔蒙变化引起的疼痛，需要医学评估

DSM-5 Criteria

DSM-5诊断标准

Genito-Pelvic Pain/Penetration Disorder includes:

A. Persistent or recurrent difficulties such as:
Pain during vaginal penetration
Marked pain in the vulva, vagina, or pelvis
Fear or anxiety about penetration
Involuntary pelvic floor tightening

B. Symptoms lasting at least six months
C. Significant distress
D. Not better explained by other medical conditions

生殖盆腔疼痛/插入障碍包括：

A. 持续或反复出现以下问题：
插入时疼痛
外阴、阴道或盆腔明显疼痛
对插入产生恐惧或焦虑
盆底肌肉不自主收缩

B. 症状持续6个月以上
C. 造成显著困扰
D. 不能用其他疾病或药物解释

How Common Is Sexual Pain?

性疼痛的普遍率

Research suggests:

6.5%–45% of middle-aged women
14%–34% of younger women
5%–15% of men

研究显示：

6.5%–45%的中老年女性
14%–34%的年轻女性
5%–15%的男性

Yet only about 40% seek professional help. Of those, many are misdiagnosed or dismissed.

但只有约40%的人会寻求专业帮助，其中不少人被忽视或误诊

Therapies for Sexual Pain

性疼痛的治疗方法

• Psychoeducation
  心理性教育

• Cognitive Behavioural Therapy
  认知行为疗法

• Mindfulness-based therapy
  正念疗法

• Schema therapy
  图式疗法

• Sensate Focus
  感官聚焦练习

• Pelvic floor physiotherapy
  盆底肌物理治疗

Often, treatment works best when psychological and physical approaches are combined.

通常心理治疗与生理治疗结合效果更好

A Closer Look at Vaginismus

重点谈谈阴道痉挛

Vaginismus involves involuntary tightening of vaginal muscles during penetration.

阴道痉挛是在插入时阴道肌肉不自主收缩

Some people can use tampons but struggle with penile penetration. For others, any insertion feels impossible.

有些人可以使用卫生棉条，但阴茎插入却不行。也有人任何插入都非常困难

Imagine clenching your fist tightly and trying to push a finger through it. That gives you a sense of how impossible it can feel.

可以想象紧握拳头，再试图把手指插进去，那种紧绷和不可能感

Causes

原因

The symptoms are physical, but the roots are often psychological.

症状是身体的，但根源往往是心理的

• Past trauma
  创伤经历

• Fear or shame around sex
  对性的恐惧或羞耻

• Painful early experiences
  早期疼痛经历

It can be primary, meaning it has always been present, or secondary, meaning it developed later.

可以是原发性的，也可以是继发性的

Can It Be Treated?

可以治疗吗？

Yes.

可以

Gradual dilation using medical dilators is common.

渐进式扩张器训练是常见方法

Practising alone or with a supportive partner helps. Patience is essential.

可以单独练习，也可以和伴侣一起练习。耐心非常重要

More severe cases may involve botox injections or specialised pelvic physiotherapy.

严重情况可能需要肉毒杆菌注射或专业盆底治疗

Psychological therapy is strongly recommended alongside physical treatment.

心理治疗通常也是重要的一部分

The Impact on Life

对生活的影响

Some people struggle with tampons or pelvic exams.

有些人连使用卫生棉条或妇科检查都会困难

It affects relationships, intimacy, and self-esteem.

它会影响亲密关系和自我价值感

Sexual Pain Has Been Dismissed for Too Long

性疼痛长期被忽视

Some patients are told: “Relax.” “Have a drink.” “It’s just anxiety.”

有些人被告知：“放松一点。” “喝点酒。” “你想太多。”

Sex should not hurt.

性不应该疼痛

Your Pleasure Matters

你的快乐最重要

Some women are taught to prioritise pleasing their partner and ignore their own pain.

有些女性被教导要优先取悦伴侣，而忽视自己的痛苦

That belief is harmful.

这种观念是有害的

Your comfort and pleasure matter.

你的舒适和快乐同样重要

Don’t Ignore Pain

不要讳疾忌医

If you experience sexual pain, seek professional support.

如果你有性疼痛，请及时寻求专业帮助

You do not have to give up your sex life.

你不必因为疼痛而放弃性生活

Pain is not a requirement for intimacy.

疼痛，从来不是亲密关系的必要条件