Understanding arousal

When you are aroused, chemical messages and hormones are sent around your body which allow physical changes to take place such as: 

• your heart rate and blood pressure increase
• blood flows to your genitals
• your muscles tense
• your heart beats faster
• your breathing becomes faster and deeper

Increased blood flow means your clitoris becomes bigger and more sensitive to touch, although you still might not be able to see it under its hood. Your labia swell, and you might notice that you start to get wet as your vaginal walls produce lubrication. The vagina expands in size and the uterus lifts up, which lengthens the vagina.

The image below shows some of these physical changes: 
 

These physical changes prepare your body for sexual contact, and can make touch feel more comfortable and enjoyable. It is important that you give your body time to respond during the arousal process so that you don’t feel any discomfort during a sexual experience. It is also important that you feel confident talking about this with your sexual partners so they can understand and respond to your feedback about how turned on you feel. 

If anything gets in the way of the arousal process, then these physical changes may not happen and your body won't be prepared for sex. This can increase the likelihood and severity of vulval pain during sex.

The impact of anxiety on arousal

The arousal process is controlled by a part of the nervous system called the parasympathetic nervous system (PNS), which is an involuntary, or automatic, system that is active when our mind and body is in ‘calm’ mode. 

There is another system in the body, called the sympathetic nervous system (SNS), which works in opposition to the PNS - when one is in control, the other closes down. The SNS controls the brain and body when we feel stressed, anxious, or in danger (in ‘stress’ mode). This is sometimes called the ‘fight or flight response’. 
When the flight or fight response is activated, it sends blood to the muscles we need to run or fight (for example, our arms and legs) and shuts down all non-essential functions that we wouldn’t need if we were in danger, including the arousal system. 

The diagram below demonstrates the impact these two systems have on the body:

The fight or flight response can kick in for both real or perceived/imagined threats, meaning that worrying about something is enough to trigger these physical changes in our bodies. As shown in the diagrams, the body has to be relaxed (or in ‘calm’ mode) in order to become sexually aroused. When you’re anxious or worried (whether about being in a sexual situation or about anything else), your body switches into ‘stress’ mode which pauses the arousal system. This can increase the likelihood and severity of vulval pain during sex.