Sex, intercourse and intimacy is a normal part of our wellbeing. Pain during sex, also known as dyspareunia, is more common than many people realise. However, just because it is common doesn’t mean it is normal.
As a Pelvic Health Physiotherapist, I want to break the silence and taboo around this issue and reassure you that help is available. If you experience pain with intimacy, you are not alone, and there are solutions to help you enjoy a pain-free, fulfilling sex life.
What Causes Pain During Sex?
Pain during sex can stem from various physical, emotional, and psychological factors. Some of the most common causes include:
- Pelvic Floor Dysfunction – Overactive or highly engaged pelvic floor muscles can cause discomfort, burning, or sharp pain during penetration or in altering positions.
- Vaginismus – An involuntary spasm of the pelvic floor muscles, making penetration extremely painful or even impossible.
- Vulvodynia – Chronic vulvar pain, sensitivity or discomfort without an identifiable cause.
- Endometriosis – A condition where endometrial-like tissue grows outside the uterus, often causing deep pelvic pain during or after intercourse.
- Menopause and Hormonal Changes – Reduced oestrogen levels can lead to vaginal dryness and atrophied (thinning) tissues, increasing discomfort and micro tearing.
- Scar Tissue from Childbirth or Surgery – Episiotomies, C-sections, or pelvic surgeries can lead to scar tissue that can cause adhesions and pain.
- Urinary Tract or Yeast Infections – Infections can cause irritation and discomfort during intercourse.
- Emotional Factors – Stress, anxiety, past trauma, or relationship concerns can contribute to pain and tension in the pelvic floor muscles.
Why You Shouldn’t Ignore It
Pain during sex can impact more than just your physical comfort. It can lead to frustration, avoidance of intimacy, strain on relationships, and decreased overall well-being. Many people suffer in silence due to embarrassment or the mistaken belief that pain is just part of their experience. The truth is, pain is your body’s way of signaling that something isn’t right, and it deserves attention.
How Pelvic Health Physiotherapy Can Help
A pelvic health physiotherapist can assess your pelvic floor muscles, identify contributing factors, and develop a personalised treatment plan. Treatment may include:
- Pelvic Floor Relaxation Techniques: If overactive muscles are the issue, we work on strategies to release tension and improve mobility.
- Manual Therapy: Hands-on techniques to ease tightness, improve blood flow, and reduce discomfort, including the use of pelvic wands.
- Education and Awareness: Understanding how your body works and what triggers your pain – can empower you to make positive changes.
- Breathing and Mind-Body Techniques: Learning to connect with and control your pelvic floor can ease tension and improve comfort.
- Dilator or trainer therapy: Gradual desensitization using medical-grade dilators can help those experiencing vaginismus or significant pain with penetration.
- Lifestyle and Postural Advice – Simple adjustments can make a big difference in reducing strain on the pelvic floor.
- Collaboration with Other Health Professionals – Sometimes, addressing pain requires a team approach with GPs, gynaecologists, psychologists or sexologists.
You Deserve Pain-Free Intimacy
Pain during sex is never something you should “just put up with.” It’s not in your head, and it’s not something that should be ignored. At Gen Health, our compassionate pelvic health physiotherapist, Jess, is here to help you understand and address the root cause of your pain in a safe, inclusive and shame free way – so you can enjoy a healthy, comfortable, and fulfilling sex life.
Disclaimer: This information is general in nature and is not a substitute for personalised medical advice. Please consult a qualified health professional before starting a new exercise program.
