Why Is Sex Painful?


Sex should be fun, pleasurable and painless that you and your partner can enjoy with intimacy!

Sex should not be painful in any way… Just as it should be painless while performing eye and vision functions, sexual organs are expected to perform their healthy functions normally and painlessly. If you experience pain during sex, you may be wondering what is normal, what is not, and what can help.

Painful intercourse, also known as dyspareunia, is a common diagnosis with 18% of the world’s population suffering from these symptoms; however, this disorder is often neglected because of people who do not want to share these problems with their healthcare professionals or who do not know who to turn to when the problem arises. As such, people fail to get the help they need, potentially leading to mental health problems, relationship difficulties, and an overall poor quality of life. Fortunately, when properly diagnosed, dyspareunia can be managed and treated by a team that specializes in pelvic health.

First, let’s talk about what can cause your pain during sex, then we’ll talk about some ways to reduce your pain.

Why do I have pain during sex?

  • Increased pelvic floor muscle tension – your pelvic floor muscles are like any other muscle in your body and may be tense or have trouble relaxing during intercourse.

  • Vaginismus – Vaginismus is defined as muscle spasms in the outer third of the vagina or at the vaginal opening. You may feel that your partner is often “hit the wall” trying to enter the vagina, or you may feel like there is a wall.

  • Vaginal atrophy/drying/thinning – This is usually the result of hormonal changes from hormonal contraceptives during breastfeeding and/or menopause.

  • Vulvodynia is manifested as a discomfort in the vulva that persists for 3 months or more and causes unexplained burning, redness, itching.

  • Injuries from pregnancy and childbirth, such as perineal tear/scarring and cesarean section scarring can also cause scar tissue that causes pain. This can cause tension in your pelvic floor muscles.

  • Endometriosis, fibroids, ovarian cysts, cervical irritation can cause painful intercourse.

  • Vulvar or vaginal infection such as lichen sclerosus, bacterial vaginosis, yeast infection can cause vaginal pain and irritation before, during and after sexual intercourse.

What can I do to relieve pain during sex?


Practice diaphragmatic breathing regularly every day and during sexual intercourse. For detailed breathing work, watch the “diaphragm and pelvic taaban” video on @pelvikoterapi instagram address!

Diaphragmatic breathing increases mobility in the pelvic floor and abdomen, providing blood flow and relaxation. Thus, it helps to calm the nervous system and reduce muscle protection.

How to do diaphragmatic breathing:

  • Put one hand on your chest and the other on your stomach and relax your chin and shoulders, protecting the long spine. If you find it difficult, start from lying on your back and as you progress, start sitting, standing and in any position.

  • Inhale slowly, gently, allowing your stomach to expand. With your breath, keep your abdomen and ribs moving evenly in all directions (as if you have a balloon in your stomach and inflate it 360 degrees in all directions). Then exhale slowly and let your belly slowly slide in. We do not want contractions in the abdomen during exhalation.

  1. USE Plenty of LUBRICANT!

  • Vaginal wetness is important to reduce friction, irritation and stiffness during intercourse. Self-wetting may decrease with decreased estrogen during breastfeeding, menopause, or the use of certain birth control methods.

  • However, not all lubricants have the same effect! Some of the ingredients we want to avoid in lubricants are: glycerin, nonoxynol-9, petroleum, propylene glycol, and chlorhexidine gluconate.

  • You can use water-based lubricants suitable for the pH of the vagina, or you can use natural coconut oil. Warning – oil and latex may not be a good match. For this reason, avoid using latex condoms if you are using oil-based lubricants, as they may tear.


Listed below are some stretches that help lengthen and relax the pelvic floor. Add 4-5 diaphragmatic breaths to each of these stretches and observe how your pelvic floor relaxes. You can do these once a day and use them just before intercourse to prepare yourself for intercourse.

  • Single leg then double leg abdominal pull

  • happy baby pose

  • child pose

  • deep squat

  • butterfly pose


You may find it easier to control your body by lying on your back or sitting on your partner, where you can easily open your legs with the side-lying position, pillows that support your knees, and you can open up space for your pelvic floor muscles to relax.


Dilators allow the pelvic floor muscles to be relaxed, massage the scar, if any, to help regain the flexibility of the tissues.


Finally, if you feel pain during sex and don’t know where to go, getting support from a pelvic floor therapist and needing medical assistance to evaluate your pelvic floor muscles and associated tissues is invaluable to point you in the right direction.

In our therapies, we focus on improving muscle tone, reducing pain and optimizing pelvic health function with manual therapy techniques, neuromuscular retraining and pelvic floor exercises!

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