Why Sex Shouldn’t Be Painful – And What to Do If It Is

Sex Shouldn’t Be Painful – Here’s What to Do If It Is

Nicole’s Journey: A Struggle for Answers

When Nicole first experienced pain during intercourse nearly a decade ago, she was determined to find a solution. After consulting multiple specialists, she was diagnosed with labial hypoplasia—a condition where the outer labia are only partially formed. Following corrective surgery, she found significant relief and remained pain-free for years, incorporating yoga into her routine to aid healing.

But six years later, the pain returned—this time, at the initial stages of penetration. For the past three years, the 33-year-old California resident has sought a formal diagnosis, but the cause of her discomfort remains unclear.

“I get a lot of ‘it’s probably anxiety or related to mental health,’” Nicole shared. “It’s disappointing since I made a ton of progress and now feel like I’m being tossed aside.”

Nicole’s experience isn’t unique. According to the American College of Obstetricians and Gynecologists, nearly 3 in 4 women will experience painful intercourse at some point in their lives—whether temporarily or as a chronic issue.

What Causes Pain During Intercourse?

Painful intercourse can stem from multiple factors, including:

• Pelvic Floor Tension: Women with tight pelvic floor muscles may experience pain not just during intercourse but also during gynecological exams or tampon use. Tightness in the neck, lower back, and hips can also contribute.
• Hormonal Changes: Decreased estrogen levels during menopause, postpartum recovery, or breastfeeding can cause vaginal dryness, making intercourse painful.
• Past Trauma or Surgeries: Stress, traumatic experiences, or muscle tensing—whether conscious or unconscious—can also lead to discomfort.

Seeking Treatment for Painful Sex

For those experiencing pain due to pelvic floor muscle tension, pelvic floor physical therapy is a highly effective treatment. According to Dr. Anna Falter, a pelvic floor therapist at the Cleveland Clinic, therapy can help relax overly tight muscles and prevent future discomfort.

Treatment Approaches:

1. Trigger Point Therapy
   • A therapist applies pressure to tight pelvic muscles to help them relax. This can be done vaginally with a gloved, lubricated finger or at home using a pelvic wand or vaginal dilators.
2. Pelvic Floor Lengthening Exercises
   • Unlike Kegel exercises, which strengthen muscles, lengthening exercises focus on relaxation. This is often paired with diaphragmatic breathing to reduce tension.
3. Daily Check-ins & Stretches
   • Simple activities like brushing teeth or sitting on the couch can become moments to check for muscle tension. Yoga poses like child’s pose, butterfly stretch, and deep squat can help release tightness.

Dr. Falter emphasizes that individualized treatment is key. Seeking professional guidance ensures exercises are performed correctly and effectively.

How Partners Can Offer Support

If your partner experiences pain during sex, there are ways to help:

• Stop Immediately If Pain Occurs: Pushing through discomfort can create negative associations with intimacy.
• Open Communication: A supportive, understanding approach can ease feelings of shame or inadequacy.
• Educate Yourself: Learning about treatment strategies helps partners provide better support.
• Explore Non-Penetrative Intimacy: Activities like manual stimulation, oral sex, affectionate touch, and meaningful kisses maintain closeness.

“At the end of any sexual encounter, you want to be able to look forward to the next time with anticipation and delight,” says relationship expert Dr. Emily Dillon. “If sex is painful, it can create a cycle of dread, which you don’t want.”

The Importance of Physical Intimacy

Despite the lack of a clear diagnosis, Nicole is committed to maintaining a fulfilling intimate relationship. She and her boyfriend have explored alternative solutions, incorporating pelvic floor therapy into their routine to alleviate discomfort.

“There was a lot of education that had to be done, which isn’t always fun or sexy,” she admitted. “But in the end, it has brought us closer together and strengthened our emotional connection.”

For those facing similar struggles, seeking medical help and communicating with a supportive partner can make all the difference. Pain-free intimacy is possible with the right approach and treatment.