Intimacy allows us to connect with our partner in a way that bonds couples closer both physically and emotionally- it can be magical.  

But for countless people, it is a source of pain—both physically and emotionally. The circumstances vary in that sometimes the pain comes during their first sexual experience or their 100th, it could be during pregnancy or often it is in the postpartum period after childbirth.  Sometimes, it is after surgery or for women, as she enters the menopausal phase of life. It can present in certain positions or during different times of the month as hormones fluctuate. 

Regardless of the circumstance, the common thread, particularly for women, is the emotional toll of this physical pain, because pain during intimacy not only affects the person suffering, it affects their partners and their relationships.

It’s an uncomfortable topic, rarely discussed openly, yet it is one of the most private and misunderstood struggles that many face. Many are often afraid or embarrassed to speak up about something that’s deeply personal, leaving countless feeling isolated and hopeless.

As a pelvic floor physical therapist, I encounter people, especially women, every day who share their fears of what their futures hold—and their frustrations of often being dismissed by other health care providers. It’s important to understand that pain with intimacy is common, but it is never normal. And there is something that can be done about it!

If you have been suffering with pain during intimacy, here are some important things to know so you can get back to feeling like yourself again!

The Dismissal: "Just Relax- Have a Glass of Wine"

Too often, when women speak to their health care providers or partners about pain during sex, they are met with suggestions that feel more dismissive than helpful. "Just relax," they’re told. "Have a glass of wine, and it will pass." "It’s just part of getting older, isn’t it?" These comments, while sometimes well-intentioned, can leave a woman feeling misunderstood, frustrated, and even ashamed of the pain she’s experiencing.

These statements are not only unhelpful, but they also trivialize a very complex issue. Let’s make one thing clear: Your pain is REAL! When it comes to pain with intimacy, there are often more challenging factors at play that need to be addressed. But for many, they find themselves stuck in a painful cycle of coping with pain, while never actually addressing the root cause of the problem.

The Ripple Effect: Pain’s Impact on Relationships and Self

Pain with intimacy can affect every aspect of life. The physical discomfort is just the beginning. For many, this issue chips away at self-esteem, causing a sense of disconnection from their own bodies. The physical barrier to intimacy often leads to feelings of shame,frustration, guilt, and sadness.

As time passes, it’s not uncommon for some to start avoiding intimacy altogether, fearing the pain or moreso, the emotional aftermath. This avoidance can strain relationships. Partners may feel confused, rejected, or helpless, which can lead to further emotional isolation. This cycle can lead to a breakdown in communication, intimacy, and trust.

The Truth: Pain with Intimacy is Common but Never Normal

According to the American College of Obstetrics and Gynecology, approximately 75% of women will experience pain during sex at some point in their lives. This pain can occur at any age, during a woman’s first sexual experience, during pregnancy or postpartum, or as she enters menopause. It might be brief or fleeting for some, but for others, it can persist or worsen over time.

The pain is a signal that something in the body needs attention. The first step in healing is understanding that there is a solution and that this pain doesn’t have to be a permanent part of your life. As a pelvic floor physical therapist, I help women uncover the underlying causes of their pain and work toward long-term solutions. 

Understanding the Causes of Painful Intimacy

The causes of pain with intimacy are varied and complex, often stemming from a combination of physical and emotional factors. 

Here are some common contributors:

Pelvic Floor Dysfunction: The pelvic floor muscles may become too tight, losing their ability to relax during intercourse. This can cause burning, throbbing, or a sensation that the partner is “bumping into something”. Chronic pain can lead to a cycle of muscle guarding, where the body braces in anticipation of discomfort.

Hormonal Changes: Hormonal fluctuations, such as those that occur during pregnancy, breastfeeding, menopause, or after childbirth, can lead to vaginal dryness, thinning tissues, and cause discomfort.

Scar Tissue and Adhesions: Scarring from childbirth (vaginal tears or episiotomies), surgeries, or trauma can create rigid, inelastic areas that restrict movement and contribute to pain.

Vaginismus: This is an involuntary contraction of the vaginal muscles in response to penetration, often creating pain and sometimes making intercourse impossible.

Endometriosis, Fibroids, or Cysts: Conditions like these can cause deep pain or a sensation of “hitting a wall” during intimacy.

Emotional and Psychological Factors: Past trauma, anxiety, and stress can also contribute to pain during intimacy, creating a mental and emotional barrier to pleasure and connection.

A Message of Hope

The most important message I want to share with you today is this: 

You are not alone. Your pain is valid, and many other women share similar experiences.

You don’t have to suffer in silence. Speaking up is the first step toward healing.

Help is available. Pelvic Floor Therapy, specialized exercises, and counseling can all help address the underlying causes of painful intimacy. With the right support, pain can be alleviated and intimacy can be rediscovered.

You deserve better. Pain is not something you should have to endure; intimacy can and should be pleasurable.

Taking the First Step

It can be difficult to bring up such a sensitive issue. Discussing your concerns with a compassionate provider who listens and understands the emotional side of intimacy pain can go a long way toward helping you feel empowered and supported. It cannot be understated the importance of finding the right provider for you! And at Pelvicore Rehab & Wellness, we strive to be that provider for all of our patients.

My message to you: You are worth it.

Don’t let discomfort go unaddressed. Whether you’re in your 30s, 40s, 50s, 60s or beyond, it’s never too late. Ready to take the first step?

Join us NEXT WEEK for our upcoming event Ask the Experts: Rediscover, Reconnect, Revive Intimacy, a carefully curated experience hosted at our Pelvicore Rehab & Wellness clinic designed to help women embrace their intimate lives with confidence and curiosity. From expert insights on intimacy as we age to practical tips for spicing things up, and everything in between, this is an opportunity to stop googling and start connecting with real experts. I hope to see you there!