Sex should be pleasurable—not painful.
Yet for many people, pain during or after sex is something they silently endure for months or even years. Some assume it’s “normal,” others feel embarrassed to talk about it, and many don’t realise that help is available.
The truth is, painful sex is common, but it is not normal. Most importantly, it’s treatable.
What is Sexual Pain?
Pain associated with penetrative sexual intercourse is known as dyspareunia. It can occur:
- Before penetration
- During penetration
- With deep penetration
- During certain positions
- After intercourse
- Following orgasm
The pain may be described as burning, stinging, sharp, aching, cramping or a deep pelvic pain.
What Causes Painful Sex?
There isn’t one single cause, which is why a thorough assessment is so important.
Some common contributors include:
- Overactive or tight pelvic floor muscles
- Endometriosis or adenomyosis
- Pelvic pain conditions
- Vaginismus
- Vulvodynia
- Childbirth-related changes
- Scar tissue following surgery or birth
- Hormonal changes (including menopause and breastfeeding)
- Vaginal dryness
- Previous infections
- Stress, anxiety or fear of pain
Often, more than one factor is contributing.
The Role of the Pelvic Floor
Your pelvic floor muscles sit at the base of your pelvis and support your bladder, bowel and reproductive organs.
Just like muscles anywhere else in the body, they can become tight, tense, overworked or painful.
When these muscles don’t relax properly, penetration can become uncomfortable or even impossible. They may also refer pain into the pelvis, hips, lower back or abdomen.
Many people assume they need to “strengthen” their pelvic floor, but in cases of sexual pain, the focus is often the opposite—helping the muscles learn to relax, lengthen and coordinate effectively.
How Can a Pelvic Health Physiotherapist Help?
Pelvic Health Physiotherapists are specially trained to assess and treat the musculoskeletal contributors to sexual pain.
Treatment is always individualised and may include:
- Education about your pain and why it’s occurring
- Pelvic floor relaxation and down-training
- Breathing and nervous system regulation strategies
- Manual therapy to reduce muscle tension
- Scar tissue management
- Graded exposure using vaginal dilators where appropriate
- Self-release tools such as a vibrating pelvic wand (promotes blood flow, helps muscles relax and helps desensitise tissues)
- Advice regarding lubricants and vaginal moisturisers
- Movement and exercise prescription (such as pelvic opening stretches)
- Pain management strategies
- Collaboration with your GP, gynaecologist, psychologist or other members of your healthcare team when needed
Your treatment plan is tailored to your symptoms, goals and comfort level. You remain in control throughout every assessment and treatment session.
You Don’t Have to Just Live With It
Painful sex can impact confidence, relationships, intimacy and quality of life—but it doesn’t have to become your normal.
With the right assessment and treatment, many people experience significant improvements in pain, pelvic floor function and confidence.
If you’ve been avoiding intimacy because of pain, or you’ve thought that it’s “just something you have to put up with,” know that there are evidence-based treatment options available.
Take the First Step
You deserve to enjoy intimacy without fear or pain.
If you’re experiencing pain with sex, we’d love to help. Book an appointment with one of our Pelvic Health Physiotherapists to begin understanding the cause of your symptoms and work together towards comfortable, confident intimacy once again.