I was surprised when one of my clients walked into my clinic at the end of a long workday without an appointment. I must have given her a look of surprise because she immediately welled up with tears and said, “I just came to give you a hug, the pain is gone.” She went on to explain that I was the first person to really “listen” to her story, treating her as a whole person and connecting all the “clinical pieces of the puzzle.” In just a few visits, she transitioned from tears of despair, frustration, and pain to tears of joy, relief, and hope.
Intimacy is meant to bond couples closer, both physically and emotionally, often described as magical. However, for countless others, it becomes a source of pain—both physical and emotional. Their stories vary; it might be their first sexual experience or their hundredth, during pregnancy, or in the postpartum period after childbirth. Sometimes, it’s post-surgery or as a woman enters menopause. Pain can manifest during certain positions or at different times of the month as hormones fluctuate.
The common thread among these experiences is that women are devastated because the pain impacts not only themselves but also their partners and relationships.
This topic is rarely discussed openly; it remains one of the most private and misunderstood struggles that many women face, shrouded in silence. Women often feel uncomfortable, afraid, or embarrassed to speak up about something so personal, leaving many feeling isolated and unheard.
As a pelvic floor physical therapist, I encounter women daily who share their frustrations of often being dismissed and their fears about the future—their stories can be heartbreaking. But here’s what every woman needs to know:
Pain with intimacy is common, but it is never normal.
The Dismissal: “Just Relax,” “Have a Glass of Wine”
Too often, when women speak to their healthcare 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 real, very complex issue. Women are often told to push through the pain, to make it work, or to “just relax.” The idea that pain with intimacy is something to be ignored or “fixed” with a quick solution like alcohol or relaxation techniques can feel dismissive of the deeper, often more challenging factors at play. It’s a painful cycle of being told to just cope, while never actually addressing the root cause of the problem.
For a woman struggling with pain during intimacy, these comments don’t help her feel better; they leave her feeling even more alone in her experience.
Let’s make one thing clear: Your pain is REAL! There is help!
The Ripple Effect: Pain’s Impact on Relationships and Self
Pain with intimacy can affect every aspect of a woman’s life. The physical discomfort is just the beginning. For many women, this issue chips away at their self-esteem, causing them to feel disconnected 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 a woman to start avoiding intimacy altogether, fearing the pain or even dreading the experience. 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, 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 persists or worsens over time.
It’s important to recognize that pain with intimacy is common, but it is never normal. The pain is a signal that something in the body needs attention. Pain during intimacy should never be dismissed or overlooked, and the idea that it’s something women “just have to deal with” is a harmful misconception.
As a pelvic floor physical therapist, I help women uncover the underlying causes of their pain and work toward long-term solutions. The first step in healing is understanding that there is a solution and that pain doesn’t have to be a permanent part of your life.
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 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.
- Conditions like Endometriosis, Fibroids, or Cysts: 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 to Women Experiencing Pain
The most important message I want to share with you today is this: There is help and you deserve it! If you are experiencing pain with intimacy, here is what I want you to know:
- 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, counseling, and specialized exercises 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.
Additionally, discussing your concerns with a compassionate provider who listens and understands the emotional side of pain can go a long way toward helping you feel empowered and supported.
Taking the First Step
If you’ve been told to “relax” or “just deal with it,” I want to tell you that there is more to the story, and it’s time to take action. Pain with sex does not have to define your life, it is not a life sentence—it is a sign that your body needs attention, and there are treatments that can help.
It can be difficult to bring up such a sensitive issue, but taking that step is a powerful act of self-care. You deserve to feel comfortable in your body, and you deserve to experience intimacy without pain.
You are worth it.
Don’t let this go unaddressed. Whether you’re in your 30s, 40s, 50s, 70s, and beyond it’s never too late to seek help. Together, as a team,we can uncover the root cause of your pain and work toward restoring your confidence, comfort, and connection—to yourself and your relationships.
Let’s rewrite the narrative. Intimacy should be a source of joy, not pain. Don’t wait to take the first step. Your healing journey starts today.