Painful Intercourse and Vaginal Pain
Why Does Sex Hurt? Causes, Treatments, and How Pelvic Floor Therapy Can Help
If you're suddenly experiencing pain during intercourse (dyspareunia), you may wonder what’s causing it and how to find relief. While many assume painful sex is solely a gynecological issue, pelvic floor physical therapy is a proven solution that can significantly reduce or eliminate vaginal pain. With safe and gentle techniques, physical therapy helps restore comfort and pleasure to your intimate experiences.
Key Takeaways:
Pain during sex (dyspareunia) can stem from various causes, including medical conditions, muscle tightness, or hormonal changes.
Pelvic floor physical therapy is a non-invasive treatment that helps relax, strengthen, and restore muscle function to reduce pain.
Treatment includes manual therapy, targeted exercises, biofeedback, dilation therapy, and other specialized techniques.
At-home exercises and partner-assisted techniques can accelerate progress and enhance recovery.
Most patients experience significant relief, allowing them to enjoy pain-free intimacy again.
Common Causes of Pain During Sex
Painful sex can result from various underlying conditions, including:
Vaginismus – Involuntary vaginal tightness caused by fear of penetration
Pregnancy or childbirth – Changes in pelvic structure and muscle tension
Menopause – Hormonal shifts leading to vaginal dryness and discomfort
Cancer treatment – Side effects from chemotherapy, radiation, or surgery
Vestibulodynia or vulvodynia – Pain around the vaginal opening, either provoked (triggered by touch) or unprovoked (constant)
Painful orgasm – Discomfort or cramping after climax
Gynecological conditions – Endometriosis, fibroids, or pelvic inflammatory disease
Vaginal skin conditions – Lichen sclerosus, eczema, or dermatitis
Urological conditions – Overactive bladder or interstitial cystitis
These conditions can cause the pelvic muscles to tighten involuntarily, worsening the pain and creating a cycle known as secondary vaginismus.
How Pelvic Floor Physical Therapy Helps
Pelvic floor therapy is a safe, effective treatment for painful sex. It helps by:
Increasing pelvic blood flow
Releasing trapped nerves and breaking down adhesions (scar tissue)
Relaxing and stretching tight tissues
Correcting postural imbalances
Restoring mobility and reducing trigger points
Strengthening and toning pelvic muscles for optimal function
What to Expect During Pelvic Floor Physical Therapy
At Raquel Perlis Physical Therapy, we tailor treatments to your needs. Your therapy may include:
Manual Therapy – Hands-on techniques like soft-tissue massage, trigger-point release, and myofascial release to ease muscle tightness. Internal vaginal work may be incorporated when you’re comfortable.
Targeted Exercises – Movements to stabilize your core, improve posture, and strengthen your abdomen, back, hips, and legs.
Pelvic Relaxation Techniques – Exercises like pelvic drops to release tension and increase vaginal comfort.
Pelvic Floor Toning – Once muscles are relaxed, strengthening exercises restore function. (Strengthening tight muscles too soon can trigger spasms.)
Biofeedback Training – Helps ensure proper execution of pelvic exercises for maximum effectiveness.
Dilation Therapy – Gradual use of fingers, tampons, and dilators to stretch and desensitize vaginal tissues.
Healing Therapies – Ultrasound or cold laser treatments to support healing of vaginal tears and scar tissue.
Electrical Stimulation (E-Stim) – Helps activate weak pelvic floor muscles for better control and relaxation.
(Note: Biofeedback, ultrasound, cold laser, and e-stim are not recommended during pregnancy.)
How to Accelerate Your Progress
You can enhance your recovery with consistent at-home therapy. We may recommend:
Hip, back, and leg stretches – Easily incorporated into daily activities or workouts.
Pelvic drops – Subtle exercises you can do anywhere, like at your desk or while standing in line.
Dilator use – To increase vaginal flexibility and reduce discomfort.
Self-massage techniques – To relieve tension and promote circulation.
Partner-assisted massage – Your partner can learn effective massage techniques to support your healing.
Portable biofeedback or e-stim units – For motivated individuals to continue therapy at home.
How Effective Is Treatment?
Most patients experience significant relief after pelvic floor therapy. Many report a drastic reduction in vaginal pain, allowing them to enjoy comfortable, pleasurable intercourse—some for the first time.
When to Seek Professional Help
If painful sex has been persistent or is affecting your well-being, it’s time to consult a specialist. A healthcare provider can assess your symptoms and recommend the best course of action. Don’t let pain take away your pleasure—pelvic floor therapy can help you regain confidence and restore intimacy. Book an appointment today to start your journey to relief!