Pain during intercourse is something many people experience, but that does not mean you have to accept it as normal. You may have been told that pain with sex is just part of getting older, having children, going through menopause, or something you simply have to work through. But persistent or recurring pain during intercourse is a sign that something may need attention.
Pain with sex can have many different causes, and it is not always just a pelvic floor problem. Common contributors can include pelvic floor muscles that are too tight or not coordinating well, scar tissue after childbirth, surgery, or injury, hormone changes during postpartum recovery or menopause, pelvic or hip mobility restrictions, nerve sensitivity, vaginal dryness or tissue changes, previous pain or injury that has caused the body to become protective, and conditions such as endometriosis or vulvodynia. Sometimes, there is more than one contributing factor.
When something hurts, your body naturally wants to protect you. The pelvic floor muscles may tighten, your nervous system may become more sensitive, and you may begin anticipating pain before intercourse even starts. Over time, this can create a cycle: pain, tension, guarding, and more pain.
That does not mean the pain is in your head. It means your body is responding to something it perceives as a threat.
One of the most important things to know is that you should not have to tolerate pain to have a healthy sex life. If intercourse is painful, your body is giving you information. Instead of simply trying to stretch through the pain or ignore it, it can be helpful to understand why it is happening.
A pelvic floor physical therapist can look at the bigger picture, including your pelvic floor, hips, spine, breathing, movement patterns, previous injuries, scar tissue, and other factors that may be contributing to your symptoms. Treatment is individualized and should always be done at your pace. An internal pelvic floor examination is not required and should only happen with your consent.
Pain with intercourse is common, but common does not mean normal, and it does not mean you have to live with it. If sex is painful, uncomfortable, or something you have started avoiding because of pain, consider talking with a healthcare provider or pelvic floor physical therapist. Finding the underlying contributors can be the first step toward feeling more comfortable and confident in your body. You do not have to just live with it.
