Painful Sex & Vaginismus
Painful Sex & Vaginismus
Pain during sex, or being unable to have penetrative sex at all, is more common than most people realise, and is rarely something you have to simply live with. Psychosexual therapy can help alongside your GP or a pelvic health physiotherapist.
Is this you?
- I experience pain during sex and I've been told nothing is physically wrong
- I find penetration difficult or impossible, no matter how much I want it to work
- My body tenses up automatically when penetration is attempted
- I've started avoiding sex, or intimacy generally, because of the pain
- I feel embarrassed, broken or alone in this
- I've had painful sex for so long I've stopped mentioning it
What are vaginismus and dyspareunia?
Vaginismus is the involuntary tightening of the vaginal muscles that makes penetration painful or impossible. It's a physical response, not something anyone chooses or imagines, and it often develops as a protective reflex, sometimes without an obvious cause.
Dyspareunia is the medical term for persistent pain during or after sex, which can have physical, psychological or combined causes. Genito-pelvic pain and penetration disorder is the wider clinical term covering both.
What can cause painful sex?
- A learned protective response, sometimes with no clear starting point
- Anxiety or fear about pain, which can itself increase muscle tension
- Underlying physical causes, including skin conditions, infections or hormonal changes, which is why a GP check is always a sensible first step
- Past experiences of pain, trauma or difficult medical procedures
- Limited or unclear sex education around what to expect from penetration
How therapy can help
- Understand the pattern behind the pain, physical and psychological together
- Reduce fear and anticipatory anxiety that can make tensing worse
- Work gradually and gently, always at a pace you control
- Build confidence and comfort with your own body, with or without a partner involved
A note on safety and accuracy
If you haven't already, it's worth seeing your GP or a sexual health clinic to rule out a physical cause before or alongside starting therapy. Psychosexual therapy works well alongside medical care and pelvic health physiotherapy, and your therapist can help you think through who else might be useful to involve.