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Painful Sex: Why It Happens and How We Can Ease It

Painful sex is far more common than most people realise, and it's rarely something you simply have to put up with. Whatever the cause, pain during sex tends to sit at the meeting point of the physical and the emotional. The first thing I want you to know is that there's usually a reason behind it, and once we understand that reason, there's almost always something we can do.

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Why Sex Can Be Painful

There are many reasons sex can hurt, and they look a little different depending on your body. Some are physical, some are to do with how the nervous system responds, and often it's a combination of the two.

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Painful sex for people with vaginas and vulvas

For people with vaginas and vulvas, pain during sex can come from a number of places, including:

• A hypertonic pelvic floor - where the pelvic floor lives in a state of chronic tension rather than being able to relax.

• Vaginismus - involuntary contractions of the pelvic floor in certain situations, very often sexual ones.

• Endometriosis and adenomyosis - conditions that can make penetration and deeper sex painful.

• Physical trauma and scar tissue - for example after birth, surgery or injury.

• IBS and other bowel-related conditions, which can contribute to discomfort in the pelvis.

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And there's much more.

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Painful sex for people with penises

 For people with penises, sex can hurt for reasons including:

• Phimosis - a tight foreskin that doesn't retract comfortably.

• A tight or short frenulum (frenulum breve) - which can pull or tear painfully during sex.

• Peyronie's disease - scar tissue that causes curvature and pain, particularly with erections.

• Dermatitis, balanitis and other skin conditions - including inflammation of the head of the penis.

• Prostate difficulties, including prostatitis.

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​And ther's much more.

 

How I Work With You on Painful Sex

If we work together on painful sex, my first job is to help you discover what's actually at the root of it. Often that means sending you to your GP for certain checks and blood tests, so we can rule things in or out and get properly to the bottom of the pain.

From there, the ideal is to remove the pain altogether. Where that isn't possible, we work out how you can have sex in a way that reduces it - that might mean exploring different sexual positions, adjusting or extending foreplay, or bringing in certain sex toys.

Alongside this, we work on regulating your nervous system, so you can stay regulated during a sexual experience rather than slipping into the pain response cycle. That's the cycle where you brace because part of you expects it to hurt - and because you're tense, it hurts more, which teaches your body to brace even harder next time. EMDR is a wonderful tool here, both for helping regulate the nervous system and for breaking that pain response cycle.