When Sex is Painful

When sex is painful, we may find ourselves wondering what’s wrong with us, struggling to relax and enjoy ourselves during intercourse, and maybe even avoiding sex all together.


An activity that we hope will be a time of connection, pleasure and playfulness…instead leads to stress, dread, confusion and maybe even arguments.


Our partner becomes confused and takes our hesitation as rejection.  We feel guilty and frustrated with ourselves, our partner, and our own body.


Sex doesn’t need to be painful–the good news is there are ways to ease the pain into a more joyful sex life!


As a sex therapist who has supported countless individuals and couples with sexual concerns, here is some of what I’ve learned:


There are many reasons for pain during sex:

  • There may be a medical explanation for the pain.

  • You may be experiencing a physical change due to a medical procedure, a change in hormones, healing from giving birth, or the natural changes our bodies go through as we become older.
  • You may be experiencing stress which is affecting your body’s ability to relax.
  • Your mind-body connection may be creating tension in your body due to anxiety, distraction, or fear related to past experiences.
  • Your body may be tensing in anticipation of sex due to a past trauma, painful experience, or negative beliefs about sex.
  • You may be experiencing conflict in your relationship and your body is having a reaction to the conflict.
  • There may be a size mismatch between you and your partner’s genitals.


Your body, relationship, and past experiences are unique so finding the right help to ease the pain will look just as unique. 


Here are common steps someone may take if they are experiencing one or more of the above issues which is impacting their ability to enjoy sex:

  • See a doctor to discuss the pain and have a physical exam.  Your doctor can help to rule out a medical explanation and only medical doctors can prescribe medication.

  • Practice relaxation techniques to help you relax your mind and body while also increasing pleasure and arousal.
  • Work with a physical therapist who specializes in pelvic floor rehabilitation.
  • Explore use of lubrication; it is normal to use lubrication at any age to help with penetration.
  • Identify what kind of foreplay helps prepare your body for pleasure and communicate with your partner.  It is normal and okay to need foreplay to become aroused.
  • Explore toys and props that can help you with foreplay, positions, using thinner/smaller toys for penetration to adapt to your anatomy, and even help create less of a mismatch between genital size to make penetration easier and more enjoyable for both partners.
  • Improve communication between partners and explore underlying issues in the relationship.
  • Find pleasure and connection in non-penetrative sex.
  • Participate in trauma focused therapy to heal from past sexual trauma.


Our sex therapists at Love Heal Grow are here to support you–you are not alone!

Sex therapy for sexual pain will include:

  1. Making recommendations to medical professionals if necessary.
  2. Listening to what you are experiencing without judgment and helping you to identify the likely cause of the pain.
  3. Providing education and resources for you to use outside of therapy.
  4. Supporting you and creating a plan to help decrease pain and increase pleasure in your sex life.
  5. Helping you communicate with your partner so you can be supported and understood.
  6. Partnering with your other medical professionals if it will help.


Reach out for support today–you deserve pain free sex.


Hi! I'm Megan Negendank, founder and executive director of Love Heal Grow Counseling.

I help hurting, worried couples & individuals heal from pain and create thriving lives & relationships. 

You can read more about me or schedule an appointment here: About Megan

Love Heal Grow Relationship Therapy Center Sacramento

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