Why Sex Hurts: Understanding Painful Intercourse and How Pelvic Floor Therapy Can Help

If you experience pain with sex, you're far from alone — even though it can feel incredibly isolating. Painful intercourse, also known as dyspareunia, affects up to 75% of women at some point in their lives. For many, the pain is brushed off as “normal,” but it’s not — and you deserve answers, support, and healing.

At Anatomie Pelvic Health, we want you to know this: pain with intimacy is common, but there are tools that can help!

So, Why Does Sex Hurt?

Painful intercourse can have physical, emotional, and neurological causes. Often, it’s a combination — and understanding the root helps us treat it effectively.

1. Pelvic Floor Muscle Tension

The pelvic floor muscles are supposed to relax and lengthen during intimacy. But for many women, these muscles are tight, guarded, or overactive, leading to:

• Burning or stinging at the vaginal opening

• Deep ache or pressure during penetration

• Inability to tolerate insertion

🧠 Research shows over 80% of women with pain during intercourse have overactive pelvic floor muscles (The Journal of Sexual Medicine, 2017).

2. Hormonal Changes

Low estrogen — especially postpartum, breastfeeding, or during perimenopause — can thin the vaginal tissues and reduce natural lubrication, making sex feel dry, irritated, or even tear-inducing.

💡 Even temporary hormonal dips (like during stress or illness) can affect sensation and comfort.

3. Scar Tissue or Birth Trauma

Perineal tearing, episiotomies, or C-section scars can all create tension, nerve hypersensitivity, or reduced mobility in the tissue — all of which can lead to pain during intimacy.

4. Nervous System Hypervigilance

The pelvic floor is deeply connected to your nervous system. If your body doesn’t feel safe (due to trauma, anxiety, or even chronic stress), the pelvic muscles may stay “on guard” — literally bracing against intimacy.

🧠 Pain can become a learned reflex. Even once the tissue heals, the nervous system may still perceive sex as a threat.

5. Past Medical or Emotional Trauma

Sexual trauma, invasive medical exams, and emotionally charged experiences can all impact pelvic floor tension and the ability to experience pain-free intimacy. This doesn’t mean it’s “in your head.” It means your body remembers.

How Pelvic Floor Therapy Can Help

At Anatomie Pelvic Health, we take a whole-person, trauma-informed approach to treating painful sex. Here’s how we help:

✅ Internal & External Muscle Work

We gently assess and treat the pelvic floor muscles using hands-on techniques (with full consent and education). The goal is to reduce tension, restore mobility, and improve circulation.

✅ Scar Tissue Mobilization

We address adhesions and restrictions around C-section, episiotomy, or vaginal tear scars that may be impacting sensation or movement.

✅ Breathwork + Nervous System Support

We teach breath-based techniques that retrain the pelvic floor to relax and respond, not just contract. This helps shift your body from “guarded” to “safe.”

✅ Empowerment Through Education

You’ll learn how your anatomy works, what’s actually happening during sex, and how to rewire the connection between your brain, body, and pelvic floor — at your pace.

You Deserve Pain-Free, Empowered Intimacy

Pain with sex can feel shameful. But it’s a symptom, not a personal flaw. And it’s treatable.

You don’t need to “just relax” or “wait it out.” You need evidence-based care, compassion, and a plan — and we’re here to guide you every step of the way.