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Painful Sex

Pain with sex is the most common reason clients come to see me. Sometimes it is from childbirth and scars from tearing and stitches with vaginal delivery. Sometimes it is from a previous pelvic surgery. It can be from endometriosis. It can be due to another diagnosis such as vulvodynia, vaginimismus or interstitial cystitis, to name a few. I will have subsequent blogs on those diagnosis.

Sex is complex and it isn't just physical. It isn't only penetrative intercourse. For vagina owners, it isn't just an anatomical and biological act. Sex involves emotions and hormones as well. Here we are talking mainly about the physical actions required for penetrative intercourse.

I recently had a client, we will call her Lucy, and she was unable to have sex with her partner. It just didn't work. The parts didn't fit. Lucy wanted to have sex her with partner and her partner wanted it. They had a good relationship so she wasn't concerned that this would ruin her relationship, although that is a concern of many of my clients, but she was ready to have sex with this partner.

Lucy and I worked together for about 4 months. Physical therapy involved a lot of stretching and the working out of tight tissues within the pelvis, usually with weekly visits to PT. At home Lucy used dilators daily to help open her vaginal canal and she did other stretches as well.

One day Lucy came and told me she was able to have sex! And it didn't even hurt! She was so excited, and I was happy for her, too!

This is just one of many stories I have been a part of throughout my career. Other women want to have babies but can't because sex is too painful, then they are afraid of the delivery as well. For some clients sex changed after having a baby or after menopause. We were able to create a therapy program for each of them to achieve their goals.

For some clients it is just a few visits, for others it may take months or years. It depends on many factors, such as has the client ever been able to achieve penetrative intercourse? How large is the partner? What hormonal changes have occurred such as pregnancy, postpartum or menopause? Is this a new partner? Was there a pelvic surgery that changed things? There are so many considerations, which is why each therapy session is individualized and I can't say someone will be better after __ amount of visits.

Here are some of the tools I recommend clients use to help decrease painful sex and make it pleasurable.

The first is vaginal dilators. There are many different brands, but this is one I like because it is made of silicone, which is body safe and easily sterilized, and the silicone is soft. Early in my career dilators only came in rigid plastic models. These silicone ones are much more comfortable.

You can purchase these at or use code 04181 at checkout for a discount. The above example is of the medium dilator set. There are different sets available for purchase, or you can purchase individual dilators. Usually we use a progressive set in order to start with what the client can tolerate and progress them to a size that is equal to their partner.

Silicone dilators need to be used with water based lubricants. Some brands I like are Good Clean Love, Ah Yes, Slippery Stuff and Sliquid. You can find links to all of those here:

The other product I really like if the painful part of sex is with deep penetration is Oh Nut. These are silicone rings that can be placed at the base of the partner's penis or the base of a dildo to limit the depth of penetration. This is a great way for both partners to continue to enjoy sex until deep penetration no longer is painful.

You can purchase those here and use code RECHARGE7 for a discount at checkout.

Sex does not have to be painful, in fact, it shouldn't be painful! Sex should be pleasurable for everyone, and we are here to help you achieve that goal.

Reach out to set up an initial phone call to find out more information on how we can help you. You can do that here:

If sex is pleasurable for you, but you know your girlfriends don't enjoy sex or complain it is painful, then please pass this along to them. Our goal is pleasurable sex for everyone!

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