Have you as a women ever been told:
“Everything looks fine.”
“Your tests/scans are normal”
“Just relax.”
“Use more lube”
“It’s in your head”
“It’s normal if you’ve had a baby”
Hearing these words can be frustrating when you’re still experiencing pain during sex and when it feels like nobody is listening or taking it seriously. For many women, pain during sex is something they quietly endure. Some feel embarrassed to bring it up. Others assume it’s “normal” after having a baby, during menopause or because they’ve always experienced discomfort. Pain during sex (known medically as dyspareunia) affects women of all ages and can occur at different stages of life. The good news is that pain is never something you should simply have to live with and in many cases pelvic floor physiotherapy can help identify and treat the underlying cause.
Pain During Sex Is More Common Than Most People Realize
Research suggests that up to three out of four women will experience pain during intercourse at some point in their lives. While the cause varies from woman to woman, the experience is far more common than many people think. Unfortunately, because it is such a personal topic, many women suffer in silence. Some avoid intimacy altogether, while others continue despite the discomfort, hoping it will eventually improve. Pain is your body’s way of telling you that something needs attention. It should never be dismissed as “just part of being a woman”, women can enjoy sex too!
Pain Can Occur During Different Phases of Life
During the Teenage and Young Adult Years
Some women experience pain from their very first attempt at intercourse (or even tampon use). This may be due to:
- Pelvic floor muscles that tighten involuntarily (vaginismus)
- Fear, anxiety or previous painful experiences/trauma
- Poor sex education
- Poor body awareness
- Raised thinking sex is “taboo”
- Muscle overactivity/spasm
- Poor pelvic floor muscle coordination
- Conditions such as endometriosis
- Hormonal influences affecting vaginal tissue
- Previous infections or inflammation
- Constipation
Many young women worry that something is “wrong” with them, when in reality these conditions are common and highly treatable.
During Pregnancy
Although many women continue to have comfortable intercourse during pregnancy, others notice increasing discomfort due to:
- Hormonal changes
- Increased pelvic pressure
- Pelvic girdle pain
- Changes in muscle tension
- Increased sensitivity of pelvic tissues
- Constipation/Hemorrhoids
A pelvic floor assessment can often help reduce discomfort and provide advice on comfortable positioning and muscle relaxation.
After Childbirth
Postpartum is one of the most common times women experience painful intercourse. Reasons may include:
- Perineal tears or episiotomy scars
- Caesarean scar restrictions
- Pelvic floor muscle tightness
- Healing tissues
- Reduced lubrication, particularly while breastfeeding
- Fear of pain causing muscles to tighten protectively
Many women are told to “wait six weeks,” but healing doesn’t automatically mean that the muscles and tissues are functioning normally again. This is where pelvic floor physiotherapy can make a significant difference.
During Perimenopause and Menopause
Hormonal changes during perimenopause and menopause often affect vaginal and pelvic floor tissues. Women may experience:
- Vaginal dryness
- Reduced tissue elasticity
- Burning sensation
- Pain with penetration
- Increased pelvic floor muscle tension
- Bladder symptoms alongside painful intercourse
- Constipation/Hemorrhoids
These symptoms are incredibly common, but they are not something women simply have to accept as an unavoidable part of ageing. Starting with something as simple as vaginal estrogen cream can already help so much! Pelvic floor physiotherapy plays an integral part in helping these women.
How Pelvic Floor Physiotherapy Can Help
Treatment depends on the underlying cause of your pain but may include:
- Education about your symptoms
- Pelvic floor muscle relaxation techniques
- Manual therapy for tight muscles and sensitive tissues
- Scar tissue mobilisation
- Breathing and relaxation exercises
- Gentle stretching and mobility work
- Progressive pelvic floor retraining
- Dilator therapy
- Bowel and bladder health advice
- Core rehabilitation
- Return-to-intimacy guidance
- Home exercises tailored to your needs
You Deserve Answers
If you’ve been told “everything is normal” but you’re still experiencing pain, please know that your symptoms are valid. You deserve to be listened to. You deserve a proper assessment. And most importantly, you deserve treatment that looks beyond scans and blood tests to understand how your body is functioning. Pain is not something you should simply accept because you’ve had a baby, are getting older or have been told nothing is wrong. With the right assessment and treatment, many women experience significant improvements in comfort, confidence and quality of life. If you’re experiencing pain during sex or pelvic pain, seeing a pelvic floor physiotherapist could be the first step toward understanding what’s happening—and finding a path back to living comfortably and enjoying your intimate life. Remember, being told “everything looks normal” should never be the end of your story, advocate for yourself!
