Pain With Sex (Dyspareunia)
Pain With Sex Is Treatable — Here’s What Causes It and How We Help
Pain with sex can come from pelvic floor muscle tension, hormonal changes, tissue dryness, or nerve sensitivity. At Pelvic Health Support, we evaluate all of these contributors through a trauma-informed pelvic exam. Understanding whether the pain is muscular, hormonal, or tissue-related is the first step toward an effective treatment plan grounded in current evidence.
If penetration feels uncomfortable, tight, or burning, an evaluation can help you understand what’s driving your symptoms.
What Is Dyspareunia?
Dyspareunia is the medical term for pain with intercourse or any penetration. It may feel like:
Burning at the opening
Sharp or tearing pain
Deep pelvic pain
Pressure or tightness
Pain that lasts for hours afterward
Dyspareunia is common, but not normal, and it always deserves a clear explanation.
The Most Common Causes of Pain With Sex
Pain is rarely caused by one single factor. The most frequent contributors include:
H3: 1. Pelvic Floor Muscle Tension (High-Tone Pelvic Floor)
Muscles surrounding the vagina may remain tight or unable to relax. This can lead to:
Burning
Tightness
Difficulty with penetration
Lingering soreness
This pattern is often missed without a pelvic floor–informed exam.
2. Hormonal Changes
Low estrogen affects tissue health around the vaginal opening and canal. This can occur:
In perimenopause and menopause
After childbirth
During breastfeeding
After stopping hormonal contraception
During cancer treatments
This leads to thinning tissue, dryness, and burning.
3. Tissue Irritation or Sensitivity
Conditions like vestibulodynia or chronic irritation from infections or products can create a pain response even without penetration.
4. Nerve Sensitivity
Nerves of the vulva, vagina, and pelvis can become overreactive due to:
Chronic tension
Past trauma
Recurrent infections
Surgery
Nerves require targeted strategies to calm overactivity.
What to Expect During Your Evaluation
Your visit includes:
Trauma-informed history
Exam of external tissue
Pelvic floor muscle assessment
Evaluation of lubrication and tissue integrity
Hormonal context (cycle, age, medication history)
We explain every step before proceeding, and you can pause at any point.
Evidence-Based Treatment Options
Depending on what we find, your care plan may include:
Pelvic floor physical therapy
Local vaginal estrogen
Non-hormonal moisturizers and lubricants
Pelvic floor Botox (for select high-tone cases)
Tissue support therapies
Nerve-calming approaches
Gradual return-to-comfort strategies
Every plan is tailored to your pattern.
When to Seek Care
Seek an evaluation if you have:
Pain with penetration
Burning at the opening
Pain that lasts after sex
Inability to tolerate pelvic exams
New or worsening dryness
Pain after menopause
Pain following childbirth or breastfeeding
These symptoms have understandable causes.
How We Can Help
Our goal is to bring clarity, evidence-based care, and relief so you can feel more comfortable in your body again.
Book a pain with sex evaluation:
