Relief for Pain During Sex
Identify the cause—pelvic floor, hormonal changes, or structural issues—and get a clear, compassionate plan.
Pain with intercourse is common and treatable. Causes range from pelvic floor muscle tension to vaginal dryness or conditions like endometriosis. We focus on validating your experience, finding the cause, and creating a stepwise plan for comfort and confidence.
Fast Facts
Pain can be at entry, deep inside, or both
Pelvic floor muscle tension is a frequent contributor
Hormonal changes can thin and dry tissues
Most patients improve with targeted therapy
Common Symptoms
- Burning or sharp pain at entry
- Deep pelvic pain with thrusting
- Tightness or difficulty with penetration
- Post-intercourse soreness or spotting
- Reduced desire due to fear of pain
Why It Matters
Dyspareunia affects intimacy, mood, and quality of life. Understanding the pattern and cause helps restore comfort and connection while addressing related issues like pelvic floor dysfunction or hormonal changes.
Diagnosis & Evaluation
Evaluation includes a detailed history, screening for infections or skin conditions, and a gentle exam focused on comfort. We assess pelvic floor muscle tone and trigger points, check for hormonal tissue changes, and consider conditions such as endometriosis, fibroids, or ovarian cysts when deep pain is present.
Superficial vs. Deep Dyspareunia
Superficial (Entry)
- Burning, stinging, or tearing at penetration
- Often related to dryness, GSM, skin conditions, or pelvic floor tension
- Improves with lubricants, local estrogen, and pelvic floor therapy
- Topical treatments and gradual desensitization can help
Deep
- Pain with deeper thrusting or certain positions
- May relate to endometriosis, fibroids, ovarian cysts, or pelvic floor trigger points
- Imaging or targeted evaluation if symptoms persist
- Position changes and tailored treatment reduce pain
Treatment Options
Plans are individualized and may include pelvic floor physical therapy, lubricants and vaginal moisturizers, low-dose vaginal estrogen for dryness, topical anesthetics for trigger areas, graded dilator therapy, and treatment of underlying conditions such as endometriosis. Counseling, sex therapy, and education on positioning and pacing can improve comfort and confidence.
What to Bring to Your Appointment
- ✓Symptom timeline and what worsens or relieves pain
- ✓Current products used (lubricants, moisturizers, medications)
- ✓History of pelvic procedures, childbirth, or injuries
- ✓Any prior imaging or diagnoses (endometriosis, fibroids, infections)
- ✓Personal goals (pain-free intimacy, comfort with exams, fertility plans)
Frequently Asked Questions
1Will pelvic floor therapy help?
Many patients improve with pelvic floor physical therapy that focuses on relaxation, breath work, trigger point release, and home exercises. It is a first-line option for muscle-related pain.
2Do I need hormones?
If tissue dryness or thinning is present, low-dose vaginal estrogen can restore comfort. We review your health history to choose the safest and most effective option.
3What if penetration is not possible right now?
We can begin with comfort-first strategies, topical therapies, and gradual dilator work guided by a therapist. Many patients progress to comfortable penetration over time.
4Could this be endometriosis?
Deep pain with periods or certain positions can suggest endometriosis. If suspected, we discuss evaluation and targeted treatment to reduce pain.
Comfort and Confidence Are Possible
We will identify the cause of pain and build a stepwise plan—so intimacy can be comfortable again.
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