When Sex Doesn’t Feel Good: A Guide To Overcoming Discomfort

Let’s talk about “sex”. 

Sex can involve many different activities - from penetrative intercourse to oral sex and the use of sex toys, such as dildos or vibrators. No matter the type, consensual sex should be pleasurable, not painful. 

In this article, we are going to focus on situations where sex may be painful, and explore solutions to help reduce or eliminate pain. For the purposes of this article, we’ll focus on those with vulvas and vaginas. 

When Sex Doesn’t Feel Good

For some, sex has never been enjoyable. For others, pain with intercourse developed over time or after a specific event. Some common reasons for painful sex can include: 

• Vaginismus or vulvodynia 
• Postpartum changes
• Genitourinary symptoms of menopause (GSM)
• Endometriosis or adenomyosis diagnosis
• Tight of pelvic floor muscles 
• Pelvic inflammation 
• PCOS 
• Emotional stress  
• Cultural influences
• History of sexual or medical trauma 

And so many more… 

Pain can occur with a touch of the vulva or clitoris, during insertion, with deeper penetration or during orgasm. 

As a pelvic floor physiotherapist, one of the most common causes of painful sex I treat is hypertonicity of the pelvic floor muscles. Essentially this means that the muscles of the pelvic floor are very tight and tender to touch. This tension can be a symptom of many of the diagnoses listed above, or it can be a stand-alone symptom due to stress, anticipation of pain, or weakness of the pelvic floor muscles. 

How To Reduce Pelvic Floor Tension 

Seeing a pelvic floor physiotherapist is a great first step in learning how to reduce pelvic floor tension (and finding out if that is the cause of your discomfort in the first place). 

You will learn how to relax and lengthen the pelvic floor muscles, and this can become a daily practice OR can be an exercise you work on before/during sexual activity. 

You will also learn IF AND WHEN you are ready to work on strengthening the pelvic floor muscles. Contrary to popular belief, tightness in the pelvic floor muscles often indicates weakness, not strength. . The important thing to note is that learning how to lengthen and relax the pelvic floor first in order to improve strength - constantly tightening or squeezing your pelvic floor muscles is not going to do the trick, sorry! ;) 

There are also tools you can use to help with self treatment at home, and here are some of my faves

Pain during insertion? Try a DILATOR SET.

• If your pain is during insertion, and it does NOT get better after initial insertion or you have difficulty inserting a penis, finger or sex toy  - try a dilator!!!
• These sets can help you gradually work towards pain-free insertion, allowing you to progress at your own pace

Pain with deeper penetration?  THE OH NUT can help!

• If your pain is with deeper penetration, is brought on by certain positions that allow deeper access to your pelvic floor, or is related to where your cervix is positioned during certain stages of your cycle. 
• The Ohnut helps to control and limit the depth of penetration from a penis or sex toy, allowing you to relax and focus on enjoying the moment. It also allows for modification by stacking more or less rings depending on how much depth you can tolerate. 

VIBRATORS are useful  if you can insert, but still experience pain!

• If your pain is with insertion, but you are able to insert a penis, finger or sex toy - vibration can help reduce the sensation of pain, relax the pelvic floor muscles and increase blood flow to the pelvic floor 
• A vibrator can be used as a self release tool, similar to dilators, and can also be used during foreplay, during insertion or for self-stimulation 
• Vibrators can also be a helpful tool for decreased sensation of the vulva, clitoris or vaginal canal - self touch and stimulation can not only help you learn more about your body’s wants and needs, but can help to bring back sensation to this areas 

And Let’s Not Forget …. Lubrication Matters!

A good quality lubricant is something EVERY sexually active individual should have at home. 

Natural lubrication levels can fluctuate day to day and as we age, and it is NOT related to arousal level! (read that again!)

There is no shame in using a lubricant during sexual activity, and it can make the experience more enjoyable for everyone involved. The type of lubricant you use (water-, silicone-, or oil-based) is up to personal preference.

Just remember, don’t use a silicone-based lubricant with a silicone sex toy. 

The Takeaway 

If sexual activities are painful or just don’t feel as good as they used to, you are not broken and you are not alone. 

There are MANY reasons that sex could be painful.

This article provides general advice, individual situations vary and are unique. 

Always consider speaking to a healthcare professional-  - whether it's your family doctor, pelvic floor physiotherapist and/or mental health professional - if you are experiencing painful sex.

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This post was written by wellbe’s pelvic health physiotherapist Amber Watkins. Click here to learn more about how pelvic health physiotherapy can help and to book your first session.