3 Little Known Ways to Deal with Painful Sex

Painful sex is one of the most common causes of sexual problems in a relationship. According to the American College of Obstetricians and Gynecologists (ACOG), nearly 3 in 4 women feel pain during intercourse at some point in their lives (1). What comes next is loss of interest in sex, lower self-esteem and conflicts with a partner. But there’s good news too! It’s possible to eliminate or reduce the discomfort and enjoy intimacy again.

Where to start?

So, what do you do when painful sex becomes a problem? The same thing you do when there’s something wrong with your health in general. You go to the doctor, in this case an OB-GYN. A medical exam may be necessary to find the cause and recommend the right treatment. You may have to consult with other specialists, such as a urologist or psychotherapist.

While modern medicine brings great results, there are more ways to support the healing process. They are based on the concept of body awareness. The idea is very simple –understand your body to feel good in it. Here are the 3 little known ways to deal with painful sex. And you’ll have more pleasure in bed, too, if you start using them!

  1. Fertility awareness

When we think of fertility awareness, we imagine an old-school form of contraception. But there’s so much more to it! Today’s Fertility Awareness Methods (FAMs) are well researched and can be used effectively for pregnancy planning (2) and health tracking. With appropriate training and experience users are also able to use these methods to avoid getting pregnant (3). Tracking your cycle can help you make sense of your health and mood. And it offers a quick remedy for women who find sex painful. How? On certain days of the cycle you have more natural lubrication and you get a natural desire boost from your body’s chemicals (4). A perfect recipe for pleasure in bed.

“The high levels of estrogen around ovulation act to heighten sexuality for many”
Toni Weschler “Taking Charge of Your Fertility”

And, most importantly, your cervix moves up, making penetration more comfortable (5). The catch? It only works for women who are not on hormonal contraceptives. Also, if you’ve gone through menopause those cyclical changes won't apply to you.

  1. Physical therapy and vaginal mapping

Most of us have heard of the benefits of physiotherapy. Manual treatment helps us deal with sore muscles and back pain. It is not widely known, however, that physical therapy may be used (6) to support people dealing with sexual pain.

One of the most common disorders associated with painful sex is called vaginismus. It is defined as an involuntary contraction of the muscles around the opening of the vagina, making penetration painful or impossible (7). The condition is still not fully understood, and treatment approaches vary. The American College of Obstetricians and Gynecologists recommends a mix of psychotherapy, manual interventions and the use of so-called dilators (8).

If you’re open to try something a bit more alternative, consider sexological bodywork. This healing practice is a mix of manual therapy, massage, reflexology and breathwork (9).

One of the therapies recommended for painful sex is vaginal mapping. A skilled therapist presses on different points inside your vagina to find scars and other painful places. During a vaginal mapping session, you may discover that some parts are completely numb. You may also have an emotional reaction, such as crying.

The bodyworker will suggest practices to help you address the issues revealed. A word of caution: since alternative therapies are not regulated in most countries, it’s important to find a trusted provider. A professional sexological bodyworker will always describe the whole session in detail and ask for your consent before touching your body. When in doubt consult a professional organization such as the European Association of Sexological Bodyworkers.

  1. Pelvic floor training

You’ve heard about Kegels, right? That you need to exercise them for better sex and to prevent incontinence? What you may not realize is that pelvic floor training can help end pain during intercourse. But only if done the correct way. There is so much false information going around. The best advice is to get an appointment with a certified trainer, preferably with background in physiotherapy. In some cases, a referral to a doctor may be necessary as well. It is estimated (10) that 10-20% of American women suffer from dyspaurenia, that is persistent pain during sexual activity.

You will be diagnosed, taught how to exercise and what to avoid doing to prevent future problems (think pushing when sitting on a toilet). Moreover, you will learn that relaxing the muscles is as important as strengthening them. In today’s fitness-obsessed world women are used to doing crunches and tightening their bellies. The key to less painful sex lies, however, in our ability to relax and loosen the tension.

Consistency is key to success

These are just a few supporting options to deal with painful sex. What works best is a mix of traditional medicine and body awareness. These methods will only work if you are consistent and trust the wisdom of your body. So, follow your doctor’s orders and don’t miss those follow-up visits. Use body awareness techniques to feel more confident and you’ll soon feel pleasure again.


(1) American College of Obstetricians and Gynecologists. Why Sex is Painful? 2017  [URL: https://www.acog.org/-/media/For-Patients/faq020.pdf Accessed 12 Feb. 2019]

(2) Frank-Herrmann P., Jacobs C., Jenetzky E., Gnoth C., Pyper C., Baur S., Freundl G., Goeckenjan M., Strowitzki T. Natural conception rates in subfertile couples following fertility awareness training. Arch Gynecol Obstet. 2017 Apr;295(4):1015-1024. doi: 10.1007/s00404-017-4294-z.

(3) Raith Paula E., Frank-Hermann, P., Freundl G., Strowitzki T. Natürliche Familienplanung heute, (Heidelberg: Springer Verlag Berlin, 2013) chap. 12.3, Kindle

(4) Vitti A., Woman Code, (Harper Collins, 2015) chap. 8, Kindle

(5) Weschler T., Taking Charge of Your Fertility, (Harper Collins, 2015), chap. 20, Kindle

(6) Reissing ED., Armstrong HL, Allen C., Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study. J Sex Marital Ther. 2013;39(4):306-20. doi: 10.1080/0092623X.2012.697535.

(7) Basson R., Vaginismus. 2013 [URL: https://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus]

(8) Armstrong C., ACOG Guideline on Sexual Dysfunction in Women. Am Fam Physician. 2011 Sep 15;84(6):705-709 [URL: https://www.aafp.org/afp/2011/0915/p705.html]

(9) Association of Certified Sexological Bodyworkers “What is sexological bodywork” [ URL: https://sexologicalbodyworkers.org/resources/]

(10) SEEHUSEN D., BAIRD D., BODE D., Dyspaurenia in Women. Am Fam Physician. 2014 Oct 1;90(7):465-470.

 © Anka Grzywacz 2019