What Can Cause Painful Sex?

Various conditions can cause pain in or around the vagina or vulva.

Dyspareunia: Pain during or after penetration at the entrance of the vagina or deeper inside the pelvis.

Vaginismus: The pelvic floor muscles tighten automatically when penetration is attempted and can be with or without pain. It can also happen trying to use tampons or smear tests. It can make penetrative sex feel impossible, even without significant pain.

Vulvodynia: Persistent pain, burning, stinging or irritation around the vulva that lasts for 3+ months and isn’t explained by infection or another identifiable condition. Symptoms may occur all the time or only when the area is touched.

Provoked vestibulodynia: Pain specifically around the vaginal entrance when pressure is applied, such as during sex, tampon use or cycling. This is actually one of the most common forms of vulvodynia.

Pain with penetration and sex

How Physio Can Help

Treatment is always approached gently and at your pace. Depending on your symptoms and what you need, physio may involve:

  • Helping overactive pelvic floor muscles relax
  • Breathing and relaxation strategies
  • Reducing sensitivity and guarding patterns
  • Education around pain and muscle protection
  • Advice and gradual exposure approaches to build comfort and confidence

There will be no pressure or expectations put on you. Everything is guided by you and your goals.

Symptoms can be affected by one or more factors, including:

• Pelvic floor muscles that are overactive or protective
• Increased sensitivity of the vulval tissues
• Hormonal changes (such as breastfeeding or menopause)
• Pregnancy or childbirth
• Previous pelvic surgery or investigations
• Persistent pain conditions
• Skin conditions affecting the vulva
• Previous painful experiences

How Can Women’s Health Physio Help With Painful Sex?

If you’re experiencing painful sex, or pain with internal examinations or using tampons, it’s worth finding out why and what you can do. Based near Lincoln, I offer effective women’s health physiotherapy to help with dyspareunia and vaginismus in a private clinic, just outside of Lincoln.

You’re Not Broken

These symptoms are far more common than many realise, because most people don’t talk about them openly. Getting support can help you to better understand what’s happening and what to do about it.

It’s about you feeling more in control of your body, health and future.

A Deeper Dive

Once we understand your symptoms, treatment may include helping the pelvic floor muscles relax, reducing sensitivity, improving control, and gradually rebuilding comfort with movement and intimacy.

Whatever we do, it will be gradual and guided by you, step by step rather than rushing or forcing progress.

What To Expect

We’ll talk through your symptoms and daily life first to help understand what’s happening. Together we’ll make a plan and talk and work through strategies and techniques to get started with straight away. At a later appointment, only if you and I think it would be useful and you feel comfortable, a pelvic floor assessment may be offered. They can be useful in some cases and for others may not be needed at all. There are plenty of different ways we assess and review symptoms.

Kegels & Dilators – Help or Hinder?

Pelvic floor exercises can help when there is weakness or poor coordination, but they may not be appropriate if the muscles are already tight. You may be glad to know that dilators are not a first-line treatment and are not needed for everyone. They can be useful in some cases further down the line, but generally as part of a broader, individualised plan. They are not tools to ‘stretch’ the tissue! With vaginismus, it’s not the stretch, it’s muscle contraction.

Pelvic Pain Physiotherapy in Lincolnshire

Inline Therapies offers women’s health physiotherapy in Lincolnshire, for bladder leaks, pelvic pain, pregnancy-related pelvic pain, vulval pain, painful sex and postnatal rehabilitation. See answers to some of the most frequently asked questions below!

Frequently Asked Questions

If you can’t find the answer you’re looking for, please get in touch.

Your first women’s health physio appointment will be for 70 minutes. This gives us the time to really understand your concerns and create a plan that works for you. During the first session we will talk through your symptoms, how they affect your daily life, and any relevant past injuries or experiences.

We may assess how your body moves and we’ll discuss findings so you know what may be happening and why. Together we’ll decide what you can get going with straight away. We’ll keep it simple and as easy to fit into your lifestyle as possible.

Follow-up appointments are a chance to check in with how things feel, any progress and to move things on. As your body adapts, your exercises and advice will evolve too. The goal is steady progress without feeling overwhelmed.

You’ll always leave with a clear plan and an understanding of the next steps. There’s no pressure to be perfect – progress over time is what matters.

If you have any questions between sessions or want to talk through anything before your next appointment, you can email support@inlinetherapies.co.uk

Yes. Some women simply find penetration impossible because the muscles tighten automatically, even though pain isn’t their main symptom.

Yes. Muscles that remain tense or overactive can contribute to pain, difficulty relaxing and discomfort during sex or internal examinations.

Any treatment or assessment is always explained beforehand and only carried out with your consent. You are always in control of what you are comfortable with. The appointments are completely led by what you want to focus on.

Due to the nature of the clinic, we do not have the facility to offer a chaperone for your appointment. Your first appointment generally does not include a vaginal examination. Instead, we focus on finding out about your symptoms and what your goals are, then putting a plan in place for you to start from that day.

In some cases, later in your treatment, you and I may feel a vaginal examination might provide extra insight. If so, we would talk through it first and I will answer any questions you might have. The decision is always yours. Your comfort and preferences will be respected at every step.

You are welcome to bring an informal chaperone, such as an adult family member or friend. Please note that the clinic will need to be made aware that a chaperone will be present at the appointment, at the time the booking is made.

If a chaperone is brought to an appointment without prior arrangement, the appointment will not proceed. However, it will still be charged as it would not be possible for the appointment to be filled at short notice by another person in need.

Every person is different, so there’s no set number or time. It will depend on your symptoms, consistency with advice and techniques, and what your goals are. For some people changes can be felt and seen within a few sessions, while for others it may be longer. There is no demand or expectation for you to book a certain number of appointments. We take each one at a time and see how things progress and change.

You’ll receive guidance on performing any exercises correctly, and advice around lifestyle changes related to your specific needs. It’s so important to remain consistent with your treatment plan at home, even if it feels challenging at times. Without consistency, changes may take much longer or not happen at all.

Everything that we work through, will provide you with the tools you need to manage these changes and maintain good pelvic health for life.

In most cases a GP referral is not required so can make an appointment with us directly. I am registered with WPA, Bupa and AXA Health Insurance. If you are a member of them, you may be able to claim your treatment through your policy. Contact your insurance provider and they will give you a ‘pre-authorisation code’ to provide at the time of booking.

However, there are a few exceptions where a doctor’s referral might be necessary. This includes if you have a specific medical condition that needs a doctor’s clearance before undergoing treatment.

You would not have an internal examination if any of the following were relevant to you at the time of the appointment. However, we can still complete a thorough assessment of everything else, which would provide information to design a treatment plan for you. Internal examinations would not be carried out with the following:

*First 3 months of pregnancy
*Within 6 weeks of vaginal or cesarean delivery
*Within 6 weeks after pelvic surgery
*Atrophic vaginitis, a condition of fragile skin seen in cases
of oestrogen deficiency
*Active pelvic infection
*Severe pelvic or vaginal pain, especially pain during
penetration or intercourse

If you can’t or don’t want to have an internal vaginal examination, it does not mean that your treatment will be limited. There are lots of other ways I can help you.

If you’re unsure whether you need a referral, feel free to get in touch for further advice.

It’s best to wear comfortable, loose-fitting or flexible clothing that allows for easy movement. Clothing needs to be comfortable and easy to move around in.

Your comfort is paramount during your appointments. We want to ensure your clothing helps rather than hinders your progress.

When an appointment is booked, the time is not available to anyone else. I know that sometimes things come up and plans need to be changed. Therefore, I ask that any changes or cancellations are made with at least 24 hours notice. You can do this via your client portal up to 24 hours prior or get in touch.

As I work on a 1:1 basis, if there is less than 24 hours notice, the appointment will need to be paid for as I would not be able to fill it with someone else. Please do get in touch if you have any concerns or questions regarding this. I would like you to feel 100% comfortable about any booking you make.

“Lisa listens to the problem and works with you to find a realistic solution – no gimmicks, just knowledge and a lot of genuine care. Brilliant, professional and kind.“

B. A, Lincolnshire