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Unwanted Pain with Sexual Activity

Unwanted pain during sexual activity can significantly impact your life. It’s a topic that regularly comes up when I’m working with clients, and it’s also a topic that can be really hard to talk about. It can be hard to find the right support. But what I want you to know is, you are not alone. And if you don’t want sexual activity to hurt, it doesn’t have to.


Unwanted pain with sexual activity can get in the way of pleasure, it can dictate when we do and when we do not engage in sexual activity, and it can completely change our feelings and beliefs about sexual activity all together.


Maybe right now you’re wondering what your feelings and beliefs even are around sexual activity. I really encourage you to do that actually, and then go a little deeper and ask yourself why you feel that way...ask what formed those beliefs? Maybe you discover there’s a feeling or belief you’re ready to leave behind.


Like I said, if you are experiencing unwanted pain with sexual activity, you are not alone. AND that there is something you can do about it.

Here are some of the common causes of this kind of pain:


  • Restrictions (knots) in the internal pelvic floor muscles.

  • Restrictions in the soft tissue at the vaginal entrance.

  • Dryness

  • Positioning of the uterus and/or cervix

  • Arousal discrepancies

  • Anticipatory tension

  • External pelvic girdle muscle tension

  • Trauma & Abuse (of any kind- this is an important distinction)

  • Depression, anxiety, excessive worry, or any other kind of mental/emotional/spiritual health difficulties

  • Beliefs, expectations, shame, and/or viewpoints that are no longer serving you

The most important part of moving through this is to be gentle with yourself. In fact, being gentle with yourself is imperative to your healing. And maybe something you’ve never been encouraged to do. Don’t forget that the strongest relationship we can have is with our body…and it deserves to be treated like your very best friend.


It’s not always necessary to know exactly why you’re experiencing pain. Yes, sometimes it helps us determine what to do about it, but if you have pain and don’t know why, it is okay.

This is a journey that FIRST requires safety. Safety within yourself. ALWAYS SAFETY WITHIN YOURSELF FIRST. The following exercises are options to explore ONLY if and when you are ready and want to. It is so helpful to work with someone along this journey- you are not alone, and you don’t have to do this alone. I selected these to give you an example of the different ways you can approach this.


  • Breath work. I know, I know…boring. BUT the quickest way to calm our nervous system is by taking a deep breath. And it’s always beneficial to start any kind healing practice with a connection to our breath. Our breath guides us in everything we do. By making breath work part of our daily lifestyle we will automatically improve our relationship to ourselves, and be able to receive information about what our body needs.

  • Look at your anatomy & when it feels comfortable, touch your anatomy. There’s no better way to know yourself than to actually get to know yourself. This can be applied to the vulva…or not. Sometimes my clients start at their shoulder…they look at their shoulder in the mirror, and then touch it and note what it feels like to have their hand on their body. I strongly encourage as much description as possible here- does the hand on the shoulder feel warm? Buzzy? Disconnected?

  • Lubrication. This helps if the pain is coming from a lack of natural lubrication, which increases friction. By making sure we have enough lubrication for any kind of sexual activity, it can help decrease pain from friction. Lubrication type though is important! Our skin absorbs 80% of what we put on it…and this area is particularly sensitive to things like fragrances which are hormone disruptors. You can find my favorite ones HERE.

  • Gradual insertion, gradual withdrawal. This exercise is applicable to your own finger, with toys, with the finger of a safe partner, a penis, etc. You insert into the vaginal or anal opening to just the first knuckle and stop and assess. Do you want the object/body part to enter further? Great, do so. If not, that’s where you stay. The same rule applies to withdrawal, just a little bit at a time.

    • This exercise is helpful for when safety with touch has been established and you’re ready for the next step. YOU are in charge the entire time. It can help decrease the amount of guarding and/or anticipatory pain.


Remember! These exercises are only options; there’s an endless number of ways to decrease unwanted pain with sexual activity but maybe one of these will help get you started, or at least confirm your hope that there is another way to live.


Have more questions or want more information from Dr. Ashley Zimmerman?


This post was reposted with permission by Dr. Ashley Zimmerman PT, DPT

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