Why is Sex Painful? Understanding the Causes and Finding Support with a Virtual Sex Therapist
Sexual intimacy is often portrayed as something that should always be effortless and pleasurable. But for many people, sex can feel uncomfortable, tense, or even painful. This experience, called dyspareunia, is far more common than most people think. Still, because of shame, fear, or misinformation, many suffer in silence and believe that painful sex is simply something they have to “get used to.”
As a certified sex therapist and licensed marriage and family therapist providing virtual therapy in Texas, Louisiana, Illinois, Colorado, Oklahoma, and Tennessee, I want you to know that painful sex is not something you have to live with. Your pain is real, and there are ways to understand it, treat it, and move toward intimacy that feels safe and pleasurable.
Common Physical Causes of Painful Sex
Sexual pain often has physical origins. Some of the most common include:
Pelvic floor dysfunction – Tight or overactive pelvic floor muscles can cause burning, aching, or sharp pain with penetration.
Endometriosis – This condition can create deep pelvic pain during or after intercourse.
Hormonal changes – Menopause, postpartum, and certain medications can lead to vaginal dryness and thinning tissue.
Infections or medical conditions – Yeast infections, UTIs, and other gynecological conditions may contribute to discomfort.
Insufficient arousal or lubrication – Sometimes the body simply needs more time and support to become ready for sex.
If you suspect a physical cause, it’s important to consult with a medical provider. Sex therapy often works in collaboration with doctors and pelvic floor physical therapists to provide comprehensive care.
Emotional and Psychological Contributors
Sex is not just a physical act, it’s also deeply emotional and relational. Pain can also come from:
Past sexual trauma or abuse
Religious trauma or purity culture messaging that creates fear, shame, or tension around sex
Anxiety or stress that keeps the body in a heightened state of alertness
Relationship challenges that leave sex feeling pressured, disconnected, or unsafe
When the mind feels threatened, the body often responds by tightening, bracing, or shutting down, which can make intimacy painful.
The Cycle of Pain and Anxiety
One of the hardest parts of painful sex is that it often creates a cycle. A painful experience may lead to anticipatory anxiety before the next time, which causes the body to tense up and makes pain more likely again. Over time, this cycle can take away not only physical comfort but also joy, confidence, and connection.
Breaking this cycle requires both compassion and a holistic approach that looks at the body, the emotions, and the relationship together.
How Sex Therapy Can Help
As a sex therapist, my role is not to provide medical treatment but to help you explore the emotional, relational, and somatic (body-based) factors that contribute to painful sex. Together we can:
Identify possible sources of pain and discuss referrals to medical providers if needed
Explore the impact of trauma, anxiety, or shame on your sexual experience
Learn grounding and somatic exercises to help your body feel safe and relaxed
Build communication skills so you can talk openly with your partner about boundaries, needs, and comfort
Create a step-by-step plan to reintroduce pleasure and safety into intimacy
Virtual sex therapy allows you to do this work from the comfort and privacy of your own home, which many clients find lowers anxiety and creates a safer starting point for healing.
You Are Not Alone
If you have been experiencing painful sex, please know that this is not your fault—and you are far from alone. Pain is your body’s way of telling you something important. You deserve to be listened to, validated, and supported. Healing is possible, and intimacy that feels joyful, safe, and free of pain is within reach.
Next Steps
If this blog resonates with you, consider taking the first step toward support. I offer virtual sex therapy in Texas, Louisiana, Illinois, Colorado, Oklahoma, and Tennessee, helping clients navigate challenges like painful sex, religious trauma, anxiety, and intimacy concerns.
Reach out today to learn more about how therapy can help you reconnect with your body, your pleasure, and your relationships.