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Does Sex Therapy Help Painful Sex?

Updated: Jul 5, 2022


A distressed woman sits on the side of her bed after painful sex

Here's how and why sex therapy can be an option for painful sex


Key takeaways:

  • Painful sex (dyspareunia) can affect both men and women but is much more common in women.

  • There are two types of dyspareunia, known as entry pain and deep pain.

  • In men, painful sex typically only occurs when something is wrong, such as an infection or a tight foreskin.

  • There are many potential causes of painful sex, including medical conditions, insufficient lubrication, or psychological causes.

  • Seeing a sex therapist can help with painful sex.

Painful sex can be an isolating experience that brings up many emotions. You might feel anxious, sad, angry, depressed, and alone, like no one – including your partner – understands what you’re going through.


It’s important to know you aren’t alone, though. Painful sex can affect both men and women but is much more common in women. In fact, approximately 75% of women will have pain during sex at some point in their lifetime.


Dyspareunia: What is it?


The clinical term for painful sex is dyspareunia. It refers to persistent pain that is felt either pre, post, or during sex. Pain can be felt in multiple areas that include:

  • The genital region

  • The vulvar region

  • Anywhere in the labia (vagina lips) or at the opening of the vagina

  • Internal pain may also occur in the uterus, cervix, or lower abdomen

Besides the physical pain, emotional pain can be involved, especially if the relationship starts to suffer a loss of intimacy or becomes strained because of the disruption to sex lives.


Types of dyspareunia


There are two different types of dyspareunia. Where your pain is felt can help determine which type you’re experiencing. The two types are:

  • Entry pain (intraorbital or superficial dyspareunia): Entry pain occurs at the entrance of the vagina during penetration. It can be caused by injury, infection, or vaginal dryness.

  • Deep pain, also known as collision dyspareunia: When pain occurs with deep penetration and is felt in the cervix or lower abdomen, it is called collision dyspareunia. This pain can be worsened with certain sexual positions. This type of pain is usually caused by a medical condition such as endometriosis or PCOS, or a history of abdominal surgeries.

The pain that’s felt during intercourse is typically classified in one of three ways:

  • Primary: Primary pain means sex has been painful for you since you first became sexually active.

  • Secondary pain: This refers to pain that occurs after experiencing pain-free sex.

  • Situational pain: The term “situational pain” is used when the pain only happens during certain times.

This pain can happen at any time – it may begin suddenly or it may start occurring gradually over time.


Who can experience painful sex?


Painful sex affects both genders but is more common in women. And, while it can occur at any age, it’s particularly common in menopausal women. Research has shown that anywhere from a quarter to half of women have experienced painful sex post-menopause.


For men, painful sex typically only occurs when something is wrong. This could be due to an infection, inflammation, or a tight foreskin that makes penetration painful when the foreskin is pushed back.


What causes painful sex?


Painful sex can have many causes. It could be due to a medical condition or there could be a psychological reason. Here are some of the many causes:

  • Painful sex in men is generally due to infections such as thrush, a sexually transmitted infection like herpes, or a tight foreskin. Other causes include tears in the foreskin that may not be visible, inflammation of the penis, testicular swelling, or an allergic reaction to spermicide or latex condoms.

  • Sex can become painful where there isn’t enough lubrication; this can be due to low arousal, a medical condition that causes vaginal dryness, or a number of other reasons.

  • Medical conditions such as infections, PCOS, endometriosis, or vaginal atrophy.

  • If sex has been painful, your body may begin to tense up in anticipation of the pain when you’re about to have sex. The muscle tension can cause sex to become uncomfortable or even painful. This can turn into a condition called vaginismus.

  • Psychological issues, such as anxiety or depression, can lower libido and make it challenging to get sexually aroused. A prior history of sexual abuse may also contribute to pain during sex.

Although the situation may seem hopeless, some treatments can help, regardless of what’s causing your sexual pain.


What about sex therapy?


A specialized form of psychotherapy (talk therapy) known as sex therapy may be able to help you if you’re struggling with your sex life, including painful sex. Sex therapy can help address multiple concerns, including sexual trauma, challenges with intimacy, difficulty orgasming, and/or painful sex. And no, you don’t have to be coupled to attend. You can attend sex therapy solo.


Sex therapists undergo specialized training to help people with sexual dysfunction or challenges with intimacy. Although attending may sound intimidating or awkward, a good therapist can help you feel comfortable about attending. It’s far better to step out of your comfort zone and see a sex therapist than to resign yourself to a life of unsatisfying and painful sex.


How sex therapy can help with painful sex


Even if pain during sex is caused by a medical condition, such as endometriosis, seeing a sex therapist can still be beneficial. Pain resides in the brain. This doesn’t mean that it’s all in your head. Rather, it means that pain is a mind-body experience. Trying to push through the pain and have sex despite it can cause your brain to develop an association between sex and pain, creating a psycho-emotional feedback loop.


Even if your gynecologist or physician can resolve the physical issue causing you pain, the psycho-emotional component can’t be changed with only a body-based intervention. A sex therapist can help you break the cycle of pain and address components like low libido. They can also help you learn to experience pleasure and develop a healthy sex life with your partner.


Get support from a qualified sex therapist in the South Florida area


Painful sex can affect your libido, your relationship, and your mental health. Having the support of qualified professionals to help you manage can be a gamechanger. Attending sex therapy can help you identify possible causes behind your pain, and learn new coping skills that can help you manage – and improve your sex life. Everyone deserves to have a fulfilling, satisfying, and enjoyable sex life!


The team at Love Discovery is ready to welcome you with open arms. If you’re ready to get started in therapy to help facilitate healing within yourself and your interpersonal relationships, make an appointment with any of our therapists today. Feeling hesitant about how we can help? Call 305.605.LOVE (5683) for a free 20-minute consultation.


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