Female Dyspareunia, or Painful Sex – What to Do?

Definition of Dyspareunia

The condition refers to recurrent pain just before, during, or after sexual intercourse. It affects both men and women. This article focuses on the causes, symptoms and treatment of dyspareunia in women. It is a common condition, with many women experiencing pain in their vagina or pelvic area during intercourse at some point in their lifetime. Dyspareunia is similar to other conditions called vaginismus, vulvodynia and vulvar vestibulitis, and are all part of pelvic floor pain and dysfunction conditions.


Dyspareunia may be experienced differently by different people. For some, the pain will be a burning or itching sensation, for others, it will be throbbing, sometimes felt for hours after having penetrative sex. Some women experience pain only with deep penetration, others near the entrance to their yonis.

Physical Causes

Some common physical causes of dyspareunia include a lack of lubrication. This may be caused by a lack of arousal, or changes in the body following life events such as menopause or childbirth. Certain infections, for example sexually transmitted, yeast or of the urinary tract can cause the condition. Medications, such as certain anti-depressants and birth control pills can cause dyspareunia. Certain household products, such as shampoos or latex condoms, can cause irritation. Other causes include injuries, pelvic surgery, or certain conditions such as IBS.

Standard Treatments for Physical Causes

These include being treated for thrush, getting an STI check, avoiding any household products which may be causing irritation and using more lubricant during sexual activity. Water-based lubricant is recommended.

Did you know? Dyspareunia is a very common and highly treatable condition

Emotional Causes

Pain in the body may be a way of the body bringing attention to something which is not in alignment within. Sexual intercourse is often intertwined with such important things in our lives as love, relationships, family and a sense of safety. When we are feeling depressed, anxious, sad or angry we may find it more difficult to engage sexually and get aroused. This in itself may lead to the body not being ready for sex, resulting in pain. Another reason can be the after effects of having experienced rape or sexual abuse.

Tight pelvic floor muscles can contribute to, or cause, pain during intercourse. Stress is a major factor in causing the muscles in our bodies to contract and tighten. Another factor is previous sexual experiences. Anything ranging from rape and sexual abuse to uncomfortable sexual experiences can lead to difficulties with relaxing. This, in turn, can lead to the fear and expectation of experiencing more pain, thus creating a cycle of a self-fulfilling prophecy.

Physical and emotional causes are often linked due to the mind and body being one entity that impact on each other, rather than two separate ones functioning independently.

How Tantric Massage Therapy can Help with Dyspareunia

1. Tantric Education

Tantric therapy includes advice on how to relax the body, as well as specific techniques to help increase pleasure and build arousal in the body. This can help to overcome any pain that is being felt during sex because the woman is not ready for penetration. Safety is a big factor, so part of tantric education includes feeling into the body to sense what is wanted and not wanted, and being able to communicate. This includes saying “no” to something which is not wanted, and asking for something which is wanted in a clear way.

2. Relaxation of Pelvic Floor Muscles

Physical massage can help to relax pelvic floor muscles that are very tight. Since they are connected to the muscles of the stomach, back, legs and pelvis, which in turn are interconnected with all other muscle groups in the body, massaging the whole body can help to promote relaxation. Sometimes the muscles are very tight and clients are advised to do regular exercises at home to both strengthen and relax the pelvic floor.

3. Release of Emotions such as Shame

Many of my female clients share that they feel a lot of shame in regards to their bodies, genitals and sexuality in general. For example, many feel shame in regards to having periods, having sex, even pregnancy and childbirth. Because of this, many women can become disconnected from their pelvic area, wanting to notice it less, and consequently feeling it less. In tantric therapy sessions, clients are invited to place more attention on this, and other, parts of the body which may be carrying some discomfort. This often brings up uncomfortable feelings or memories.

Clients are invited to stay conscious, focusing on their breath, to witness and experience whatever comes up, in manageable portions. In this way, women learn to re-connect with their own bodies. By releasing or integrating any emotions which may have become stored in the body, psychological causes of vaginal pain can be healed. Therapists create a safe container and hold space to enable healing to occur.

For example, this may include acknowledging and consciously feeling grief from a miscarriage, or fear from a rape. These emotions are sometimes expressed outwardly and at other times simply felt inwardly and witnessed. Over time, this helps them to lose their ‘charge’. Women learn to feel safe again in their bodies and learn to love the bodies that they are in, letting go of any blame or shame towards themselves. A Yoni massage is often offered to help overcome pain in the pelvic area.

4. Use of Breath

When we shallow breathe or hold our breath, we are often not wanting to fully feel the emotion or sensation we are experiencing. Simultaneously, we also contract our muscles when we are not breathing. Consequently, women can end up with a lot of tension in the pelvic floor muscles. Deep breathing is important in helping clients to relax. Focusing on the pelvic floor by “breathing into” it can help women to re-connect with those parts of their bodies. Mindfulness plays an important role in tantric therapy. A good exercise to do both during sessions and at home is to notice those moments when the deep breathing stops. It is usually an indication that something uncomfortable is arising that the person holding their breath is not wanting to experience. Read more about the power of breath in tantric therapy.

5. Learning to Focus on the Positive

An important part of tantric therapy is focusing on pleasure. Once the stresses and traumas leave the body, we want to change the focus to something more positive. One way to do this is to re-train the brain to focus on the positive. For example, noticing what feels good in the body throughout the day. This may be areas of well-being, comforts, or positive thoughts or emotions. A great idea is to include all of the 5 senses as well as thoughts, internal physical sensations and emotions. This can take time and it is important to be patient with oneself as new neural pathways, thought patterns, habits and world view are created. Read more about ways in which we limit pleasure.

Further Information

I offer sessions in Teesside, within easy driving distance of Leeds, York and Newcastle, and in London.

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7 Steps to Pain-Free Sex by Claudia Amherd