When Love Hurts: Talking About Pelvic Pain and Intimacy This Valentine’s Day (or any day!)

With our superstar Pelvic Physio, Agnes Budyn

Pain during intercourse is far more common than many people realize — yet it’s rarely talked about. For those experiencing pelvic pain with penetration, intimacy can feel stressful, frustrating, or even something to avoid altogether. This can affect not only physical comfort, but emotional connection, self-esteem, and relationships.

The important thing to know is that painful intercourse is not “normal,” and help is available.

What Is Pelvic Pain During Intercourse?

Pelvic pain during intercourse (often referred to as dyspareunia) can show up in many ways, including:

• Pain with penetration or initial entry

• Deep pain beyond entry

• Burning, stinging, or sharp sensations around the entrance or deeper

• Tightness or feeling unable to relax

• Pain that lingers after intercourse

  
  

It can occur at any age and may be linked to events such as childbirth, surgery, hormonal changes (including perimenopause and menopause), trauma, infections, endometriosis, or long-standing muscle tension. In many cases, there isn’t just one cause — pelvic pain is often multifactorial, involving muscles, nerves, connective tissue, hormones, and the nervous system.

Why Pelvic Pain Is Often Missed or Dismissed

Many people think and are sometimes told that painful sex is “just part of life,” something to push through, or something that will resolve on its own. Others feel embarrassed bringing it up or aren’t sure which healthcare provider to ask or how to bring it up. 

Unfortunately, ignoring pelvic pain can reinforce muscle guarding, fear, and nervous system sensitivity — making symptoms persist or worsen over time.

How Pelvic Physiotherapy Can Help

Pelvic physiotherapy is a specialized area of physiotherapy focused on the muscles, nerves, joints, and connective tissue of the pelvis. Pelvic physios are trained to assess and treat the underlying contributors to pelvic pain in a safe, respectful, and individualized way.

Depending on your symptoms and comfort level, pelvic physiotherapy may include:

1. Education & Understanding Your Pain

Pain is not just a tissue dysfunction — it’s also influenced by the nervous system. Learning why pain is happening can be incredibly empowering and can reduce fear and tension around intimacy.

2. Pelvic Floor Muscle Assessment

Contrary to popular belief, pelvic pain is often related to overactive or tense pelvic floor muscles, not weakness. These muscles may be unable to fully relax, making penetration painful and impossible. Assessment can be external and/or internal (with consent), and always moves at your pace.

3. Hands-On Treatment

This may include gentle manual therapy to:

• Release muscle tension or trigger points

• Improve tissue mobility

• Calm irritated nerves

Treatment is never meant to be painful and is always adjusted to your comfort.

4. Breathing, Relaxation & Movement Strategies

Breathing patterns, posture, hip mobility, core coordination and even jaw tension, all influence pelvic floor function. Learning how to relax the pelvic floor — not just strengthen it — is often key.

5. Gradual Return to Comfortable Intimacy

Pelvic physios can guide you through strategies for:

• Reducing pain with penetration

• Using tools such as dilators

• Improving communication and confidence

• Returning to intimacy at a pace that feels safe and comfortable

  
  

Pelvic Physio Is About More Than Sex

While painful intercourse may be the main concern, pelvic physiotherapy often helps with related symptoms such as:

• Pelvic pain outside of intercourse

• Pain with gynecological exams or tampon use

• Urinary urgency, frequency, or leakage

• Bowel discomfort

• Low back or hip pain

  
  

You’re Not Broken — and You’re Not Alone

Pelvic pain during intercourse can feel isolating, but it’s a valid medical concern and one that deserves care and attention. With the right support, many people experience significant improvement and reclaim comfort, confidence, and connection.

If intimacy has been painful, Valentine’s Day — or any day — can be a reminder that love shouldn’t hurt. Pelvic physiotherapy can be a powerful step toward healing, understanding your body, and rediscovering intimacy without pain.

Agnes Budyn, P.T.