Pain with sex is more common than many people realise, yet it is often under-reported and misunderstood. Painful sex (also called dyspareunia) can affect people of all ages and genders and can occur with vaginal, anal or other forms of penetration.

There are many possible reasons someone may experience pain with sex, and it is rarely “all in your head”. Pelvic health physiotherapy is an evidence-based treatment option and can be highly effective in reducing pain and improving comfort, confidence and enjoyment with intimacy.

Common causes of painful sex

- Vaginismus or involuntary tightening of the pelvic floor muscles

- Pelvic floor muscle overactivity or guarding

- Postnatal changes following vaginal or caesarean birth

- Scarring or tissue changes following surgery or cancer treatment

- Hormonal changes (including breastfeeding or menopause)

- Persistent pelvic pain conditions such as endometriosis

- Previous pain, trauma or fear associated with penetration

Often, multiple factors contribute to pain, and a thorough, respectful assessment is key to effective treatment.

Pelvic Health Physiotherapy for Vaginismus

Vaginismus is a condition where the pelvic floor muscles involuntarily tighten in response to attempted penetration, making vaginal penetration painful or impossible. This may include pain with sex, tampon use, internal examinations, or medical procedures.

Vaginismus is not a conscious response and is not caused by weakness. It is often linked to protective muscle guarding, heightened nervous system responses, previous pain, fear, or past negative experiences and it is very treatable.

Pelvic health physiotherapy is a key evidence-based treatment for vaginismus and focuses on restoring comfort, control and confidence.

Physiotherapy for vaginismus may involve:

- Education about pelvic floor anatomy and the pain response

- Strategies to calm and regulate the nervous system

- Pelvic floor muscle relaxation and coordination training

- Gentle, graded exposure approaches guided entirely at your pace

- External treatment initially, with internal assessment or treatment only if and when you feel ready

- Support with dilator therapy if appropriate (never mandatory)

Treatment is always consent-led and individualised, with the goal of helping you regain comfortable, pain-free penetration and a sense of safety in your body.

How pelvic health physiotherapy can help with painful sex

Pelvic health physiotherapy focuses on understanding the muscular, nervous system and movement factors contributing to pain.

Your care may include:

- A detailed discussion of your symptoms, goals and concerns

- Education about pain, pelvic floor function and the body’s protective responses

- Pelvic floor muscle assessment (external and/or internal, only with your consent)

- Gentle, hands-on techniques when appropriate

- Breathing, relaxation and down-training strategies

- Gradual exposure and return to penetration, guided at your pace

- Supportive guidance around intimacy, exercise and daily activities

Internal examinations and treatment are never mandatory and will only occur if and when you feel comfortable.

A supportive, consent-led approach

Pain with sex can affect physical comfort, emotional wellbeing and relationships. We provide a trauma-informed, respectful and individualised approach, prioritising consent, safety and clear communication at all times.

If you are experiencing pain with sex or penetration, pelvic health physiotherapy may be an important part of your care and recovery.

Our Springfield Pelvic Health Clinic

Elevate Pelvic Health provides expert women’s health physiotherapy to the Springfield Central community and surrounding suburbs, including Brookwater, Augustine Heights, and Spring Mountain.

You can find us conveniently located inside the Total Fusion Lions complex at 16 Eden Station Drive. Our clinic offers a private, supportive environment where we combine evidence-based care with a deep understanding of the local community’s needs. Whether you are visiting us for pregnancy support or pelvic floor rehabilitation, our Springfield team is here to help you move with confidence.

Getting Here: We are just a short walk from the Springfield Central train station, with ample parking available on-site at the Lions stadium precinct.