If sex or intimate touch causes you pain, you may have spent a long time wondering whether something is wrong with you, whether you're "doing it wrong," or whether you should simply push through it. None of those things is true. Unintentional and unwanted pain during intimacy, whether penetrative or not, is a recognised and treatable issue, and one that many people (cishet women especially) experience in silence.

This article looks at two related conditions, vaginismus and dyspareunia, and at pain that shows up beyond penetration too. The aim isn't to diagnose you, but to give you the language and the reassurance to take the next step, whatever that looks like for you.

What Is Vaginismus, and How Is It Different from Other Pain?

Vaginismus is an involuntary tightening of the muscles around the vagina whenever penetration is attempted or even anticipated, whether that's with a penis, finger, sex toy, tampon, or a speculum during a medical exam. It isn't something you can consciously control, and it isn't a sign of reluctance or low desire. It's closer to a protective reflex, similar to flinching, that the body has learned to produce.

Dyspareunia is a broader term for genital pain associated with sex. Unlike vaginismus, it isn't defined by muscle spasm specifically, and it can have many different physical causes. Clinically, the two are often grouped together under the term genito-pelvic pain/penetration disorder, because they frequently overlap and can be hard to tell apart without an assessment.

A useful distinction: dyspareunia can happen with any kind of intimate contact, not only penetration. Pain or discomfort during touch, oral sex, or even closeness that involves pressure on sensitive tissue all fall under this wider umbrella, which is part of why it helps to think about sex more broadly than penetration alone.

If pain shows up specifically with anal sex or touch, that has its own causes and considerations, which we cover in our article on anodyspareunia.

Why Does This Happen? Common Causes and Triggers

There is rarely a single cause. Physical contributors can include skin conditions such as eczema or lichen sclerosus, infections, hormonal changes (including those linked to menopause, breastfeeding, or certain contraception), endometriosis, scarring from surgery or childbirth, or reduced lubrication.

Psychological and relational factors matter just as much. Anxiety about pain itself can create a cycle: a painful or frightening experience leads the muscles to brace defensively next time, which makes penetration more difficult, which reinforces the fear. Past sexual trauma, shame around sex, or simply not having had a chance to feel safe and unhurried with a partner can all feed into this pattern too.

It's worth saying plainly: pain that has psychological components is no less real, and no less worthy of care, than pain with a clear physical cause. Most cases involve some mixture of both.

How Common Is Pain During Sex?

Pain during sex is one of the more common, and most under-reported, sexual health concerns. Many people live with it for years before seeking help, often because they assume it's just "how their body is," or because the conversation feels too embarrassing to start, even with a GP.

You are not broken, and you are not alone in this. Clinicians who work in this field, including women's health physiotherapists and psychosexual therapists, see this regularly. They are not shocked by it. It is, quite simply, part of their everyday work.

What Actually Helps?

Treatment depends on the underlying picture, which is why an assessment matters more than guessing. A GP can rule out or treat physical causes such as infection, skin conditions, or hormonal issues. From there, support might include pelvic floor physiotherapy, gradual desensitisation techniques such as vaginal trainers, and psychosexual therapy to work through fear, past experiences, or relationship dynamics that are keeping the cycle going.

Take a moment to reflect: when did you first notice the pain, and what was happening in your life or your relationship at that time? You don't need an answer right away, but noticing the context can be useful information to bring to any future conversation, whether with a GP, a physiotherapist, or a therapist.

How Do I Talk to My Partner(s) About This?

Secrecy and shame tend to make pain harder to manage, not easier. A partner who understands that the tightening or pain is involuntary, rather than a rejection of them, is far better placed to be patient and collaborative rather than hurt or confused.

It can help to separate the conversation from the moment itself. Raising it outside the bedroom, in a calm, low-pressure setting, gives both of you room to think rather than react. You might simply say what you've learned here: that this is a recognised, common, treatable issue, not a reflection of how you feel about them. A partner who can really listen rather than just hear the words, and who isn't fighting to be the one who's "right" about what's going on, can make a big difference.

Ask yourself: what would it feel like to stop carrying this alone?

If pain during sex or intimacy is something you've been navigating, you’re not alone. I work with clients on exactly these issues, with care, expertise, and absolutely no judgement. If you'd like to explore this further, book in for an initial consultation to talk through what's going on and what support might look like for you.

Tiga-Rose Nercessian (she/her), PhD Sex & Relationship Psychotherapist (UKCP, NCPS, COSRT Accredited) | Founder of Intimata | Specialising in Relationship Intelligence & Enhancement and Neurodivergent Intimacy.