Vaginal Pain During Intercourse- SOLVED

I handed a tissue to my client, Eileen*. “I’m so afraid he’s going to cheat, but I don’t know what to do! It hurts when we have sex… I try to do it for him, but it just gets too painful,” she said through tears. Her partner, Ron*, turned and hugged her. That was the first time she felt comfortable enough to express that to him.

“First,” I replied, “sex isn’t going to be good for either one of you unless both of you are in it with the right intentions. We can fix this.”


Eileen’s issue was painful intercourse. She had pain off and on for years but finally sought medical help when it caused a rift in her marriage. Eileen’s gynecologist ruled out endometriosis, cystitis, pelvic inflammatory disease and referred her to a urologist who ruled out any bladder or kidney issues. Eileen was beside herself, completely unsure of what she should do next and afraid there was no remedy.

After all the doctors and tests, Eileen was worried about her body, her health as well as her relationship with Ron. During a coaching session, Ron confessed that he felt guilty hurting his partner during penetration which put a damper on his libido.

Since pelvic floor muscles are just that — muscles— I suggested a physical therapist who could assess Eileen’s pelvic floor and, if need be, manually manipulate and lengthen her vaginal muscles.

Before jumping into myofascial release on the tissue, there are other causes of pelvic pain that should be ruled out, according to physical therapist Erica Azzaretto from 5 POINT Physical Therapy PLLC. in Manhattan. In addition to gynecological or urinary issues, pelvic tightness and pain can be caused by:

  • Sitting at a desk job in a high-stress environment

  • Hip or back weakness which causes the pelvic floor to overcompensate

  • Irritable Bowel Syndrome (IBS) or constipation and straining on the toilet

  • Clenching due to stress or anxiety

  • Perimenopause, menopause or a post-hysterectomy drop in hormones that can cause thinning of the vaginal walls and dryness

  • Hormone levels that are off because of birth control

  • Ovarian cysts

  • Certain fitness activities like an intense barre class


Azzaretto also suggested screening for sexual trauma or physical trauma that could cause a vaginismus reaction, a tightening or closing so nothing can enter the vagina. The reaction is similar to closing your eyelids or flinching when something gets too close to your eyeball. Even being forced to use tampons before you’re ready can cause vaginismus.


As it turns out, in the endless quest to keep every part of her body youthful and tight, Eileen was using Yoni eggs and Kegel exercises to maintain her vaginal integrity as she got older… and she was a bit too committed to the practice. Eileen had activated her vaginal muscles to the point of rigidity.




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“When people think about their pelvic floor they think, ‘Oh, I need to Kegel,’ but a lot of times when we Kegel, it’s not beneficial,” Azzaretto explained. “When you tell someone [whose pelvic floor is already tight] to Kegel, they’re going to start getting pelvic pain, pain with sex or it can actually cause weak orgasms because the muscles are overworked.”

“The reasoning for a Yoni egg or vaginal weight would be to tighten the pelvic floor a little bit and increase the level of orgasm, but … you have to make sure you don’t have any pelvic floor issues,” Azzaretto continued. “So, when you start using the eggs, you want to make sure you’re not having any increased leakage or incontinence because that could be a sign that your muscles are actually too tight.”

Don’t just think of Yoni eggs as a trendy suggestion from Gwyneth Paltrow, actress and owner of the lifestyle brand Goop. You’re making a change to your body. Consider Yoni eggs a medical device and check with your doctor before starting any new routine, just as you would before beginning a fitness boot camp.

“It’s like someone that has tight hamstrings and then they’re doing a ton of hamstring curls,” Azzaretto said. “It’s going to make your hamstring go crazy! It’s the same exact thing. If you have a tight bicep and you are doing a million bicep curls, you can have a bicep spasm.

“You have to really have a pelvic floor without any issues before using a Yoni egg.”

Eileen’s problem, painful intercourse, isn’t uncommon. Pain during penetration can flag a host of problems, but there are ways vagina-owners can be proactive, including talking to their doctor and using lube to prevent dryness.

And don’t forget the benefits of a good vibrator to “get the juices flowing, for lack of a better word,” Azzaretto added. Not only can sex toys retrain your mind to associate pleasure with penetration, but they are handy tools during foreplay.

Eileen still sees the physical therapist, just as anyone with knots in their neck sees a masseuse or chiropractor. Her confidence has returned and she allows herself to express vulnerabilities to Ron, who is relieved that Eileen isn’t in pain anymore. And the lovers are back to their sexy adventures and intimacy.

*Names changed to protect anonymity.

Lia Holmgren