You’re Not Broken: The Truth About Painful Sex

If sex hurts, you are not broken.

I want to start there because so many women come into pelvic health carrying shame, frustration, or the quiet belief that their body is somehow failing them.

Maybe sex has always been uncomfortable.

Maybe it started when you began trying to get pregnant.

Maybe pregnancy changed things.

Maybe you gave birth months or years ago and sex still doesn't feel the way it used to.

Or maybe you're avoiding intimacy altogether because you don't want to deal with the pain.

Whatever your story is, pain with sex is common, but that doesn't mean you have to accept it as your normal.

There are reasons it happens. And there are ways we can work toward making things feel different.

When sex hurts, there can be a lot going on

Pain with sex — often called dyspareunia — can happen for many different reasons.

Sometimes it's related to the pelvic floor muscles. Sometimes hormones are involved. Sometimes there is scar tissue, changes after childbirth, inflammation, or another physical factor.

And sometimes your nervous system has learned that something about penetration or intimacy doesn't feel safe.

That doesn't mean the pain is “in your head.”

Your nervous system and your body are constantly communicating with each other. When your brain senses a threat, your body can respond by tightening muscles, changing breathing, increasing sensitivity, or preparing to protect you.

Your pelvic floor can be part of that protective response.

Your pelvic floor may be trying to protect you

We often hear about pelvic floor weakness, especially after pregnancy and birth.

But pelvic floor muscles can also be too tense or overactive.

If those muscles stay contracted or have difficulty relaxing, penetration can become painful.

For some people, that can look like burning, pressure, aching, or a feeling that penetration just isn't possible.

For others, the muscles may tighten automatically when penetration is attempted. This can happen with a condition called vaginismus, where involuntary pelvic floor muscle tightening makes penetration painful or difficult.

And here's the important part:

Your body isn't doing this because it's broken.

Your body may be trying to protect you.

That protection can become a pattern, even when the original reason for it is no longer present.

What about when you're trying to get pregnant?

This is one of the crueler parts of painful sex.

When you're trying to conceive, sex can start to feel less like intimacy and more like a scheduled task.

And when sex already hurts, the pressure to have intercourse during a fertile window can make everything even harder.

You may find yourself thinking:

I just need to get through it.

Maybe it won't hurt this time.

We have to do this today.

But you deserve care, too.

Trying to become pregnant shouldn't mean ignoring your pain or forcing yourself through something that hurts.

If sex is painful while you're trying to conceive, that's worth talking about with your healthcare provider and a pelvic health therapist.

You deserve support before pregnancy, too.

Pregnancy can change things, too

Pregnancy brings enormous physical changes.

Hormonal shifts, increased blood flow, changes in your pelvis and posture, growing abdominal pressure, changes in the pelvic floor, and changes in how you feel about your body can all affect intimacy.

And sometimes there are emotional factors, too.

Pregnancy can bring up previous experiences with pain, medical procedures, trauma, or difficult relationships with your body.

You might want intimacy but find that your body isn't responding the way you expect.

Or you might simply not want sex at all.

Both deserve respect.

There is no requirement to maintain a particular level of sexual activity during pregnancy.

And if sex is painful, you don't have to push through it because you think you're supposed to.

And then there's postpartum pain

Postpartum recovery doesn't end just because you've been cleared at your six-week appointment.

Your body has been through something enormous.

Depending on your birth experience, you may be healing from tearing, an episiotomy, a cesarean birth, stitches, scar tissue, pelvic floor changes, hormonal changes, or a combination of many things.

If you're breastfeeding, lower estrogen levels can also contribute to vaginal dryness and discomfort.

And then there's the nervous system piece.

If birth was frightening, traumatic, painful, or simply not what you expected, your body may carry some of that experience even when you don't consciously think about it.

Sometimes the body remembers before we have words for what happened.

That doesn't mean you're destined to hurt forever.

It means your body may need some support.

Hormones, scar tissue, and everything in between

Painful sex doesn't have one single cause.

For some people, hormonal changes may contribute to dryness or tissue sensitivity.

For others, scar tissue may be affecting how an area moves or responds to pressure.

Some people develop pelvic floor muscle tension after pain, injury, pregnancy, birth, or other experiences.

And sometimes several factors are happening at once.

That's why I don't believe in a one-size-fits-all approach to pelvic health.

You are not a checklist.

Your pain deserves to be understood in the context of your body, your experiences, and your goals.

Healing doesn't mean forcing yourself through pain

Pelvic floor therapy isn't about me telling you to “relax” while you grit your teeth through something uncomfortable.

It's about figuring out what your body needs.

Depending on your situation, therapy may include education about your pelvic floor, breathing and nervous system regulation, movement, exercises, hands-on techniques when appropriate and with your consent, scar tissue work, positioning strategies, and gradual approaches to rebuilding comfort and confidence.

Sometimes healing means learning how to relax muscles that have been working overtime.

Sometimes it means learning to recognize when your body is becoming protective.

Sometimes it means rebuilding trust with your body.

And sometimes it means figuring out what intimacy can look like while you're healing.

There is no single timeline.

You get to decide what healing means for you

Maybe your goal is to be able to have comfortable penetrative sex again.

Maybe you want to be able to use a tampon or menstrual cup without pain.

Maybe you're trying to conceive and want intercourse to stop feeling like something you have to endure.

Maybe you're postpartum and want to reconnect with intimacy without fear.

Maybe you aren't interested in penetration at all — you just want to understand your body and feel more comfortable in it.

Your goal matters.

Pelvic health care should support the life and relationships you want, not tell you what they should look like.

You are not broken

If sex hurts, you don't have to keep telling yourself that this is just how your body is now.

You don't have to feel embarrassed.

You don't have to apologize.

You don't have to force yourself through pain because you're worried about disappointing someone.

And you don't have to wait until things become unbearable before asking for help.

Pain is information.

Your body is communicating something, and you deserve someone who will listen.

If painful sex is affecting your pregnancy journey, your relationship, your postpartum recovery, or simply your relationship with your own body, you deserve support.

You don't have to figure it out alone.

I'm here to help you understand what's happening, make sense of what your body is telling you, and work toward feeling more comfortable and confident in your body again.

You are not broken. There is hope, and you deserve care.

Amber Schmitt 

www.sustainablepelvichealth.com

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