Pain during intercourse is a topic that often remains unspoken. This leaves many individuals silently struggling with discomfort, confusion, and frustration. 

In this blog post, I’ll shed light on the differences between two common conditions - dyspareunia and vaginismus. I’ll also explore the impact of hormonal changes on sexual health and how to identify when the sympathetic nervous system is involved. 

I'll also share holistic solutions that have helped me and my clients overcome painful sex and enjoy intimacy again.  But first, let’s back things up a bit…

My Personal Story

My own experience with chronic low back pain began at the age of 14, shortly after starting my menstrual cycle. At the time, I was handed birth control pills and advised to rely on anti-inflammatory medications like Advil. 

This approach, however, only masked the symptoms without addressing the root cause.  

When I entered college and started engaging in sexual activity, the pain intensified. Sometimes, I’d even bleed. I reached out to doctors who assured me that this was normal and that I should continue having more sex to relieve the pain. 

Some even suggested drinking alcohol to relax before intercourse. A misguided piece of advice that I now know can have adverse effects on health and hormones.  

As time passed, my condition worsened, and I began experiencing frequent UTIs, often after each sexual encounter. The cycle of antibiotics continued even after I stopped testing positive for UTIs, as the symptoms persisted (I now know this was due to pelvic floor muscle tension). 

I also started grappling with recurrent yeast infections and gastrointestinal issues. These physical challenges took a toll on my relationships. I feared intimacy due to the debilitating pain.

I also experienced a sexual trauma during this time, which only increased my pain and made me more fearful of intercourse.

The Cultural Dilemma

My story is not unique. Many women face similar challenges. We live in a culture where women's pleasure is downplayed, and our pain is normalized. 

Our society and medical system often steer women away from seeking real help. This leaves us alone, navigating a landscape of discomfort and dissatisfaction.

Dyspareunia vs Vaginismus: What’s the Difference?

Dyspareunia and vaginismus are both disorders that can lead to painful sex – but for different reasons.

  • Dyspareunia refers to persistent pain during sexual intercourse.
  • Vaginismus involves involuntary muscle spasms that make penetration difficult or impossible. 

Distinguishing between the two conditions is crucial for effective treatment. 

Dyspareunia typically stems from physical causes, such as infections, scarring, or hormonal changes. But vaginismus is often rooted in psychological factors, such as anxiety or trauma. It’s possible to have both!

With both of these conditions, it's important to seek care from a pelvic floor physical therapist. They can get you on a treatment plan and show you the right way to use dilators or pelvic wands between sessions. 

Identifying Hormonal Contributions

Hormonal imbalances can play a significant role in sexual pain. Many factors can affect vaginal lubrication and tissue health, including:

  • Irregular menstrual cycles
  • Hormonal birth control
  • Pregnancy
  • Postpartum
  • Peri-menopause
  • Menopause 

Understanding these hormonal shifts is essential to fully address sexual discomfort. 

I recommend working with a skilled practitioner to weed out where the hormonal changes are coming from. Your healthcare provider may also suggest options like V-Magic Vulva Balm and estrogen topicals to help you find relief. 

The Role of the Sympathetic Nervous System

The sympathetic nervous system is in charge of the body's "fight or flight" response. And it can exacerbate sexual pain by causing muscle tension and anxiety. 

When your sympathetic nervous system is in overdrive, it’ll send you signals. This could present as an increased heart rate or shallow breathing during intercourse. The trick is to recognize these signs and use relaxation techniques and stress management tools to calm the nervous system.

Holistic Solutions for Dyspareunia & Vaginismus

Yoga and Meditation 

My journey began with gentle, restorative, and yin yoga, coupled with meditation and breathwork. These practices helped me release pelvic floor tension and regain balance in my body.  

Pelvic Floor Physical Therapy

Pelvic floor physical therapists are experts in pelvic dysfunction, including painful sex. A pelvic floor PT can guide you through exercises and manual techniques to ease muscle tension and discomfort.  

Try limiting sugar, alcohol, gluten, and dairy. These can increase inflammation and susceptibility to infections. Hydrate with plenty of water and electrolyte-rich beverages to support overall health.  

Nurture your body and melt away stress and tension with self-care practices. Some of my favorites include Epsom salt baths, self-touch and body mapping, essential oils, dry brushing, and castor oil packs.

Holistic Healing
Consider a holistic approach to healing. This may include supplementation, yoga nidra, and reducing toxins in your environment.  

Professional Support 

Invest in practitioners you trust, such as chiropractors, naturopaths, acupuncturists, and mental health therapists, to address your unique needs.


My journey from pain and frustration to healing and empowerment led me to specialize in pelvic health. If you’re struggling with pain during intercourse, I see you. Know your experiences are valid and seek the support you deserve. 

If you live in the Tucson area and are tired of living with dyspareunia or vaginismus, I’m here to help. By addressing hormonal imbalances and exploring holistic solutions, you can embark on a path toward pain-free and fulfilling sexual experiences. 

Remember, your pleasure matters -- and your pain can be transformed into an opportunity for growth and self-discovery. If you’re ready to start your healing journey, book your free discovery call here




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Dr. Emily Mason

Dr. Emily Mason

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