Why Is Pain During Sex Still So Dismissed? A Complete Guide
Over 650 women have healed Vaginismus at Proactive who came with the same story: sex hurts, but everyone keeps telling them it's normal. They've been told to "just relax," to "have a glass of wine," or worse, that pain is just part of being a woman.
Dr. Taru who herself experienced vaginismus, realised the lack of information regarding vaginismus. Hence Dr. Taru and our team have spent years building an 8 week vaginismus program because we believe something radical: your pain is real, and it deserves to be taken seriously. Too many Indian women have been conditioned to think painful sex is "just part of it." It's not.
Understanding Painful Sex
Let's start with the basics. Painful sex has medical names: dyspareunia (pain during penetration) and vaginismus (when your vaginal muscles involuntarily tighten). But here's what those textbook definitions miss: your body can "brace for pain" without you even realizing it.
If you've tensed up at the dentist before they even touched your tooth, you understand how anticipation makes muscles clench. The same happens with sex - your body remembers pain and tries to protect you by tightening up, even when your mind wants intimacy.
Here's the frustrating part: painful sex is often dismissed as "just anxiety." But anxiety usually works alongside physical factors - it's both, and they feed into each other.
Most Indian doctors still don't routinely screen for vaginismus, but we do it by default. One patient came in convinced she needed hymen surgery. After proper evaluation, she didn't need surgery at all - she needed therapy to address the fear and muscle tension around penetration.
With societal conditioning pushing women from being "asexual" before marriage to suddenly becoming "baby-making machines," we need to understand that bodies need time to adapt. Dismissing your pain isn't the answer.
Common Medical Causes
Vaginismus
This is the big one. Vaginismus is when your vaginal muscles involuntarily tighten in response to fear, anxiety, or trauma. It's not something you're doing on purpose, it's your body's protective response.
Here's a startling statistic: 7 out of 10 patients who come to Proactive reporting painful sex are diagnosed with vaginismus. That's why our treatment approach includes both pelvic floor therapy and trauma-informed counseling.
And here's something crucial: there's nothing structurally "wrong" with your vagina if you have vaginismus. Hymen surgery is never the solution despite what you might have been told. To know more join our weekly vaginismus webinar.
Endometriosis
Endometriosis is when the tissue that normally lines your uterus decides to grow in other places like your ovaries, fallopian tubes, or pelvic cavity. It's not just about bad periods. Many women with endometriosis report deep, stabbing pain during sex, especially around their menstrual cycle.
The problem? It often takes years to get diagnosed. We've seen too many women tell their pain is "normal period pain" when it's actually a chronic condition that needs proper treatment. At Proactive, we fast-track this process with proper imaging and specialist referrals.
Pelvic Inflammatory Disease (PID)
PID is usually caused by untreated infections, and it can make sex incredibly painful. You might feel pain during penetration, but also a deep ache that continues after sex. The good news is that PID is treatable, but it requires proper diagnosis first.
We offer non-judgmental STI testing and treatment because we know that shame around sexual health often prevents women from getting the care they need.
Vaginal Atrophy
This one's especially common after menopause or major hormonal shifts, but it can happen postpartum too. Essentially, your vaginal tissues become thinner and less elastic, which can make penetration uncomfortable or painful.
Many of our postpartum patients experience this without anyone warning them it might happen. Here's what we want you to know: vaginal dryness and thinning are medical conditions, not personal failings.
Psychological Factors
Anxiety and Sex
When you're afraid of pain, your nervous system goes into protection mode. Your muscles tense up, blood flow decreases, and ironically you become more likely to experience the very pain you were trying to avoid. It’s a cruel cycle.
For many women, this fear isn’t just physical, it's deeply psychological. About 85% of our vaginismus patients report anxiety specifically tied to sex. And that anxiety doesn’t exist in a vacuum.
News of sexual assault like the Nirbhaya case and others does more than shake us. It settles into our bodies. It heightens fear, tightens control, and teaches us that sex might not be safe.
But here’s what we don’t do: we never tell you to “just relax.”
Instead, we guide your body and mind to unlearn fear through medically informed therapy and gradual desensitization. We help you rebuild safety, trust, and comfort on your own terms.
Healing is possible. And you don’t have to go through it alone.
The Role of Stress and Trauma
Past trauma, cultural shame around sex, or sexual assault can all create physical pain responses. We've had women tell us they think about news stories like Nirbhaya when they're trying to be intimate, or they feel overwhelmed by cultural messages that sex is something that happens "to" women rather than "with" them.
Our approach creates space to process these emotions not override them. We don't tell you to push through trauma; we help you work through it.
Relationship Dynamics
Sometimes the pain isn't just about your body it's about feeling safe with your partner. Performance pressure, lack of emotional safety, or any form of coercion can block your body's natural arousal response.
We've heard this from so many women: "I wanted to be okay with it, but my body said no." That's your nervous system protecting you, and it's worth listening to. Consent isn't just verbal, it goes deeper than that.
Physical Contributors to Pain During Sex
Lack of Lubrication
This can happen for so many reasons: hormonal changes, anxiety, medications, or simply not being aroused enough. The important thing to understand is that it's not your fault.
Too many patients have told us, "I thought it was my fault that I wasn't wet enough." We provide education about lubrication without any stigma because this is basic biology, not a personal failing.
Menstrual Cycle Influences
Your cervix and uterus can be more sensitive at different points in your cycle. Some women experience more pain around ovulation, others during PMS. This isn't something to just endure it's information that can help you understand your body better.
Tracking your cycle can actually reduce confusion around when pain spikes and help you plan accordingly.
Hormonal Changes (Menopause, PCOS, Postpartum)
When your estrogen levels drop whether due to menopause, PCOS, or postpartum changes your vaginal tissues can become thinner and produce less natural lubrication. This isn't "you being frigid" or "not trying hard enough." It's your body adapting to hormonal changes.
Our PCOS and postpartum patients often report unexpected pain that no one warned them about. Knowledge is power here understanding what's happening in your body can reduce anxiety and help you seek appropriate treatment.
Treatment Options: Why One-Size Solutions Often Fail
Here's the problem with most healthcare approaches to painful sex: they're fragmented. You might see a pelvic physiotherapist who focuses only on your muscles, a gynecologist who prescribes pills or suggests surgery, and a psychologist who talks about past trauma. But rarely do these professionals communicate with each other.
We understand that women might feel intimidated and scared about a physical exam and the pain they might endure, but at Proactive we try our best to not conduct any physical examination, especially for vaginismus.
Sex-related pain is almost never just physical or just emotional it's both, and the two factors influence each other constantly.
We've seen too many women who come to us after trying "everything" , special lubricants, yoga classes, antibiotics, even hymen surgery none of which worked because the root cause was never fully understood.
At Proactive, our treatment integrates multiple approaches:
- A gynecologist who rules out medical conditions and addresses any underlying health issues
- A trauma-informed therapist who works with anxiety, shame, cultural conditioning, and past experiences
- A pleasure coach who helps retrain your body's responses and teaches you how to work with your muscles rather than against them
All of these professionals work together, not in separate silos. They share information, coordinate treatment plans, and adjust approaches based on your progress.
This multidisciplinary approach has helped over 650 Indian women move from pain and fear to confidence and pleasure—without anyone telling them it's all in their head.
The Bottom Line
Pain during sex is not normal, and it's not something you have to live with. Whether the cause is physical, emotional, or both, there are effective treatments available. You deserve healthcare providers who take your pain seriously, who understand the complex interplay between body and mind, and who work together to help you heal.
If you're experiencing pain during sex, know that you're not alone, you're not broken, and there is hope. Your body isn't betraying you—it's trying to protect you. With the right support, you can teach it that intimacy can be safe and pleasurable again.
Why Choose Proactive For Her
We've helped over 650 Indian women move from painful, anxiety-filled experiences to confident, informed pleasure. But numbers only tell part of the story—what makes us different is how we approach your care.
We're India's only women-led clinic that truly integrates care. While other places might refer you from one specialist to another, we've built a team where your sex therapist, gynecologist, and mental health counselor actually talk to each other. They coordinate your treatment, share insights, and adjust approaches based on what's working for you. You're not starting over and explaining your story to each new provider—we work as one unified team.
We never pressure you into internal exams. Too many women have told us horror stories about being forced into uncomfortable examinations before they were ready, or having their pain dismissed because "everything looks normal" during a pelvic exam. We understand that for many women dealing with vaginismus or sexual trauma, the idea of an internal exam can be terrifying. We work at your pace, build trust first, and only proceed with examinations when you feel comfortable and ready.
We don't dismiss your pain as "in your head." We've heard from countless women who were told by previous doctors to "just relax," "have a glass of wine," or that their pain was "psychological" (as if that made it less real). While we absolutely address the mental and emotional aspects of painful sex, we never use that as a reason to minimize your experience. Pain is pain—whether it stems from endometriosis, vaginismus, hormonal changes, or trauma responses.
Whether you're 19 or 49, we treat you with dignity and empathy, every single time. We don't make assumptions about your sexual experience, your relationship status, or what you "should" know about your body. We've worked with women who've never been able to use tampons, women experiencing pain after childbirth, women dealing with menopausal changes, and women whose pain started after sexual assault. Each story is different, and each deserves the same level of respect and individualized care.
Our approach recognizes something that many healthcare providers miss: sexual health is health, period. It affects your relationship with your partner, your confidence in your body, and your overall quality of life. You deserve providers who understand this and who are committed to helping you reclaim pleasure and intimacy on your own terms.
FAQs
Is pain during sex normal?
No, pain during sex is never normal. While many women experience it, it's always a sign that something needs attention—whether physical, emotional, or both. You shouldn't have to "tough it out" or accept pain as part of intimacy.
What's the difference between vaginismus and dyspareunia?
Dyspareunia is the medical term for any pain during penetration. Vaginismus is a specific type where your vaginal muscles involuntarily tighten, making penetration difficult or impossible. About 70% of women with painful sex at our clinic have vaginismus.
Will I need surgery to fix painful sex?
Very rarely. Most cases of painful sex can be treated without surgery through therapy, pelvic floor exercises, and addressing underlying causes. Hymen surgery, in particular, is almost never the solution for vaginismus or painful sex.
How long does treatment take?
It varies greatly depending on the cause and individual factors. Some women see improvement in weeks, others need several months. The key is working with a team that addresses both physical and emotional aspects together, rather than treating them separately.
Can painful sex be "just psychological"?
Pain is never "just" psychological—it's real regardless of the cause. While anxiety, trauma, or stress can contribute to painful sex, dismissing it as "all in your head" ignores the complex relationship between mind and body.
Do I have to have internal exams right away?
Not at Proactive. We work at your pace and never pressure you into examinations before you're ready. Building trust and comfort comes first. Many women need time to feel safe before any physical examination.
Will my partner need to be involved in treatment?
Not necessarily, but it can be helpful. Some women prefer to work on their own healing first, while others benefit from couples therapy. We tailor treatment to what feels right for you and your situation.