Sexual Pain
Pain During Sex
Is Not Inevitable.
Sexual pain is common, clinically significant, and — in most cases — treatable. It is also one of the most under-assessed and under-treated concerns in older adults. This hub brings together the clinical evidence, practical tools, and honest language to help you understand what is happening and what your options are.
Psychologist-authored · Peer-reviewed sources · clinically grounded toolsUnderstanding Sexual Pain
These articles establish the clinical foundation — what sexual pain is, how to describe it accurately, what the medical terminology means, and why older adults are disproportionately affected and underserved.
Where to Start
Sexual Pain Is Not Just a Young Person's Problem
The opening article in this series. Addresses the "it's just part of aging" dismissal directly — with the epidemiological data that contradicts it — and explains why older adults are both more likely to experience sexual pain and less likely to receive assessment or treatment for it.
Describing Pain
Is This Normal? How to Describe Sexual Pain Accurately
Most people arrive at a clinical appointment unable to describe their pain in the terms most useful to a provider. This article gives you the vocabulary — location, type, timing, triggers, severity — and explains why precise description leads to faster and more accurate assessment.
Clinical Terminology
The Names Your Doctor Uses: A Clinical Glossary
Vulvodynia, vaginismus, dyspareunia, provoked vestibulodynia, genitopelvic pain/penetration disorder — the clinical names for sexual pain conditions are specific and matter for diagnosis and treatment. This article demystifies the terminology so you can participate in your own care.
Why Sex Hurts: Specific Conditions
Sexual pain in later life has identifiable causes. These articles address the most clinically significant ones — what is happening physiologically, why aging is a factor, and what the evidence says about treatment.
GSM · Menopause
GSM: Why Sex Hurts After Menopause
Genitourinary syndrome of menopause (GSM) is the single most common cause of sexual pain in postmenopausal women — and one of the most undertreated. This article covers the physiology of GSM, its symptoms, why they worsen without treatment, and the full evidence base for local and systemic interventions.
Pelvic Floor
The Pelvic Floor Across a Lifetime
Pelvic floor dysfunction is a major contributor to sexual pain — and one that spans both genders, though it presents differently. This article traces how the pelvic floor changes across a lifetime, how dysfunction develops, and the clinical evidence behind pelvic floor physiotherapy as a first-line treatment.
Sexual Pain in Men
Male sexual pain is underdiagnosed, understudied, and rarely discussed — even in clinical settings. It is not rare, and it is not untreatable.
Male Pain
Male Sexual Pain: What It Is and Why It's Overlooked
Covers penile pain, testicular pain, pain with ejaculation, and pelvic pain in men — their causes, the clinical landscape, why these conditions are rarely raised in appointments, and what the evidence-based treatment options look like. An important read for anyone who has been told their pain is not a real concern.
Pathways to Relief
These articles address what treatment for sexual pain actually looks like — practical, evidence-based options from dilator therapy to pelvic floor physiotherapy — and the realistic picture of what recovery involves.
Dilator Therapy
Dilators: A Practical Guide
Vaginal dilator therapy is one of the most evidence-supported treatments for vaginismus, pelvic floor hypertonicity, and post-menopausal vaginal changes — and one of the most avoided. This guide covers how to start, what to expect, common difficulties, and how to use dilators as part of a comprehensive treatment approach.
Adaptation
When You've Decided to Work Around the Pain
Not everyone chooses to pursue treatment, and not everyone's pain is fully resolvable. This article addresses the decision to adapt — to shift the goal from penetration to pleasure, to redefine what a satisfying sex life looks like — with clinical framing that validates this as a legitimate and often wise choice.
When Pain Is Chronic, Unexplained, or Cancer-Related
Some sexual pain is persistent, difficult to diagnose, or connected to cancer treatment. These articles address the more complex clinical terrain — with the same directness and clinical grounding as the rest of this series.
Chronic Pain
The Hidden Weight of Chronic Sexual Pain
Chronic sexual pain does not stay in the bedroom. This article examines the psychological, relational, and identity-level impact of living with persistent sexual pain — the grief, the avoidance, the shame, and the clinical evidence on psychological approaches that help alongside physical treatment.
Cancer Treatment
Sexual Pain After Cancer Treatment
Chemotherapy, radiation, hormone suppression, and surgical treatment for cancer can all produce lasting changes to sexual anatomy and function — changes that are frequently not discussed before or during treatment. This article covers the specific mechanisms of cancer-treatment-related sexual pain and the evidence-based approaches to managing them.
Undiagnosed Pain
When Pain Has No Clear Diagnosis
Some people experience real, persistent sexual pain without ever receiving a clear diagnosis. This article addresses the experience of diagnostic uncertainty — why it happens, what to do when it does, how to continue pursuing appropriate care, and how to manage pain and maintain intimacy in the absence of a definitive answer.
Clinical Tools for Your Own Use
These worksheets are designed for individual use — to prepare for appointments, track your experience over time, work through the psychological dimensions of pain, and rebuild a sense of yourself as a sexual person beyond the pain.
Clinical Prep
WS1: My Pain Profile
A detailed mapping tool to help you describe your pain accurately — location, type, timing, triggers, and severity. Designed to be brought to appointments and updated over time. Complements the interactive Pain Profile Builder below.
Fear-Pain Cycle
WS2: Fear-Pain Cycle Mapping
A CBT- and acceptance-based worksheet to help you recognize the fear-pain cycle in your own experience — the pain, the anticipatory fear, the muscle guarding, and the avoidance that reinforces all of it. A foundation for psychological work alongside physical treatment.
Partner Communication
WS3: Talking to Your Partner About Sexual Pain
A structured guide to preparing for and having the conversation with a partner about what you are experiencing — what to say, how to say it, what you need from them, and how to navigate their response. Complements the interactive Partner Conversation Planner below.
Treatment Tracking
WS4: Treatment Tracker & Progress Journal
A structured tracking tool for monitoring treatment over time — appointments, interventions, pain ratings, what helped, what didn't. Designed to make patterns visible and give you concrete data to bring to your care team.
Identity & Reclamation
WS5: Reclaiming Your Sexual Identity
Pain reshapes how people understand themselves as sexual beings — often in ways that are lasting and damaging. This worksheet guides you through a structured reflection on who you are as a sexual person beyond the pain, and what reclaiming that identity might look like for you.
Related Resource
The Complete Guide to STIs
Some sexual pain — particularly with urination or penetration — can be related to an undiagnosed STI. This comprehensive reference covers every major infection, how they spread, symptoms, testing, and treatment. Relevant when pain has no clear gynaecological explanation.
Start Here: In-Browser Exercises
These three tools let you begin the reflection and preparation work directly in the browser. They are starting points — the downloadable worksheets go deeper, and clinical work with a pelvic floor physiotherapist or registered psychologist goes deeper still.
Interactive Builder
Pain Profile Builder
Map the key features of your pain. Use this as a starting point before completing WS1, or to prepare for a clinical appointment.
Where is the pain?
What does it feel like?
Rate your pain
Psychoeducation Tool
The Fear-Pain Cycle: Where Am I?
Tap each stage to learn what it involves, then note where you recognise yourself. Based on the CBT framework in WS2.
For a structured version of this exercise with clinical prompts, download WS2: Fear-Pain Cycle Mapping above.
Guided Planning Tool
Partner Conversation Planner
Prepare for a conversation with your partner about sexual pain. Four steps, private to your browser. Complements WS3.
Step 1 of 4
What do I most want my partner to understand about my pain?
Not a clinical explanation — what do you most need them to grasp? That it's real? That it's not about them? That you still want intimacy, just differently?
What am I most worried my partner will think or say?
Naming the fear specifically often reduces its power. Partners frequently surprise people — in both directions.
What do I need from my partner right now?
Being specific makes it easier for a partner to actually respond. "I need support" is harder to act on than something concrete.
When and where will I have this conversation?
Out of bed, when neither of you is stressed or tired, with enough time not to rush. The setting matters more than the script.
This is your starting point. For a structured written exercise with more depth, download WS3: Talking to Your Partner About Sexual Pain above.
A note on this content: The articles and tools on this page are written by a Registered Psychologist specialising in sexual health and pain. They are educational resources grounded in peer-reviewed research, and are not a substitute for clinical assessment or treatment. If you are experiencing sexual pain, please speak with your family physician and request a referral to a pelvic floor physiotherapist and/or a registered sex therapist or psychologist with experience in sexual pain. You do not have to accept pain as a permanent feature of your sexual life.