Why Does Sex Hurt? Understanding Painful Sex, Vaginismus, and How Sex Therapy Can Help

Why Does Sex Hurt? Understanding Painful Sex, Vaginismus, and How Sex Therapy Can Help

Many people quietly search questions like “Why does sex hurt?”, “Is painful sex normal?”, or “What is vaginismus?” late at night, often feeling confused, frustrated, or alone. Painful sex is far more common than most people realize, yet it is rarely talked about openly.

Our team of experienced sex therapists work with individuals and couples who are navigating painful sex, vaginismus, and the emotional toll these experiences can create. Pain during sex is not something that needs to be tolerated or ignored. With the right support, it is both understandable and treatable.

This article answers the most common questions people ask about painful sex and vaginismus and explains how sex therapy can help restore comfort, confidence, and intimacy.

Why Does Sex Hurt?

One of the most common search queries is simply, “Why does sex hurt?” Pain during sex, clinically referred to as dyspareunia, can have multiple contributing factors. These may include pelvic floor muscle tension, hormonal changes, medical conditions, anxiety, past trauma, or sexual shame.

Painful sex can occur even when someone feels aroused or emotionally connected to their partner. Many people wonder why penetration hurts even with lubrication or why sex hurts sometimes but not others. These experiences often reflect how closely the body and nervous system are connected to emotional stress, expectations, and fear.

Painful sex is not “all in your head,” but it is also rarely just a physical issue. This is where sex therapy becomes an essential part of treatment.

What Is Vaginismus?

Another highly searched question is, “What is vaginismus?” Vaginismus involves involuntary tightening of the pelvic floor muscles, making penetration painful or impossible. People often ask if vaginismus is real or psychological. The answer is that it is very real and involves both physical and emotional components.

Common questions include:

• How do I know if I have vaginismus?

• What does vaginismus feel like?

• Can vaginismus start suddenly or after childbirth?

• Is vaginismus permanent?

Vaginismus can develop due to anxiety, sexual trauma, medical procedures, chronic pain, religious or cultural sexual shame, or fear of penetration. It is not a personal failure or a sign that something is “wrong” with the body.

Is Painful Sex Normal?

While painful sex is more common than you’d expect, it is not something that should be accepted as normal or unavoidable. Pain is the body’s signal that something needs attention.

Questions such as “Why does sex hurt after childbirth?” or “Why does sex hurt after menopause?” are especially common. Hormonal shifts, tissue changes, and life stressors can all play a role. Sex therapy helps individuals understand these changes and develop strategies to reduce pain and rebuild comfort.

Can Anxiety or Stress Cause Painful Sex?

A frequent question is, “Can anxiety cause painful sex?” The short answer is yes. When the nervous system is in a state of stress, the body often responds by tightening muscles, including the pelvic floor. This can lead to pain during penetration or a feeling that the body “shuts down” during sex.

This could explain why tampons may feel fine while sex hurts or why pain appears inconsistently. These patterns often point to nervous system responses rather than structural problems alone.

How Is Vaginismus or Painful Sex Treated?

One of the most common questions people search is, “Can painful sex or vaginismus be treated?” The answer is yes. Effective treatment often involves a combination of emotional, physical, and relational support rather than a single solution.

Painful sex rarely has only one cause. Muscle tension, nervous system responses, anxiety, trauma, hormonal changes, and relationship dynamics often interact. Because of this, treatment is most successful when it addresses both the body and the mind.

How Sex Therapy Helps with Painful Sex

Sex therapy plays a central role in helping individuals understand and heal from painful sex and vaginismus. Our team of Chicago sex therapists provide a safe, nonjudgmental space where clients can talk openly about experiences that are often accompanied by shame, fear, or frustration.

Sex therapy helps by:

Reducing fear and anxiety. Many people notice their bodies tense automatically during intimacy. Sex therapy helps identify fear responses in the nervous system and teaches tools to calm the body, making pain less likely to occur.

Addressing sexual shame and beliefs. Questions such as “Is vaginismus all in my head?” or “Am I broken if sex hurts?” are common. Sex therapy helps clients understand that painful sex is not a personal failure. Challenging shame-based beliefs can significantly reduce muscle tension and avoidance.

Supporting gradual, pressure-free intimacy. Sex therapy does not focus on “pushing through” penetration. Instead, therapists guide clients through gradual, non-penetrative intimacy exercises that build safety, trust, and comfort. This approach often reduces pain by removing performance pressure.

Improving communication with partners. Painful sex can strain relationships. Sex therapy helps individuals and couples learn how to talk about pain, boundaries, and desire in ways that foster understanding rather than guilt or fear.

How Pelvic Floor Physical Therapy Helps

Many people also search questions like, “Does pelvic floor therapy help vaginismus?” or “Do pelvic floor exercises work for painful sex?” Pelvic floor physical therapy is often a crucial part of treatment.

Pelvic floor physical therapists are trained to assess and treat muscle tension, coordination, and pain in the pelvic region. For individuals with vaginismus or painful penetration, therapy may include:

Muscle relaxation and coordination work. Rather than strengthening, treatment often focuses on learning how to relax overactive pelvic floor muscles and improve control.

Education about pelvic anatomy. Understanding how the pelvic floor works can reduce fear and confusion. Many people feel relief simply learning that their symptoms have a physical explanation.

Gentle, gradual exposure. When appropriate, pelvic floor therapists may use manual techniques or guide clients in using vaginal dilators at a pace that feels safe and controlled. These tools are never forced and are introduced thoughtfully.

Collaboration with sex therapy. Pelvic floor physical therapy is most effective when paired with sex therapy. Addressing muscle tension without addressing fear or anxiety can limit progress.

Why Combining Sex Therapy and Pelvic Floor Physical Therapy Works

A common concern is, “Which treatment should I start with?” In many cases, combining sex therapy and pelvic floor physical therapy leads to the best outcomes.

Sex therapy addresses the emotional and relational aspects of pain, while pelvic floor physical therapy focuses on the physical patterns contributing to discomfort. Together, they help retrain both the nervous system and the muscles to respond differently during intimacy.

Clients often find that as anxiety decreases through therapy, physical treatment becomes more effective. Similarly, as physical discomfort lessens, emotional safety and desire increase.

How Long Does Treatment Take?

Another frequent question is how long treatment will take. The answer varies depending on the individual, the severity of symptoms, and contributing factors such as trauma history or medical conditions.

Some clients notice improvements within a few months, while others benefit from longer-term support. Progress is rarely linear, and setbacks are normal. What matters most is moving at a pace that feels safe and sustainable.

Can You Heal Without Penetration Being the Goal?

Many people worry that treatment will pressure them toward penetrative sex. Effective treatment does not treat penetration as the goal. Instead, the focus is on comfort, agency, and pleasure.

Many individuals discover that redefining intimacy and expanding their understanding of sexual connection reduces pressure and supports healing. Penetration often becomes easier when it is no longer the central focus.

When to Seek Support

If painful sex or vaginismus is affecting confidence, desire, or relationships, seeking support sooner rather than later can prevent symptoms from becoming more entrenched. Working with a sex therapist and, when appropriate, a pelvic floor physical therapist can provide clarity, relief, and a clear path forward.

Painful sex and vaginismus are treatable conditions. With compassionate, coordinated care that addresses both emotional and physical experiences, individuals and couples can move toward intimacy that feels safe, comfortable, and connected.

How Should Parents Talk to Kids About Sex? A Chicago Sex Therapist Shares Guidance

How Should Parents Talk to Kids About Sex? Guidance from a Chicago Sex Therapist

Written by Abby Gerding

Talking about sex with children can be one of the most difficult tasks for parents. Parents often worry that their kids aren’t ready to have that talk, that they will say the wrong things, or share too much. These questions can make the conversation feel daunting, but these conversations are very important. Having open, honest, age-appropriate discussions about sexuality can lead to healthier relationships in adulthood, decreased shame, and built trust and safety in a parent-child relationship. 

As a Chicago sex therapist, I often support parents who want to raise confident, informed, and emotionally healthy kids- but aren’t sure how to start the conversation. These conversations don’t have to be scary, and you don’t have to tackle them alone. This article addresses some of the major questions parents have, including when to start, what to say, and how therapy can provide support for parents who are still uncertain.

When Should I Start Talking to My Child About Sex? 

Sex education and talking to kids about sexuality starts at an early age. Talking about sex with younger children can seem scary, but it is important to note that this does not mean that parents need to explain intercourse to a toddler. These early conversations often involve discussions on boundaries, consent, respect, and body awareness. It can be as simple as using correct terms when naming body parts.

As kids get older, conversations will evolve and involve introducing new topics as they become appropriate for their development. As a Chicago sex therapist, I often tell parents that early age-appropriate conversations lay the groundwork for lifelong comfort and safety. 

Starting these conversations early and having them often offers parents the chance to build trust with their children and become a reliable source of information. This also provides kids with an open environment to ask questions about what they want to better understand. 

What Exactly Should I Say When I Don’t Know the Answers? 

Oftentimes, parents find themselves faced with a question from their child that they may not have the answers to. This may feel uncomfortable, but it is okay to not have all the answers. A Chicago sex therapist can help parents build language and confidence for these sensitive topics. When in doubt, the most important thing a parent can do is remain open. 

When parents are feeling unsure, responses like “That’s a good question, let’s look it up together” or “I’m not sure, let me find some information on that for you” can be a great starting point. It is best to lead with honesty and curiosity rather than avoidance. Children appreciate authenticity and openness, and learning together can build trust. 

Will Talking About Sex Encourage My Child to Be Sexually Active? 

One common misconception related to sex education is that having an open dialogue about sex will lead to earlier and riskier sexual behavior. Many parents in Chicago express this concern, but as a Chicago sex therapist, I reassure them that honest dialogue promotes responsibility, not risk. 

Actually, the opposite is true. Research suggests kids who receive comprehensive sex education are more informed about their options, which is associated with higher rates of contraceptive use, healthier partnerships, and reduced  risk of unintended pregnancies. Open communication can also reduce feelings of sexual shame and promote better relationship satisfaction in the long term. 

How Can I Make the Conversation Age-Appropriate?

Age-appropriate conversations are based on development and understanding. Across all ages, it is important to use accurate terminology, clear language, and check in regularly. Only having “the talk” once reduces the ability to naturally build on conversations over time. A Chicago sex therapist can help parents tailor these discussions to their child’s maturity level and emotional needs. Below are some examples of age-appropriate topics:

• Early Childhood: naming parts of the body, setting boundaries, consent, and having an awareness that there are different variations of families.

• Middle Childhood & Preteens: understanding puberty and changes to the body, menstruation, understanding healthy relationships, having an awareness of diverse gender and sexual orientations, and building media literacy. Conversations around reproduction and pregnancy also tend to come up around this stage. 

• Teens: advanced understanding of consent, various types of sexual behavior, pleasure, safer sex practices, advanced understanding of interpersonal violence and healthy relationships, and more sophisticated media literacy.

How Do I Stay Calm When My Child Asks Uncomfortable Questions? 

Uncomfortable questions can come up, and it is normal to feel some awkwardness around them. The best thing parents can do in these situations is to pause and take a breath. It is better to take the time to answer thoughtfully and calmly. Starting with phrases like “that’s a really mature question” and “I’m proud you asked me” can help to give parents time to collect their thoughts. 

Practicing self-soothing and emotional regulation can be a great way to teach your kids that talking about sex is safe. Sex therapists can help parents navigate any anxiety around these conversations through role-play or practice questions. 

How Do I Talk About Consent and Healthy Relationships? 

 Consent and respect are topics that can be introduced in everyday ways at a very young age. They are not explicitly tied to sex. Consent can be modeled by asking children if they’d like a hug before greeting them and respecting their answer. Discussing sex early and often helps children feel comfortable voicing when they do or don’t want to be touched. This increases their safety and agency, as well as teaches them to listen to and respect others’ answers. Consent education can also help to prevent abuse and violence, because kids begin to understand that unwanted touch is not okay, and that they should reach out to a trusted adult. Simple phrases like “your body belongs to you” and “it’s okay to say no” are great ways to reinforce their autonomy. 

With teens, consent can be focused on sexual touch. It is important to emphasize mutual consent and respect before sex. Teaching teens about enthusiastic consent and the nuances of what should be considered non-consent is appropriate for this stage of development. With social media use, digital consent is a topic that should be introduced with older kids and teens. As sex therapists, we help parents frame these conversations through empathy and empowerment rather than fear.

What If My Child Is Hearing Misinformation from Friends or Online? 

In this digital age, kids are exposed to sexual content at an earlier age than they were a decade ago, whether that is through media or peers. Many families I see as a Chicago sex counselor want tools to help their kids navigate online information responsibly. It can be helpful for parents to ask their children what they have heard or seen about the conversations being had at home. Even asking them what their friends say about various topics can build some insight into what kinds of information they are getting. When misinformation arises, it is best to address it calmly and correct it using credible sources. 

How Can I Share Our Family Values Without Shaming My Child? 

Parents can share their beliefs and values around sex and relationships in a way that is non-shaming. The best way to do this is by taking on a non-judgmental approach. Being non-judgmental requires an openness to alternative ways of doing things. Parents can communicate their values by using “I” statements to discuss personal or familial values rather than speaking negatively about alternative views. It is important to remember that shame often blocks communication, and one way to avoid shame is to lead with compassion. When in doubt, working with a sexuality professional can help parents express values in a way that fosters connection over fear. 

Should I Wait Until They Ask, or Start the Conversation Myself? 

It is often best to be proactive in approaching these conversations with kids. Many children won’t bring it up first or ask questions because they aren’t sure how their parents will react. Some may sense feelings of discomfort or judgment around the topic, which may lead to hesitation. 

One great way to get the conversation started is through media, books, or even natural life events. Consider this helpful guide on using media to spark new conversations. Therapy can also be a useful tool to help parents build the confidence to start these discussions. 

What If My Child Asks About My Sex Life?

Children tend to ask questions because they are curious and want to better understand relationships. While it may feel like they are prying, it is likely driven by their desire to learn more about the world around them. It can feel difficult for many parents to navigate this scenario. In my role as a Chicago sex therapist, I help parents balance honesty with appropriate privacy. 

These situations can be a great opportunity to teach a child about boundaries and privacy. Responding with statements like “that’s a private part of adult relationships, but I can tell you how adults show love and respect,” conveys warmth and is non-shaming. 

TLDR 

Talking about sex with kids can be a tough task for parents. The best way to navigate these conversations with children is to lead with openness, curiosity, and compassion. Creating a shame-free, non-judgmental environment will provide kids with a space to ask questions and build trust. These conversations are done best when they occur often, rather than all at once. Continuing to build off of previous discussions is a great way to ensure that they are age-appropriate. For more resources, check out our comprehensive sexuality education guide. 

If you’re a parent in Chicago who feels unsure about how to navigate these important talks, our team of Chicago sex therapists can help you approach these discussions with confidence and care.

How Can Couples Maintain Intimacy With Limited Privacy at Home?

Finding Privacy and Maintaining Intimacy When You Have Children at Home

For many couples, the biggest challenge to intimacy after becoming parents is not a lack of love, attraction, or desire. It is the gradual loss of privacy. When children are in the home, the space that once belonged to a couple alone becomes shared. As Chicago sex therapists, we regularly hear couples say they want to feel close again but never quite feel alone enough to relax into intimacy.

This experience is not a personal failure or a relationship problem. It is a natural consequence of parenting in a home that is constantly active. Understanding how privacy shifts over time and learning how to work with those changes can help couples maintain intimacy without waiting for a future stage that may never feel perfect.

Why Privacy Is Essential for Intimacy

Sexual intimacy depends on more than time and opportunity. It requires psychological safety. When privacy feels uncertain, the nervous system stays alert. Even subtle vigilance can make it difficult to feel present, playful, or connected.

Privacy allows partners to let go of self monitoring and fully engage with each other. When couples do not feel private, sex can become quieter, more rushed, or avoided altogether. Over time, this can lead partners to assume their desire is gone, when in reality the conditions for intimacy are simply not supportive.

Infants and Toddlers: Creating Predictable Windows

During early parenthood, privacy is limited by exhaustion and unpredictability. Babies and toddlers require constant care and can interrupt at any moment. While this stage is demanding, many parents feel less self conscious because children at this age are developmentally unaware of sexual behavior.

Expert guidance at this stage focuses on predictability rather than spontaneity. Creating small, intentional windows of connection during naps or early bedtimes can help intimacy feel possible again. It is also helpful to release expectations about what sex should look like. Short moments of closeness and touch can maintain connection even when sexual encounters are less frequent.

Early Childhood: Introducing Gentle Boundaries

As children grow and become more curious, privacy begins to feel more fragile. Parents may worry about children walking in or asking questions, which can create anxiety during intimate moments.

At this stage, it is helpful for couples to begin establishing gentle boundaries around adult space. This might include teaching children to knock, reinforcing bedtime routines, or using simple language about privacy without introducing shame. When boundaries are clear, parents often feel more relaxed and less guarded during intimacy.

A sex therapist often helps couples work through the emotional discomfort that can arise here. Learning to tolerate mild uncertainty without abandoning intimacy is an important developmental step for couples.

School Aged Children: Redefining Privacy

Many couples are surprised by how challenging intimacy becomes once children are school aged. Kids stay up later and spend more time independently in their rooms. Even when children are not in the same space, parents may feel uneasy or inhibited.

Expert guidance at this stage involves redefining what privacy means. Absolute silence or certainty is rarely realistic. Instead, couples benefit from developing confidence in age appropriate boundaries and trusting that intimacy can exist even when the house is occupied.

Couples may also need to move intimacy earlier in the evening or into other parts of the day when energy is higher. Working with a sex therapist near me or a Chicago sex therapist can help couples identify patterns that keep intimacy stuck in an unrealistic time window.

Teenagers: Reclaiming Adult Space

With teenagers, privacy often exists physically but feels emotionally complicated. Parents may worry about being overheard or feel self conscious knowing their children are more aware of sexuality.

At this stage, expert guidance focuses on separating parental roles from adult identity. Parents are still allowed to be sexual beings. Clear household norms around privacy, respect, and closed doors support both teens and parents.

Many couples benefit from addressing internal blocks rather than external obstacles. Anxiety and avoidance often linger even when opportunities are present. A sex therapist can help couples reconnect with desire and intimacy without fear or embarrassment.

Why Waiting for the Perfect Time Does Not Work

Many couples delay intimacy until conditions feel ideal. In reality, perfect privacy rarely arrives. When intimacy is postponed indefinitely, disconnection can quietly grow.

Maintaining intimacy with children at home requires flexibility and intention. It means working with the stage you are in rather than waiting to move past it. Small consistent moments of connection often matter more than rare ideal ones.

How a Sex Therapist Can Help

Working with a sex therapist can help couples understand how privacy challenges interact with desire, anxiety, and communication. A Chicago sex therapist helps couples normalize their experience and develop realistic strategies that support intimacy in real life.

Sex therapy supports couples in identifying what is blocking intimacy emotionally as well as practically. It provides a space to talk openly about fears, expectations, and needs without judgment.

When to Seek Support

If privacy concerns are a major reason intimacy has declined or if sex feels tense or avoided, it may be time to seek help. Searching for a sex therapist near me can be the first step toward restoring connection.

Couples do not need to be in crisis to benefit from sex therapy. Often, early support prevents resentment and disconnection from taking hold.

Intimacy Is Still Possible

Having children at home changes the landscape of intimacy, but it does not eliminate it. Couples who maintain fulfilling sexual relationships over time are not the ones with perfect conditions. They are the ones who adapt with support and intention. If finding privacy feels like the biggest barrier to your sex life, you are not alone. With the right guidance from an experienced marriage therapist, intimacy can grow alongside your family rather than disappearing as it grows.