Pain during sex: what to do and why it should not be endured

Common is not the same as normal

We have to start here, because many women go years without seeking help over exactly this confusion.

That pain during sex is common means it happens to many women. It does not mean it should be accepted, that it is part of a sex life, or that it passes on its own with time.

Pain has identifiable causes and in most cases has treatment. Enduring it is not patience or generosity: it is what entrenches the problem.

The cycle that sustains it

This is the part that explains why it gets worse over the years.

It hurts once. The next time the body anticipates it and tenses. The tension increases the pain. After several times, the body prepares for pain before anything happens, and anticipation alone produces contraction.

On top of that comes the emotional layer: avoidance appears, the other person reads it as rejection, and next time there is pain plus pressure.

Getting out of that cycle takes two things at once: treating the cause and stopping the pushing meanwhile. The second is usually what is missing.

What may sit behind it

Not for self-diagnosis, but to know there are concrete answers and the appointment is worth making.

• Lack of lubrication, very common while breastfeeding, postpartum and in menopause.
• Involuntary contraction of the pelvic floor muscles, which can make penetration very painful or impossible.
• Infections or skin conditions in the area.
• Endometriosis or other causes of pelvic pain.
• Scarring from a birth or surgery.
• Hormonal changes, including those associated with some contraceptives.
• A history of abuse, which can trigger defensive responses with no conscious decision.

Many of these are addressed well. Some resolve with something as simple as suitable lubricant; others need pelvic floor physiotherapy, which exists and works.

How to raise it at the appointment

The most useful practical part.

Say the word pain. Explicitly. Many appointments stop at “I do not feel like it”, and the key information gets lost there.

Describe three things: where it hurts, when it appears (at the start, during, after) and what kind it is (burning, stabbing, pressure).

Say since when and what has changed.

And if it does not get addressed, seek another opinion. It still happens that the answer is “that is normal” or “just relax”. It is not, and that answer is not the end of the road: there are specialized professionals and pelvic floor physiotherapists.

What to do in the marriage meanwhile

Stop penetration entirely. Not as punishment or an indefinite pause: as part of the treatment. Every episode of pain reinforces the anticipation.

Keep physical contact with no expectation. It is what keeps you from losing both things at once. If all contact leads to the same place, the contact gets avoided too.

Name what is happening. A repeated “no” with no explanation reads as rejection, almost always. One sentence is enough: “it is not that I do not want to, it is that it hurts and I am dealing with it.”

And from the other side: do not push, even if she says she can bear it. This is the most important part for the partner. Her being willing to endure it does not make it harmless: the body still learns the same thing.

About the passage that usually gets quoted

In believing contexts the text in 1 Corinthians about not depriving one another comes up frequently, and it sometimes gets used to ask for availability despite pain.

It is worth reading the whole thing: the passage speaks of reciprocity and mutual agreement, including agreeing to abstain for a time. And the text addressed to the husband in 1 Peter asks for considerate treatment and honor as an explicit condition, not an option.

No reasonable reading of those passages asks a person to endure physical pain. A body that hurts is not withholding anything: it is signaling.

When to seek help without waiting

• If the pain is severe or increasing.
• If there is bleeding during or after.
• If there is pelvic pain outside of sex as well.
• If penetration is outright impossible.
• If it appeared suddenly after never having happened before.

For this week

Two things.

Book the appointment, with the word pain included and the three descriptions prepared.

And agree an explicit pause, said out loud between you: no penetration until after the appointment, with physical contact that leads nowhere.

That agreement, once said, immediately removes the pressure and rejection layer, which is usually half the problem.

What the research says

Sexual desire does not always appear before the encounter. In Basson’s circular model, for many people — more often women and more often in long relationships — desire is responsive: it emerges after closeness and stimulation, not before.

Rosemary BassonModelo circular de la respuesta sexual femenina

What it does not prove:It is a descriptive model and does not apply the same way to everyone. And none of it justifies pressure: responsive desire describes how desire appears, not an obligation to comply.

The arrival of the first child produces in many couples an abrupt, measurable decline in satisfaction and communication quality, sustained over time and more pronounced in mothers. This is not an impression: it is one of the most replicated findings about the marital life cycle.

Doss, Rhoades, Stanley y MarkmanEstudio longitudinal sobre la transición a la paternidad (2009)

What it does not prove:It is a population average: some couples improve. Knowing it helps you prepare for the change, not assume it is doomed.

Emotionally Focused Therapy describes a cycle that repeats in most distressed couples: one pursues and protests, the other shuts down and withdraws, and each move triggers the other. Working on the cycle, rather than the topic, is what changes the pattern.

Sue JohnsonHold Me Tight · Emotionally Focused Therapy

What it does not prove:EFT has clinical trial support, but it is a treatment delivered by trained professionals. Recognizing the cycle at home helps; it is not the same as doing therapy.

Relationship research is mostly correlational and conducted on specific populations. It describes group tendencies; it does not predict what will happen in any particular marriage, including yours.

What the Bible says

1 Corinthians 7:3-5

Intimacy is described as mutual and reciprocal, with shared authority over one’s own body, and any pause is framed as by mutual agreement and for a time. The key word in the passage is mutual.

Reciprocity implies care for the other, not a claim over the other. A mutual agreement cannot be demanded unilaterally.

Beware of misuse:This text has been used to pressure or force sex within marriage. A passage about mutual self-giving cannot become an enforceable obligation: sexual coercion within marriage is abuse.

1 Peter 3:7

The instruction is addressed to the husband: live with understanding, treat his wife with honor, and recognize her as heir of the same gift. The text adds a rarely quoted consequence: failing to do so hinders his own prayer.

It joins daily treatment with spiritual life: a husband cannot treat his wife badly and consider his prayer a separate matter.

Beware of misuse:The phrase about the "weaker vessel" has been used to argue that a wife is inferior or less capable. The verse itself undoes that reading: it calls her an equal heir and places the entire demand on the husband.

Song of Songs 7

The Bible devotes an entire book to desire, the body and delight between spouses, and does so without embarrassment. Marital intimacy appears as good in itself, not as something to be tolerated.

For many believing couples the first step is not technical but one of permission: understanding that discussing this is not improper.