Painful sex

You are not alone

Many women experience pain during and after sex and unfortunately some women experience pain every time they have sex. You may have been given a physical and/or medical reason why sex is painful but sometimes it’s not clear why it hurts. 

Whether you have a clear diagnosis or not for the cause of the pain, it’s easy to feel frustrated, helpless and hopeless if you’re dealing with this issue. It can affect your relationship, your self esteem and your enjoyment of life. 

It is important to know that even if conventional medicine has found no cause for pain, it does not mean there you can’t reduce or eliminate the pain so you can enjoy a satisfying sex life. 

Firstly, let’s take a quick look at the differences between pain during sex and after sex.

Pain during sex: 

Usually the pain occurs when a penis (or other object) tries to enter the vagina. For some women, even very shallow penetration is extremely painful. 

For other women, penetration is okay until it gets very deep or is repeated again and again as is typical during sexual intercourse. 

You may find that some positions are comfortable but others are painful.

What causes pain during sex? 

Tight pelvic floor

Your pelvic floor is a band of muscles that support the organs in your pelvis, namely your uterus, bladder and bowels. They control the release of urine and faeces and they help with sexual sensation and function. You have control over these muscles although it’s likely that like most of us, it’s only when you start to have issues that you pay attention to them. 

In women, tightness in the pelvic floor can cause pain with sex because your pelvic floor is supporting all the parts of your body associated with sex. If there is any pain, your body further tightens to prevent the pain. 

Just the thought of painful sex in the past causes your brain to further tighten the pelvic floor muscles as a form of protection leading to more pain.

Relaxation exercises can help. I use a combination of Sobada, abdominal and pelvic massage to help relax the area and some other modalities like EFT Tapping to help release the recurring pattern of sex – tight muscles – pain – further tightening. 


In a recent study, 85% of women with endometriosis reported painful sex. 

Women who have been diagnosed or suspect they have endometriosis often experience this kind of pain due to adhesions and endometriosis tissue that is found close to the vagina. Each thrust pushes against them causing pain.

Often, the whole pelvic area is tender and sensitive and any increased blood flow (see the section below) causes pain during or after sex. 

You can read more about endometriosis here. 

Pain after sex: 

You may have sex and then find you experience excruciating pelvic pain afterwards. When you are aroused and during sex, there is an increase in blood flow in your pelvis. Your body is preparing for sex, producing arousal fluid to lubricate your vagina and facilitate a good sexual experience possibly including an orgasm. 

Blood flow to your pelvis after sex 

After sex, while you should be enjoying a post-coital glow, your body should be reducing the blood flow to your pelvis and sending all that blood back to the heart. Unfortunately, if the blood flow in your pelvis is not circulating as best as it should, you can experience pain. 

It’s a bit like a traffic jam in your pelvis. All these cars have flooded to the area to prepare for the sexual experience but now their job is finished and they need to transport the waste products of the cells out of the area, the roads are blocked and they are stuck. 

It’s quite possible that you are also experiencing other symptoms of lack of good flow

(blood, lymph and nerve energy) in your pelvis like painful periods or painful ovulation, heaviness and pain after eating, constipation or diarrhoea, feeling of heaviness and bloating in your pelvis around your period. 

Pudendal nerve: 

Damage to the pudendal nerve can lead to pain and affect your ability to have or enjoy sex. The pudendal nerve is a major nerve in your pelvic region that sends movement and sensation information from your genital area. 

The pudendal nerve runs through your pelvic floor muscles and one of it’s functions is to provide your brain with information about touch, pleasure and pain to your vagina. 

What can affect your pudendal nerve? Pressure on the nerve due to difficult labours and births, accidents/trauma, pelvic surgery

Should I push through the pain? 

NO! Pain is your body’s way of telling you that something is wrong and I don’t believe you should push through the pain. I believe you should get help so you can correct the underlying issue. Hopefully you have a patient and caring partner who can support you through this. Ignoring the pain can actually make the situation worse in the long run. 

What’s going on emotionally? Or “Do you really want to have sex with this person?”

Your body is smart. So smart it sometimes knows before you do if it really wants to get intimate with someone. That’s a subtle way of saying – “Maybe you don’t actually want to be having sex with this person”

I know this is a super sensitive topic because there are many women in loving, committed relationships who are experiencing painful sex. I’m not talking to them. I’m talking to women who are feeling obligated to have sex with someone they don’t really want to and their body is protesting and reflecting what they may not be able to admit to themselves. 

Think about it. If someone you don’t know approaches you and is about to touch you, you most likely tense up and flinch, preparing for an unwanted touch. The same thing can happen with sex. If you suspect this may be true with you, I suggest contacting a qualified couples therapist to discuss your issues together. 

How can you improve the situation? 

When working with clients who are experiencing painful sex, my goal is to improve blood flow and relax the pelvic muscles and pelvic floor muscles and reduce any tension or pain in the lower back using abdominal and pelvic massage, known as Sobada. You can read about the relationship between Sobada and Arvigo Techniques of Maya Abdominal Therapy here. 

When you’re aroused the blood flow to your pelvis increases and after sex, that extra blood flow needs to drain back into regular circulation in your body. If blood flow in the area isn’t good, you may actually experience pain free sex but suffer terribly afterwards. Sobada imp

When vaginal pain occurs it may be caused by stress and tension in the whole pelvis, and if we release the area with Sobada massage over the abdomen and back, the pain often reduces significantly and even disappears completely. 

In addition, it will restore the uterus to its ideal position and improve blood flow to the area, making the experience of having sex more pleasurable and relaxing. If the pain is caused by endometriosis,  Sobada can help to decrease pain and discomfort at different times during the month as well as pain connected to sex. 

We are so much more than just our physical body. I allow plenty of time in client sessions to discuss how you’re feeling emotionally and find ways to help you release any negative feelings gently and improve your self esteem and relationship while we are working together. 

I use a combination of flower essences (Bach Flowers Essences and Israeli Flower Essences, guided imagery and Tapping (EFT Emotional Freedom Technique) because they are all effective methods for supporting women. 

I’m a holistic therapist and I am here to help you!


I love helping women to overcome their fertility challenges and other issues related to your cycles, pregnancy, periods and/or anxiety. 

I treat women with abdominal and womb massage techniques known as Sobada (formally the Arvigo Techniques of Maya Abdominal Massage) and reflexology.

I’m also an Advanced EFT Tapping practitioner and I work with women in particular issues around anxiety, depression, stress levels. 

I teach Fertility Awareness to help women better know their bodies and improve their chances of conceiving or prevent pregnancy naturally.     

I live in Modi’in, Israel and that’s where I spend my days helping women during their fertile years, pregnancy, menopause and other hormonal conditions. Bodywork sessions (massage and reflexology take place in my clinic in Modi’in but EFT Tapping sessions and Fertility Awareness education can take place online or in person).

Learn more about working with me here.


I came to Annette about half a year ago in the middle of a terrible endometriosis attack with extreme pains that lasted for several days. Even at the end of the first treatment I felt a reduction in pain. For several years I have tried various types of alternative treatments and never experienced anything that helped like the treatment from Annette. 

Since then I have been going to Annette once every week or so. After many years of taking the contraceptive pill continuously because of endometriosis I stopped the pill in order to get pregnant. I was terrified the pains would get worse once I stopped the pill. I was pleasantly surprised that I didn’t have any painful endometriosis attacks  when I stopped the pill. I had also made changes to my diet with the help of a dietician who specialises in endometriosis. The month after I stopped the pill I got pregnant naturally.

Annette is sensitive, professional, pleasant and very exact in her treatment. I am so happy I came to see her. I warmly recommend her to anyone with endometriosis, it was really life-changing for me. 

Rinat, Modi’in

I came for treatment after being diagnosed with adenomyosis. I was suffering from pain all the time and I was so discouraged. The treatment allowed me to express myself, my difficult feeling and at the same time feel much better physically. 

Annette, thank you so much for the support, for listening and your kind words. I really enjoy coming to you. Thank you for helping me not to feel discouraged and to feel more positive. 


My dear Annette, the treatment with you was great. Physically - relaxing and releasing and also emotionally I feel like I have a place to unload everything that is weighing me down and then feel so much lighter and more optimistic. When I come to you, I also feel like I am doing something to improve the endometriosis which worries me a lot. I am hoping with your continued help it will continue to improve. 

Neta, Modi'in

I always look forward to coming for treatment with Annette. I have seen a big reduction in endometriosis related pain and side effects. I feel like the abdominal massage and reflexology has helped me recharge my body to feel like new again. Annette is amazing and has magic hands. Thank you so much. 



I came to you a year ago in pain and sad without any tools to effectively deal with my medical situation (suspcied endometriosis). It has been a journey. From treatment to treatment I feel stronger and learned to treat myself. Thank you so much for everyone, love, Noam.

Hi Annette, I wanted to share with you that I have been thinking a lot about the year that has passed since Pesach until today. Last Seder night I was experiencing extreme pain all over my body and before the last day of chag I came to you for a treatment for the first time and left with a really really good feeling.

I am so happy with everything I received from you in the past year - physical treatment that touched especially where it was needed, emotional guidance that also touched exactly where it was needed and in general I feel like you are a life teacher and a source of inspiration. 

I am so happy that I met you, almost by chance (or actually not by chance at all). Thank you so much. Happy Passover.

Update from two months later: pregnant naturally without returning to IVF. 

Adina, Modi'in

The treatment for me was a safe space. One one per week that I know is just for me. Connecting to my body and thoughts, to my breath and my heart beat were a gift to myself. 

Especially in a person like Annette it complemented the experience not just in her impressive experience and her dedication but also her pleasant manner and lack of judgement. She always succeeded in sending me home with a great feeling and new ideas. 

The physical sensation and also emotional and mental at the end of each treatment was perfect. The scent of the oils sent me back many generations to the period of time when people were more connected to nature and to themselves and helped create an indescribable calm. 

I don’t understand how the treatment works but it just works. As someone with endometriosis, from the first treatment I felt an improvement and relief from symptoms and with time it just kept improving until I no longer worried about pain each time I expected my period.

Even with the attempts at getting pregnant, which was not easy and included fertility treatments like IVF, Annette’s treatment helped balance my body, to be calm and optimistic and even to enjoy the process. Annette was also like a life coach about different life challenges and always advising me well. Thank you for everything!! 

Rotem, Beit Shemesh

These may also interest you…

Endometriosis: Causes and treatment options

Endometriosis: Causes and treatment options

What is endometriosis?  Endometriosis is a condition in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus.  In most cases, these endometriosis lesions are found in the area of your...

read more
Pelvic pain

Pelvic pain

One of the main reasons women with endometriosis contact me is for relief from the pelvic pain that has taken over their life.  I’m happy to share that I have been able to help many women reduce and sometimes entirely eliminate pelvic pain.  You may suspect...

read more


Awareness and diagnosis of adenomyosis has skyrocketed in recent years but it still feels like endometriosis’s ignored step sister.  What is adenomyosis?  Adenomyosis is when the tissue that normally lines the uterus (endometrial tissue) grows into the wall of the...

read more


Maybe you’ve known you have endometriosis for a while but now you want to get pregnant?  Maybe you’ve never heard about endometriosis but your doctor suggested it may be why you are having trouble getting pregnant? While endometriosis can sometimes make it harder to...

read more


Unfortunately, it can take up to ten years for a woman to be correctly diagnosed with endometriosis. In the meantime, she may be suffering from any or all of the following symptoms:  Common signs and symptoms of endometriosis include: Painful periods (dysmenorrhea)....

read more