Allura Sex Therapy Centre | Sex therapy in downtown Vancouver and online across Canada
The short answer: Sexual pain is common, it’s real, and it’s treatable. Pain during or after sex (clinically called dyspareunia) can have physical causes, emotional and relational causes, or, most often, a mix of both. The most effective care usually involves a team: a medical provider to assess the body, a pelvic floor physiotherapist when muscles are involved, and a sex therapist to help with the fear, tension, avoidance, and relationship strain that pain so often brings with it. You don’t have to keep pushing through it, and you don’t have to figure it out alone.
Maybe it started after having a baby. Maybe it’s been there since the very first time you tried. Maybe sex used to feel good, and somewhere along the way it started to sting, burn, or ache, and now your body braces before anything has even begun.
Many people with sexual pain spend years quietly enduring it. They tell themselves it’s normal, or that they just need to relax, or that they’re being dramatic. Some have been told exactly that by a professional. And over time, pain tends to bring company: dread, avoidance, guilt toward a partner, and a growing sense that something is wrong with them.
Nothing is wrong with you. Sexual pain is one of the most common concerns people bring to sex therapy, and with the right support, it can get better.
What is sexual pain?
Sexual pain is any pain that happens before, during, or after sexual activity. It can feel like burning, stinging, rawness, a sharp pain at the entrance, a deep ache with penetration, or soreness that lingers afterward. For some people it happens every time; for others it comes and goes.
Some terms you may have come across:
Dyspareunia is the general term for painful sex.
Vaginismus describes involuntary tightening of the pelvic floor muscles that makes penetration painful, difficult, or impossible.
Vulvodynia is ongoing pain or burning in the vulva without a clear cause. When the pain is at the vaginal opening and triggered by touch or pressure, it’s sometimes called provoked vestibulodynia.
Genito-pelvic pain/penetration disorder is the umbrella diagnosis in the DSM-5 for pain, fear, and muscle tension related to penetration.
Sexual pain isn’t only experienced by people with vulvas. People with penises can experience pain with erection, penetration, or ejaculation, often connected to pelvic floor tension, chronic pelvic pain, or other medical conditions. These concerns deserve the same care and attention.
Is it normal for sex to hurt?
It’s common, but it isn’t something you should have to accept. Occasional mild discomfort can happen, for example if you’re not fully aroused or a position doesn’t feel right. Pain that’s recurring, getting worse, or making you avoid sex is your body telling you something, and it’s worth listening to.
One of the most important messages we share with clients: you shouldn’t have to push through pain to have sex. Pushing through tends to make pain worse over time, not better.
What causes sexual pain?
Sexual pain usually has more than one contributing factor, and the factors often build on each other.
Physical and medical causes. Infections, skin conditions, endometriosis, scar tissue after childbirth or surgery, and hormonal changes that affect lubrication and tissue health (during breastfeeding, perimenopause, menopause, or with certain medications) can all cause pain. Bladder and bowel conditions can contribute too. This is why a medical assessment is an important part of the picture.
Pelvic floor tension. The muscles of the pelvic floor can become tight or overactive, sometimes in response to pain, stress, or trauma. Tight muscles can cause pain on their own and can make other sources of pain worse.
Not enough arousal. When sex starts before the body is fully aroused, there may be less natural lubrication and less physical readiness, which can make penetration uncomfortable. This is especially common when sex feels rushed, pressured, or focused on a partner’s timeline.
Anxiety, fear, and anticipation. Once sex has hurt, the body learns to expect it. Bracing for pain tightens muscles, which increases pain, which increases fear. This cycle can continue even after the original physical cause has healed.
Past experiences and early messages. Sexual trauma, painful medical experiences, or messages growing up that sex is shameful, dangerous, or something to endure can all shape how safe the body feels during sex.
Relationship factors. Feeling pressured, unheard, or worried about disappointing a partner can make it harder to relax, harder to speak up, and harder to stop when something hurts.
The pain-tension-fear cycle
This is one of the most important things to understand about sexual pain, and it’s often where sex therapy makes the biggest difference.
Pain leads to fear of pain. Fear leads the body to brace and tighten. Tension leads to more pain. And over time, many people start avoiding not just sex but touch, closeness, or anything that might lead to sex, which can create distance in a relationship and add guilt or shame on top of the pain itself.
Breaking that cycle often requires more than treating the body. It means helping the nervous system feel safe again, rebuilding trust in your own body, and changing the patterns that have formed around sex in your relationship.
Why sex therapy helps with sexual pain
Sex therapy is talk therapy – the same as any other counselling, with a therapist who has specialized training in sex and intimacy. There is no nudity, touching, or physical examination in session, ever.
What sex therapy offers is help with the parts of sexual pain that physical treatment alone doesn’t reach. That can include working with the anxiety and anticipation that keep the cycle going, processing past experiences that are living in the body, reducing shame, and helping partners talk about pain without blame or pressure.
And often, the work isn’t only about sex. Stress, anxiety, grief, trauma, or a relationship that doesn’t feel safe can all show up as tension in the body. Sometimes addressing those parts of your life is exactly what allows the pain to ease.
Sex therapy also helps couples find ways to stay close while healing. Many people with sexual pain feel like their only options are painful sex or no intimacy at all. A sex therapist can help you widen what intimacy looks like, so pleasure and connection don’t have to wait until the pain is gone.
Who else should be on your care team?
The best outcomes for sexual pain usually come from a team approach:
A physician, gynecologist, or other medical provider to assess and treat any physical causes.
A pelvic floor physiotherapist to assess and treat muscle tension and help retrain the pelvic floor.
A sex therapist to address the emotional, relational, and nervous system pieces, and to support you throughout the process.
If you haven’t had a medical assessment yet, that’s an important first step, and your sex therapist can help you think through what to ask. If you’ve been dismissed by a provider in the past, you deserve a second opinion.
What can help in the meantime
While you’re getting support, a few things can make a difference:
Stop pushing through pain. Give yourself permission to stop or pause whenever something hurts. This alone can begin to calm the fear response.
Take penetration off the table for now, if you need to. Many couples find relief in agreeing to a temporary break from penetrative sex while still enjoying other kinds of touch and closeness.
Prioritize arousal. Take more time, slow down, and focus on what feels good. A quality lubricant can help too, especially during breastfeeding or menopause.
Talk with your partner outside the bedroom. Sharing what’s happening when you’re not in the middle of sex can reduce pressure and help you feel like a team.
Get assessed. Especially if the pain is new, getting worse, or comes with other symptoms like bleeding, discharge, or bladder pain.
When should you see a sex therapist?
Consider reaching out if pain is making you avoid sex or intimacy, if fear or anxiety about pain is affecting your relationship, if you’ve had medical treatment but the pain or fear hasn’t fully resolved, or if you’ve never been able to have the kind of sex you’d like. You don’t need to have a diagnosis first, and you don’t need to be in a relationship.
Sex therapy for sexual pain at Allura
Allura Sex Therapy Centre is a group practice dedicated to sex, intimacy, and relationships. We see clients in person at our downtown Vancouver office and online anywhere in Canada, so you can work with a sex therapist who has specialized training in sexual pain, wherever you live. Our team works with individuals and couples of all genders, orientations, and relationship structures.
When it’s helpful, we coordinate with physicians, pelvic floor physiotherapists, and other providers, whether that’s someone here in Vancouver or someone in your own community elsewhere in Canada.
Getting started is simple. You can choose the counsellor who feels like the best fit from our Meet Our Counsellors page and connect with them directly, or our Clinic Manager can help match you based on your concerns, preferred style, availability, and whether you’d like to meet in person or online through our Counsellor Connection Form. Allura brings together experienced sex therapists under one clinic. Each manages their own practice independently, and all of us share a commitment to specialized, ethical sex therapy.
Frequently asked questions
Is painful sex normal?
It’s common, but it isn’t something you should have to live with. Recurring pain during or after sex is worth getting assessed and treated.
Can sexual pain be treated?
Yes. Most sexual pain can improve with the right combination of medical care, pelvic floor physiotherapy, and sex therapy.
Does sex therapy for sexual pain involve physical exams or touch?
No. Sex therapy is talk therapy. Any physical assessment or hands-on treatment is done by a medical provider or pelvic floor physiotherapist, not your sex therapist.
Is sexual pain “all in my head”?
No. Sexual pain is real, and it often has physical causes. At the same time, the brain and nervous system play a role in all pain, which is why addressing fear, stress, and past experiences can help alongside medical treatment.
Can sex therapy help with vaginismus?
Yes. Sex therapy is often a key part of treatment for vaginismus, especially in working with the fear and anticipation of pain, alongside pelvic floor physiotherapy.
Should my partner come to sessions?
It can help, but it isn’t required. Many people start individually, and some bring a partner in once they feel ready.
Can I see a sex therapist online for sexual pain?
Yes. Allura offers online sex therapy to clients across Canada, as well as in-person sessions at our downtown Vancouver office. Let us know which province you’re in when you reach out so we can match you with the right counsellor.
Is sex therapy covered by extended health benefits?
Many extended health plans across Canada cover sessions with Registered Clinical Counsellors, though coverage depends on your plan and sometimes your province. It’s worth checking with your provider before your first session.
If sex has been hurting, we hope this helps you feel a little less alone with it and a little more hopeful about what’s possible. Wherever you are in Canada, when you’re ready to talk it through, our team is here. See which counsellors are currently accepting new clients.