She Kept Having Sex Through the Pain. Here’s Why. (Patreon)

Genito-pelvic pain in women is more common than most people realize, and it rarely comes from “just one thing.”

Pelvic pain can show up at any point in someone’s life and is often shaped by a mix of physical changes, emotional stress, past experiences, and nervous system protection. The following case is a real-life example of how pain can persist long after an infection resolves, how women often continue having sex through pain to avoid judgment, and how healing happens not by forcing the body, but by helping it feel safe again.

I worked with a 39-year-old woman who developed persistent vulvar and vaginal pain after two things happened close together: a very distressing end to a long-term relationship and a bacterial vaginal infection.

The infection cleared. The pain didn’t.

For over a year, vaginal insertion was uncomfortable. Even using her vibrator caused her to tense and pull away, leading her to avoid self-pleasure altogether. Despite this, she continued having sex while dating, tolerating the pain because she didn’t want partners to think something was “wrong” with her. She often experienced small tears around the vaginal opening after sex, which increased fear and distress.

What we found

On assessment, she had increased tone in the superficial pelvic floor muscles, a guarded vaginal opening, and involuntary clenching of her glute muscles. Her vulvar and vaginal tissues appeared slightly pale and dry.

Even light touch triggered pain and withdrawal. Internal assessment had to be done very gently due to sensitivity.

This pattern fits what’s commonly known as vaginismus or penetrative disorder, the involuntary vaginal muscle guarding that interferes with penetration and is often paired with fear and anticipation of pain.

This wasn’t “in her head.”

Her nervous system had learned that erotic touch was a threat.

How we approached treatment

The goal was not to push through pain, but to help her body relearn safety.

Early work focused on touch she controlled herself, without pressure or partner involvement. This included slow breathing, stretching, gentle external touch, and gradually approaching the vulva at her own pace. Sensory supports like soft lighting, music, and calming scents helped reduce threat.

She later progressed to using a vibrating pelvic floor relaxation tool, which can help reduce pain by modulating sensory input. From there, we slowly introduced a vaginal dilator using a graded, consent-based approach. (A video tutorial is included here.)

After about six months of consistent nervous system work and gradual tissue adaptation, she returned to penetrative pleasure pain-free. Vulvar tearing resolved, fear decreased, and she felt empowered to communicate her needs during sex.

Why this matters (especially for partners)

Many women tolerate pelvic pain silently to avoid disappointing a partner or feeling “broken.” Supportive partners who slow down, listen, and remove pressure often play a critical role in healing.

Pain is not a personal failure.

It’s a protective response, and protection can soften when safety and access to pleasure is restored.

Medical Disclaimer: This content is for educational and informational purposes only and does not replace individualized medical care. It is not intended to diagnose, treat, or cure any condition. Always consult your own qualified healthcare provider about your specific health needs.