As a GP working in the NHS and in my private clinic, Dr Kahv Intimate Wellness, one of the most common things women say to me is this:
“I didn’t know if this was something I was allowed to bring up.”
They are talking about pain with sex. Sometimes they whisper it. Sometimes they apologise for mentioning it. Often, it is the first time they have ever said it out loud. And I want to say this clearly: sexual pain is a health issue — and it deserves care, time, and proper attention.
Sexual pain is more common than you think
Pain during sex affects women of all ages and backgrounds. In my work, I see women who have never been able to have comfortable penetrative sex, women whose pain began after childbirth or surgery, women in long-term relationships, and women navigating perimenopause or menopause.
Pain can feel like burning, tightness, tearing, deep pelvic aching, or discomfort that lingers long after intimacy ends. For some women it happens every time. For others, only occasionally — which can be just as distressing. What matters is not how often it happens, but how it affects you.
What women often fear
By the time many women reach my clinic, they are carrying more than physical pain. They often carry fear of being dismissed, worry that they are “overreacting,” or guilt about how sex has changed in their relationship. Some have been told tests are normal and felt stranded after that.
Some worry it is “all in their head.” Some feel broken.
My role, first and foremost, is to help women feel believed and understood.
How I approach sexual pain in my NHS GP work
In NHS general practice, time is limited — but listening still matters. When a woman tells me sex is painful, I do not rush to conclusions. I ask open questions, listen for patterns, and consider physical, hormonal, emotional, and relational factors together.
Sometimes the cause is clear and treatable with straightforward medical care. Sometimes it needs further investigation or referral. Often, it is a combination of factors — and that is where reassurance and explanation are just as important as treatment.
Even in a short appointment, my aim is that a woman leaves knowing: Her pain is real. She is not abnormal. Support exists.
What changes in my private work
In my private clinic, I provide psychosexual and relationship therapy, alongside medical expertise. This allows the time and space to go deeper. Sexual pain rarely fits neatly into one box. It sits at the crossroads of the body, the nervous system, lived experience, beliefs about sex, and relationships. When women feel rushed or reduced to symptoms, that complexity gets missed.
In private consultations, I work holistically. That means:
Taking a full medical and sexual history
Exploring hormonal, pelvic, skin, nerve, and muscle factors
Understanding stress, trauma, relationship context, and sexual beliefs
Moving at the patient’s pace — always
Examinations are never assumed. Consent is ongoing. Nothing happens without explanation.
Pain is not “just psychological” — or “just physical”
One of the most damaging myths about sexual pain is that it must be either physical or psychological. In reality, the body and mind are deeply connected — especially when it comes to sex.
Pain can cause fear. Fear causes tension. Tension increases pain.
Understanding this cycle is empowering. It removes blame and opens up multiple ways to help.
Why safe spaces matter
Many women do not struggle because help does not exist, but because they do not know where it is safe to ask. Appointments can feel rushed. Language can feel clinical. Questions can feel embarrassing. And so women stay silent, or search online without knowing what information to trust.
That is why spaces where women can hear from specialists, doctors, therapists, nurses, and sexual health experts — in a calm, respectful, non-judgemental environment — matter so deeply.
A safe space allows women to:
Ask questions they have never said out loud
Hear explanations that make sense
Learn without pressure or shame
Feel less alone
When women are given access to expert advice in a way that feels human and unhurried, understanding replaces fear.
Why talking matters
Silence allows pain to become entrenched — physically and emotionally. Early support can prevent pain from becoming chronic and protect relationships, self-esteem, and mental health. You do not need the perfect words. You do not need a diagnosis. You just need to say something:
“Sex hurts.”
“I avoid intimacy because of pain.”
“I’m worried something isn’t right.”
That is enough. You are not broken.
Sexual pain is not a personal failure. It is not something to tolerate, push through, or minimise. And it is not something you have to navigate alone. Whether I see women in the NHS, through my private psychosexual and relationship therapy work, or in wider educational spaces, my message is always the same: your experience matters.
When women are given time, expertise, and safe spaces to listen, learn, and ask questions, real change becomes possible — not just in pain, but in how they feel about their bodies and themselves.
If sex hurts, your body is asking for care. And care should never feel out of reach.
Written by: Dr Kahverry Rajeswaran
IMPORTANT CONTEXT
Educational information only. Not therapy, medical advice, diagnosis or crisis support.