Dear Katherine,

I have this problem that I’ve been dealing with for most of my life, but it’s gotten to the point where I don’t want to deal anymore. I have an extremely sensitive pelvic floor. Because of this I have a very difficult time having sex with men. For lack of a better expression, I’m super “tight.” I often get muscle spasms, and penetration is extremely painful. I’ve been with men and women, but I’m currently mostly interested in men.

My question is: How and when is it appropriate to bring this issue up with a new partner? I want to be honest about why I keep not having sex with them, but I’m also self-conscious about saying, “Hey, we’ve been dating for a month, are you ready to go to therapy with me?”


My Dearest,

I feel your pain!

Pain during sex is something a lot of people (and their partners) deal with to varying degrees. Pelvic pain, for any gender, is a serious affliction and one not to be taken lightly. About 15 percent of women suffer from some kind of pelvic pain at some point in their lives. Millions of men do as well, but the research is not as fully developed.

I’m going to take a straightforward approach to address your issue. Many people suffer from pain during sex. How to articulate that can be challenging. My general rule of thumb—say something! Your partner doesn’t want to hurt you (if they’re a decent human), and giving them the heads up when they are is a great service.

That being said, the subtleties of chronic pain are often not just about talking about it. It’s about dealing with it. I suggest you consult with a medical professional about best practices when it comes to treatment.

Understand What’s Ailing You/Your Partner There are a lot of different kinds of pelvic pain out there. It sounds like for you it’s always been a thing. Vaginismus is the name for the painful spasm of the pelvic floor in women. This condition has a number of different treatments, which you can talk to your doctor or medical professional about. Check out this book or this physical therapy spot that specializes in this condition and may be able to recommend you a place to go in your area.

Take an Anatomy Lesson. Then Give One. When discussing pain with your partner it’s helpful to say exactly what hurts and what doesn’t. Just saying, “Ow, stop” is an OK place to start, but when you’re ready to continue seeking pleasure together, familiarize yourself and him with a bit of anatomy—inner labia, outer labia, clitoris, hymen, vaginal canal, cervix. It might feel really good to have somebody touch your clitoris and less good to have somebody go for your cervix. The more specific you can be about what hurts and what feels good, the more responsive your partner can be.

Penetrate Yourself I’m curious about your desire to involve a partner in this process pretty early. While there are many people out there who would be willing to go through that with you, this is ultimately a journey you’re on with yourself. Generally, the treatment for chronic pelvic pain is both psychological (figuring out circumstances that set it off) and physical (the gradual insertion of small and then larger phalluses into the vagina (think: Qtip, finger into yourself). This should definitely be done with help from a specialized physical therapist. After you’ve spent some time figuring out what YOU want to put in you, then ask your partner to help. This is actually a rule of thumb for people who don’t experience pain during sex—knowing how to ask for what you want is a HUGE help. (FYI, for men, treatments and therapies are more loosely defined but tend to involve a combination of physical and psychological therapy.)

Understand Your Partner’s Side When you do bring this up with somebody you’re with, understand that you may have been sending them subtle signs of rejection that have built up over time. They may feel sensitive or overwhelmed or frustrated by having to deal with this. That doesn’t mean they aren’t into you or don’t want to try it, but they may be already feeling a little bummed about not being able to give you pleasure. Starting the conversation early in a relationship will help your partner understand that your pain or lack of interest actually doesn’t have to do with him.

It Might Get a Little Clinical Look, talking about pain during sex can be a little bit of a boner kill. If you’re dealing with vaginal inserts and stopping and starting in order to establish comfort it can be hard to find the spontaneity that can make sex joyful. That’s totally fine. Just remember that eventually it will be worth it to have you both enjoy sex.

Focus on Foreplay I wrote an article on this a while ago that should be helpful. Foreplay can be the best part of sex. Re-invest your time in that once you’ve established your limits with a new partner. That way you won’t be worrying about that moment when you have to make “The big reveal.”

We should probably all talk more openly about what we do and don’t want when we’re with a new partner. You happen to have a situation that’s a little bit more extreme, but if you start by assuming that everybody you’re with also has his or her limits and painful experiences, it will make the conversation far easier.

Godspeed, my friend. I wish you more pleasure and less pain in your sexual future.


Just the Tips is’s weekly advice column with professional matchmaker Katherine Cooper. Have a question for Katherine about sex, love or dating? Shoot her a note at or follow her @kathkathcoop.