What Your Partner Doesn't Understand About Painful Sex (And How to Talk About It)
Last updated: April 2026
Pain during sex does not exist in a vacuum. It shows up in the moments before intimacy, in the tension that builds when a partner reaches out, and in the silence that follows an encounter that didn't go the way either of you hoped. It affects confidence, desire, and the quiet sense of closeness that holds a relationship together. And yet, so many women navigate it without ever finding the words to explain what is actually happening to them.
That is not because the words don't exist. It is because the medical reality of painful sex is poorly understood, even by many clinicians, let alone by partners who are doing their best to interpret something they cannot feel or fully see.
At The GSM Collective in Chicago, Dr. Sameena Rahman works with women who are dealing with exactly this. As a board-certified gynecologist and Fellow of the International Society for the Study of Women's Sexual Health, Dr. Rahman approaches painful sex as what it is: a medical condition with identifiable causes and real treatment options. Her practice is also built on the understanding that those treatment options work best when a woman's partner is part of the conversation.
This is a guide to having that conversation.
Dyspareunia Is a Medical Condition, Not a Message
The medical term for painful intercourse is dyspareunia. It affects a significant number of women at some point in their lives, and it has documented physiological causes. Pelvic floor muscle hypertonicity, vestibulodynia (a form of vulvodynia), endometriosis and associated inflammation, nerve-related issues, and periods of hormonal vulnerability that lead to changes in the vulva and vagina, like those that happen in menopausal transition and the genitourinary syndrome of menopause. None of these are abstract or mysterious. They are real, diagnosable, and in most cases treatable.
This matters for your partner to understand because the instinctive interpretation of painful sex is almost always relational. Partners wonder whether they are doing something wrong, whether you are less attracted to them, or whether something has shifted in the relationship. That interpretation is understandable, but it is inaccurate, and it moves the conversation in the wrong direction.
The framing that tends to land: "What I'm experiencing has a name. It's called dyspareunia, and it's a medical condition that affects many women. It is not about you, our relationship, or how I feel about you. It is about something happening in my body that we can actually address."
Leading with that framing gives your partner something concrete to hold onto, rather than a gap they will likely fill with self-doubt.
What Your Partner Might Be Feeling (That They Probably Won't Say)
Partners often silently carry their own version of this difficulty. They may feel shut out if you pull back from intimacy without an explanation. They may feel guilt when they sense that something is wrong during sex, even if they don't understand what. Some feel rejected in ways they won't articulate because they don't want to make the situation about themselves.
None of that is unreasonable. Intimacy is layered, and disruption in that space can feel personal even when it isn't. Acknowledging this directly can open up the conversation in a way that defensiveness or explanation alone usually can't.
"I know this might be hard to hear, and I want to make space for whatever you're feeling too. This isn't something I've been hiding from you to protect myself. I didn't have the language for it, and honestly, I wasn't sure how to start."
When you open the conversation that way, you invite your partner in rather than presenting them with a problem to solve or a verdict to accept.
Practical Language for Specific Moments
General conversations about painful sex are important, but they don't cover everything. There are also specific moments, before, during, and after intimacy, where having language in place makes a real difference.
Before: "I want to be close to you, and I also need us to be able to slow down or stop if something is uncomfortable. That doesn't mean something is wrong between us. It means I'm learning to pay attention to my body." Sometimes people need to do some preparation work beforehand, like stretching or relaxing the muscles.
During: Some couples find it useful to establish a simple shorthand before intimacy. Dr. Rahman often describes a color-based system: green means continue, yellow means slow down or shift, red means stop. Whatever language feels natural to both of you, the goal is to remove the pressure of having to articulate something in a moment when articulating anything is hard.
After: "I want to check in with you. I know our intimacy has felt different lately, and I don't want that to sit between us without talking about it."
These aren't scripts to memorize. They are entry points. The actual conversation will take its own shape depending on your relationship, your partner's communication style, and where you are in the process of seeking care.
Expanding What Intimacy Looks Like Right Now
One of the most useful reframes during this period, and one that Dr. Rahman emphasizes with patients, is loosening the definition of intimacy itself. For many couples, penetrative sex has become the default measure of physical closeness, which means that when it is painful or off the table, there is a sense that intimacy has gone away altogether.
It hasn't. Sensual touch, oral sex, mutual pleasure that doesn't involve penetration, even sustained physical presence and emotional attunement, all of these sustain a bond. They also often reduce the performance anxiety that can compound pain and make it harder to address physiologically.
"While I'm working on this with my doctor, I want us to find other ways to stay close. I don't want to put intimacy on hold entirely. I just need us to be open to it looking different for a while."
Partners who understand this tend to become assets in treatment rather than sources of additional pressure.
When Your Partner Asks If This Will Get Better
They will ask. And the honest answer is that, for most women seeking appropriate care, yes, it does get better. But it requires accurate diagnosis and the right treatment approach, which is rarely a single intervention.
Dr. Rahman's practice takes what's often called a biopsychosocial approach, meaning she treats the biological causes of pain while also addressing psychological and relational factors that influence how pain is experienced and how recovery unfolds. The GSM Collective includes nurse practitioners and pelvic floor physical therapists, enabling coordination in one place rather than across disconnected providers. Additionally, she has a network of sex therapists that she works with and can refer to.
This is worth explaining to your partner, not as a sales pitch for any particular practice, but because it shifts the framing from "we don't know what's wrong" to "there are people who specialize in this, and we are going to find them." That reframe matters for both of you.
"There are specialists who focus specifically on this. I'm going to find the right care, and I want you to understand what we're working toward together."
Starting the Conversation Is the Intervention
Many women wait a long time before talking to a partner about painful sex, and even longer before talking to a provider. The reasons vary: embarrassment, uncertainty about whether what they're experiencing is real or serious, and fear of how the conversation will land. But the silence tends to create more distance than the disclosure ever would.
Telling your partner what is happening is not a burden on the relationship. It is an act of trust. Most partners, given clear and compassionate information, will respond in kind. And most relationships, given space to work through this together, come out with communication patterns that are more honest and more durable than before.
Painful sex is a medical issue. It is also an intimacy issue. Both of those things can be addressed, and they are most effectively when the people involved talk to each other and to the right providers.
If you are ready to take the next step, The GSM Collective is available to help. Dr. Sameena Rahman and her team offer extended consultations designed to give you the time and clinical attention this kind of care requires. To schedule, call 312-574-3434 or visit thegsmcollective.com.
