A note before you begin: Positional adjustments help significantly with pain during sex — but they are not a substitute for professional support. If you experience persistent pain, vaginismus, or pain that has been present for months or years, SIM & TAST sex therapy addresses the root cause directly. Your first consultation is completely free.
Pain during sex — clinically known as dyspareunia — affects a significant number of women and is one of the most underreported and undertreated conditions in women’s sexual health. Many women are told that pain is normal, that it will improve over time, or that they simply need to relax. None of these responses is adequate or accurate.
Common causes include vaginismus (involuntary tightening of the vaginal muscles), vulvodynia, endometriosis, insufficient arousal and lubrication, cervical sensitivity, hormonal changes particularly postpartum or perimenopausal, and psychological factors including past trauma and anxiety around sex.
The styles in this guide share one principle: the receiving partner is in complete control of every aspect of what happens. Depth, pace, angle and whether to continue at all. No style in this guide requires the receiving partner to endure any discomfort. Pain is a signal to stop — not to push through.
The giving partner lies completely flat and still. The receiving partner straddles on top and is the sole initiator of all movement and entry. The receiving partner controls the angle, the pace and the depth of entry using their own body — hovering, pausing, and proceeding only when and as far as feels entirely comfortable. The giving partner remains completely passive.
- 1Giving partner lies flat on their back, arms relaxed at sides or resting lightly on the receiving partner’s thighs. They do not grip, pull, push or initiate any movement. Their role is complete stillness and verbal encouragement.
- 2Receiving partner straddles, taking as long as needed. They use their hand to guide entry at the angle that feels most comfortable to them — often a slightly forward-tilting angle rather than directly downward. They lower themselves only a few millimetres at a time, pausing between each small movement.
- 3If pain is felt at any point, the receiving partner stops immediately and rises slightly. There is no obligation to continue or to achieve any particular depth. Each session may only involve partial entry — this is not failure, it is progress.
For vaginismus specifically, the involuntary muscle spasm that causes entry pain is triggered by anticipation of pain and loss of control. Giving the receiving partner absolute control over all movement removes the loss-of-control trigger. The gradual progression — millimetres at a time — allows the pelvic floor muscles to relax progressively rather than bracing against anticipated sudden movement.
Adequate arousal before attempting entry is not optional for women experiencing pain — it is essential. The vaginal canal lengthens and lubricates only when the woman is fully aroused. Attempting entry before full arousal is one of the most common causes of pain, regardless of the position used. Spend significantly more time on non-penetrative intimacy before attempting entry — a minimum of 20 minutes of arousal-focused foreplay is a practical starting point for women experiencing pain.
Both partners lie on their sides in a spooning position. The side-lying position is one of the most therapeutic options for pain during sex because it naturally limits penetration depth, distributes no body weight on the receiving partner, and allows the receiving partner to press their top knee forward at any moment to further reduce or stop depth completely.
- 1Both partners lie on the same side — receiving partner in front, giving partner behind. Bodies close but not pressing hard against each other. The receiving partner’s top leg rests on a firm pillow at hip height.
- 2The giving partner does not initiate entry. The receiving partner reaches back and guides entry themselves — controlling the angle and depth from the first moment. Only the receiving partner initiates movement.
- 3The receiving partner’s top knee pressed forward toward their chest is their depth-reduction tool throughout. At any moment they feel discomfort, the knee comes forward immediately. The giving partner follows this signal without question or hesitation.
The lateral geometry of spooning physically prevents deep penetration — the giving partner’s forward hip movement is limited by their own leg position and the receiving partner’s body. This built-in depth limit is passive and structural — it does not require the receiving partner to actively manage depth at every moment, which reduces anxiety and allows greater relaxation of the pelvic floor muscles.
For women with vaginismus, beginning sessions without any attempt at penetration — simply spooning with skin contact and warmth — for several sessions before progressing to entry is a therapeutic approach that significantly reduces the conditioned anxiety response. The body learns to associate this position with safety and comfort before penetration is introduced. This desensitisation approach, when done consistently, produces real results.
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Positional adjustments help. But if pain has been part of your experience for months or years, sex therapy with SIM & TAST addresses the root cause — physically and psychologically. Real healing is possible. Your first consultation is completely free.