"Why 'Just Use Lube' Isn’t the Answer to Sexual Pain: A Pelvic Floor PT’s Perspective"

Sexual pain can be frustrating, isolating, and deeply misunderstood. If you’ve ever confided in someone about discomfort during intimacy and heard, “Just use lube!”—you’re not alone. While lubrication can help, it is not a magical fix-all. As a pelvic floor physical therapist, I’ve worked with countless individuals who have been told this and left feeling dismissed and even more confused.

Let’s explore why this advice is often incomplete—and what you actually need to know.

The Myth: "You Just Need Lube"

Yes, dryness can cause friction, which may lead to discomfort. In these cases, lubrication (especially a high-quality, body-safe one) can be part of the solution. But when pain persists despite using lube, something deeper is likely going on.

The Reality: Sexual Pain Often Has Multiple Causes

Pain during penetration, arousal, or orgasm may stem from a complex mix of physical, emotional, and neurological factors. Here's what might actually be at play:

1. Pelvic Floor Muscle Dysfunction

If the muscles around the vagina (your pelvic floor) are tight, guarded, or not coordinating properly, penetration can feel like hitting a wall—literally. These muscles may be holding tension due to:

• Trauma (physical or emotional)

• Chronic stress or anxiety

• History of painful exams or sexual experiences

• Postpartum changes

• Surgery or injury

Lubricant doesn’t change the underlying muscle tension. This is where pelvic floor physical therapy can help.

2. Nerve Sensitivity

The pudendal nerve and other nerves in the pelvis can become irritated or sensitized, leading to burning, stinging, or sharp pain with touch or penetration—even if everything is "well-lubricated."

3. Hormonal Changes

Low estrogen, especially postpartum, during breastfeeding, or in perimenopause/menopause, can thin the vaginal tissue, making it more fragile and sensitive. Lube may help with friction, but hormonal support may be necessary to actually heal the tissue.

4. Emotional and Psychological Layers

Anxiety, fear, or unresolved trauma can lead to subconscious muscle guarding or a feeling of “shutting down” during intimacy. This protective response can persist even with plenty of lubrication.

Why Pelvic Floor PT Makes a Difference

As a pelvic floor PT, I assess the whole body—not just the area of pain. Treatment may involve:

• Manual therapy to release tight muscles and fascia

• Neuromuscular re-education to retrain how the pelvic floor works with the breath and core

• Education about your anatomy and how your body responds to stress or trauma

• Support and empowerment, so you feel safe in your body again

Sexual pain is real, and there are real solutions beyond surface-level fixes.

What You Deserve Instead of Dismissal

When someone says “just use lube,” it minimizes your experience and bypasses the complexity of sexual function and pain. You deserve a full-body, compassionate, and evidence-based approach. Pelvic floor therapy can uncover the root causes and help you build confidence, comfort, and connection in your intimate life.

If you’re dealing with pain during sex, know this: you’re not broken, and you’re not alone. Help exists—and it's more than just a bottle of lube.

Want to learn more about how pelvic floor therapy can help you? Reach out, ask questions, and advocate for care that sees and supports the whole you.