This is genital pain that may be experienced either before during or after penetration of the vagina. This limits tolerance to sexual activity and gynecological exams. The pain can be experienced either at the entrance of the vagina, deeper or even both areas. This pain may be caused from hormonal imbalances, skin disorders such as Lichens Sclerosus, surgeries, cancer or even post-partum. With a skilled pelvic PT, the pain will be more tolerable or even abolished with penetration. Various massage techniques and stretches are quite effective. Positioning with sexual activity is also reviewed.