5% of women are affected by painful intercourse at some point in their life.
For many people, sexual intercourse is a pleasurable and intimate experience. However, for those who experience pain during sex, the thought of engaging in sexual activity can be daunting. Painful sex is a distressing condition that can cause physical discomfort and emotional distress, and may have a negative impact on sexual function, relationships, and overall quality of life. The good news: painful sex is treatable!
What Causes Painful Sex?
There are many potential causes of painful sex, including physical, psychological, and emotional factors. Some of the most common physical causes of painful sex include:
Pelvic floor muscle dysfunction: Pelvic floor muscles support the pelvic organs and help control urinary and bowel function. When these muscles are tense, they can cause pain during intercourse.
Hormonal imbalances: Changes in hormone levels can affect vaginal lubrication, leading to discomfort or pain during sex. Hormonal imbalances can occur due to menopause, breastfeeding, and certain medical conditions.
Scar tissue: Scarring from childbirth, surgery, or other medical conditions can cause the vaginal tissues to become sensitive. Scarring can make it difficult to stretch and accommodate a penis or other objects during intercourse leading to pain, discomfort, or tearing.
Vaginal infections: Infections such as yeast infections, bacterial vaginosis, and sexually transmitted infections can cause inflammation and pain in the vaginal area.
How Can Pelvic Floor PT Help Painful Sex?
Pelvic floor physical therapy is a specialized form of physical therapy that can help with a variety of pelvic floor issues, including painful sex. The pelvic floor muscles, like any other muscles in the body, can become tense or tight. The pelvic floor muscles play a vital role in supporting the organs in the pelvic region, such as the bladder, uterus, and rectum. They also control the opening and closing of the urethra, vagina, and anus. When these muscles become tight or overactive, it can lead to pain, discomfort, and difficulty with urination, bowel movements, or sex. Here are some ways in which we can help:
Relieve muscle tension
Pelvic floor physical therapy can help to release muscle tension in the pelvic floor muscles, which can be a common cause of painful sex. Therapists can teach patients relaxation techniques to help reduce muscle tension.
- Address scar tissue
Scar tissue from previous surgeries, injuries, or birth can cause pain during sex. Therapists can use massage techniques to decrease sensitivity and improve the function of the pelvic floor muscles.
- Educate and plan
Pelvic floor physical therapists can educate patients about their anatomy, sexual health, and how to maintain a healthy pelvic floor. This can help to prevent future problems and improve overall quality of life.
Pelvic floor physical therapy is a non-invasive and effective treatment for pelvic floor muscles and improving overall sexual health and well-being.
Top 4 Exercises for Pain-free Sex
If you’re experiencing painful sex due to tense pelvic floor muscles, it’s important to know that there are exercises that can help. Learning how to relax the pelvic floor muscles can reduce muscle tension, decrease sensitivity, and increase your overall comfort during sex. The following three stretches are the most common exercises I teach my patients as they learn to relax their pelvic floor and work towards pain-free sex.
Diaphragmatic Breathing
Diaphragmatic breathing, also known as belly breathing or deep breathing, can help to relax the muscles of the pelvic floor and reduce tension in the body. Here are some tips on how to perform. Find a comfortable, quiet place to sit or lie down. Place one hand on your chest and the other hand on your belly. Breathe in slowly through your nose, feeling your belly expand and rise up into your hand out. Try to keep your chest still and relaxed. Hold your breath for a few seconds. Slowly exhale, feeling your belly fall while your chest remains still. Repeat this process for several minutes, focusing on slow, deep breaths that fill your belly and relax your body. Remember, inhale = belly rises; exhale = belly falls. This exercise can be performed all throughout the day in a variety of positions. In my opinion, this exercise can’t be overdone. The more, the merrier!
Happy Baby
The happy baby stretch is a yoga pose that can help to release tension in the pelvic floor muscles and increase mobility in the hips. To perform the happy baby stretch, lie on your back with your knees bent and feet flat on the floor. Keeping your knees and feet wide, grab the inside edges of your feet and gently pull your knees towards your armpits. (If you have trouble reaching your feet, your shins or knees are a good alternative.) Hold the pose for several breaths. The goal is to feel a gent drop through your pelvic floor muscles as you breathe in. As you breathe out, you may feel a gentle rise. Hold the position for at least 20 seconds, 2-3x per day.
Child’s Pose
Child’s pose is another common yoga pose that can help to stretch and release tension in the lower back, hips, and pelvic floor muscles. To perform child’s pose, start on your hands and knees with your wrists directly beneath your shoulders and your knees beneath your hips. Lower your hips back towards your heels and stretch your arms out in front of you. Rest your forehead on the floor and take several deep breaths, allowing your spine to lengthen and your hips to relax. As you inhale, you should feel a gentle drop in the pelvic floor and as you exhale, you might feel it rise. You can hold the pose for several breaths or several minutes, depending on your comfort level.
Figure Four
The figure four stretch is a simple exercise that can help to release tension in the hips and lower back, which in turn can help to alleviate tension in the pelvic floor muscles. To perform the figure four stretch, lie on your back with your knees bent and feet flat on the floor. Cross your left ankle over your right knee, creating a figure four shape with your legs. Use your hands to gently push your left knee away from your body, feeling the stretch in your left hip and glute. To intensify this stretch, you can elevate your right leg against a wall as you perform the figure four position. Hold the stretch for several breaths, then release and repeat on the other side.
Experiencing painful sex can be a difficult and disheartening experience. But it doesn’t have to hurt! By working with a pelvic floor physical therapist and incorporating exercises such as diaphragmatic breathing and pelvic floor stretches into your routine, you can take steps to reduce tension in the pelvic floor muscles and improve your sexual comfort and enjoyment. However, it’s important to remember that everyone’s body is different, and what works for one person may not work for another. If you continue to experience pain during sex, it’s essential to speak with a healthcare provider or a pelvic floor physical therapist for personalized recommendations and treatment options. With the right treatment approach, many women are able to find relief from painful sex and improve their overall quality of life.
Kari Hough, PT, DPT • Pelvic Health Specialist