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Painful Intercourse: The Pelvic Floor Series 4

This next topic is very personal. Painful intercourse can be devastating.  It can leave us feeling isolated, embarrassed and hurt.  The worst emotion that we may experience with painful sex is shame.  Sex in general can bring up a lot of feelings of shame.  We need to dispel some of these feelings, as sexual intercourse should be a healthy piece of our relationship.  If you are struggling with pain with sex, you are not alone. Current research shows that around 25% of women and 19% of men have pain during intercourse.

There are many reasons why you may have developed pain during or after intercourse.  We will name a few common causes, but please note that there often is no direct cause.  The level of emotion that is involved in a healthy sexual experience is too deep for this blog but can be a very large part of our experience.  It can take only one bad experience for our brain and body to jump into protection mode and produce pain to protect us.  If you are experiencing pain with sex the very best thing you can do it talk to a pelvic health specialist. Physical Therapists who have specialty training are the gold standard for managing pain so that you can improve your intimacy experience.

Here are some things that may be a cause of pain with sex:

  • Menopause
  • Surgery for your spine or hips
  • Chronic use of oral contraceptives (birth control)
  • Sexual trauma
  • Treatment for gynecological cancer
  • Endometriosis
  • Interstitial Cystitis
  • Irritable Bowel Syndrome
  • Constipation
  • Labor and Delivery

The very first thing you should consider if you are struggling with pain with intercourse is to see a pelvic specialist.  These are Physical Therapists who are trained in assessing the pelvic floor, as well as understanding the complex nature of pain with sex.  It isn’t just a muscle issue and for this reason you need a provider who understands how to include treatment for the brain and nervous system, your pelvic and abdominal organs, your muscles and boney structural alignment as well as your emotional component. Your provider should NEVER make you feel shameful about the condition.  To read more on Shame and how damaging it can be click here.  A doctor or therapist who tells you repeatedly to “relax” or “have a glass of wine” or “just have more sex” is absolutely wrong, has NO IDEA how to manage your condition and will not be able to help you.  You should RUN, and I mean RUN out of their office and find a new provider.  If you do not live in the Kansas City metropolitan area, please use the Contact Us  on our website and we can guide you in finding a Skilled Pelvic Specialist In your area.  The last thing you need is to feel worse about yourself because a provider doesn’t understand your problem.  This can cause more harm than good.

Some simple first steps to reducing your pain are:

  1. Forgive yourself. If this has been a problem for awhile you are likely making statements like “I am just not worthy of having sex” or “I don’t deserve to have good sex”  or “I am just not made for this to work”.  All of these statements are untrue.  You do deserve to have a sexual relationship.  You are worthy of intimacy and happiness.  You are not alone, there are many who suffer with this condition, and many before you who have improved and are happy. It may seem hard to talk to someone about it, but I can assure you our specialists in pelvic pain make it comfortable!  We can relate to feeling hopeless, we understand how it feels to be afraid to talk about sex and intimacy with a stranger, and I can promise you once you do it, you will already feel better.
  2. Begin Meditating. There are a lot of apps on our phones that are free, some that cost money but many choices to help us begin a practice of meditation.  Taking time for you, to calm your nervous system and clear your head is incredibly important.
  3. Aerobic Exercise. A brisk walk, elliptical or a swim for 20-30 minutes 3-4 days a week is so helpful for calming muscles and nerves, as well as clearing your head.  Not to mention the cardiovascular, bone and joint benefits!
  4. Learn more. Our blog is a good start! If you are reading this you have already started the process of healing.  Research has shown that when you understand your body you reduce the fear and threat that is associated with the pain – pain actually improves. Reach out to us for questions and guidance, we don’t want anyone to continue feeling alone and helpless.

In general, the muscle tension that arises from pain can be in the pelvic floor, but it can also be many of the muscles that attach at the pelvis, hips and spine.  To understand these muscles better, click here to read our blog, “The Pelvic Floor and Core Musculature. ” Education is key!  This blog is full of links to hep you find more information, please use it!

There are many issues that can arise from poor function in the pelvic floor and this blog series is here to address several of these and bring you more information about each one.  If you find that these blog topics hit home, and you are having some or many of these symptoms, you should consider a free consultation with one of our specialists to determine if treatment is right for you.  Click this link to schedule a consultation now ( )


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