Pelvic Pain During Sex
- 6 days ago
- 3 min read
by Erica Whaley, OT
Pain with intercourse can be very personal and uniquely frustrating. It can impact sexual desire, intimacy, and personal relationships, making it a distressing symptom for many. This blog post will break down what may be causing this pain and offer suggestions for next steps in finding relief.
Pelvic Pain During Sex: Information and Statistics
Also known as dyspareunia, pain with intercourse can occur just before, during, or after sex (or a combination of these). Pain may be felt at a superficial level of penetration, deeper in the pelvis, or at external pelvic organs and skin. Though it is more common in women, it can occur in people of all genders and at any age.
Some estimates state that up to 75% of women, and 28% of all people in the US, will experience dyspareunia at some point in their lives. However, these symptoms are often under-reported, making statistics vary widely across different studies. At Wellest, as a pelvic specialty clinic, we often hear from our patients that they didn’t know who to discuss these symptoms with, or they didn’t realize that they could be addressed at all. This can feel very isolating and make it difficult to seek help.
What’s “Normal?”
Sometimes, mild discomfort with intercourse that gets better with a little time or small changes can be okay. These situations might include:
The first time attempting penetrative sex
Immediately after childbirth (once you have been cleared by your doctor)
Certain times in your menstrual cycle
If more lubrication is needed and things feel dry
In these cases, it might be worth trying some simple strategies to see if pain improves:
Using plenty of gentle, hypoallergenic, scent free lubricant (visit our Favorite Products page!)
Trying new positions or using pillows to support hips or legs
Extending foreplay to encourage a slow transition into arousal
Diaphragmatic breathing and stretching to encourage relaxation
Being open with your partner(s) about what feels good
However, if these strategies don’t help, or if you are noticing deep, sharp, stabbing, or intense pain, bleeding or pelvic cramping after sexual activity, pain that lasts for hours after intercourse, or pain with tampon insertion or pelvic exams, your body might be telling you that it needs additional help.
Contributing Factors to Pelvic Pain During Sex
There are many factors that can contribute to pain with intercourse, involving multiple body systems. These are:
Changes in the vaginal, vulvar, or anal skin, like infections, scar tissue, or hormonal considerations (after childbirth, with birth control, or during peri- and post-menopause) that can impact the skin and tissues in these areas and make them more sensitive
Pelvic muscle tension and nerve sensitivity causing pain with stretch, movement, and touch at the area
Poor circulation and/or pelvic congestion causing increased pressure and discomfort
Psychological factors like anxiety around pain, fear of intimacy due to pain, or relationship stress that make intimacy more challenging
Related conditions, like endometriosis or hypermobility, which can impact these systems mentioned above and exacerbate symptoms
It is important to have a team of providers that can assess these various factors to ensure that you have comprehensive care.
How Pelvic Floor Therapy Can Help with Pelvic Pain During Sex
Pelvic floor physical therapists and occupational therapists are experts in helping you understand the root cause for your pelvic floor symptoms. We can work with you on determining which of the above contributing factors seem to be driving the pain, and provide treatment and proper referrals as needed to help you find relief.
In pelvic floor therapy sessions, we address the muscles directly with manual therapy to improve blood flow, tissue healing, and muscle tension, which can significantly help with symptoms. We learn what muscles or movements inside and outside of the pelvis might be contributing to tension throughout the body, and improve pelvic awareness, muscle relaxation, and coordination. We can also help with supporting the body around intercourse, from discussions to troubleshoot positioning and personal preferences, to supporting the nervous system and improving the body’s protective guarding response around touch to this sensitive area after it’s been causing pain.
About Wellest Integrative Health
At Wellest, we love to treat the whole person - not just the symptoms. We want you to find relief and get back to intimacy in a way that feels comfortable and fulfilling. Through our holistic, full-body approach, we’ve helped people of all genders and ages feel at home in their bodies and reach their goals.
Give us a call - we’d love to hear from you!
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