As a Pelvic Health Physical Therapist, I have heard so many patients confess that sexual intercourse is painful for them. As heartbreaking as this is for me to hear from my patients, it’s what they often say next that is even more so.
“Well he was my first so…”
“Well I had a baby last year so…”
“Well I just figured sex was supposed to hurt.”
Unfortunately, in our society there is not much open discussion on sexual health and as a result, too many people experience painful sexual intercourse and assume that’s just how it has to be. People often live with a great sense of shame around these issues and feel as though there is something wrong with them personally.
If that sounds familiar, let me be the first to say that:
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Pain with sexual activity (which is known as dyspareunia in medical terms, pronounced dis-puh-roo-nee-uh) is much more common than we are led to believe and can affect anyone regardless of sex, gender, age, or race.
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Dyspareunia can occur for a variety of reasons, such as hormonal changes, trauma, injury to the pelvic tissues (think of a tear during childbirth or a fall on your tailbone), etc.
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When you experience pain with intercourse, this can cause the pelvic floor muscles to tense. These muscles can then learn to tense in anticipation of sexual intercourse, which can cause more pain and keep you stuck in a vicious cycle. BUT there is absolutely help out there! Pelvic health physical therapy has helped many patients resolve their pain and get back to the sex lives they want!
People are often hesitant to discuss intimate problems with their health care providers but I assure you that there is no such thing as TMI to a doctor. If you are suffering from pain with sexual activity, I urge you to bring this up with your physician so that together, you can decide the best course of action moving forward. They may want to perform a few simple tests, such as a urine culture or an ultrasound, to rule out any medical conditions which may be contributing to your symptoms. But they should also be referring you to a local Pelvic Health Physical Therapist! (And if they don’t, North Carolina is a direct access state which means you do not need a physician’s referral to see a physical therapist!)
In the meantime, try these 3 exercises to relax the pelvic floor:
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Deep breathing: Focus on filling your belly – and your pelvic floor – with air as you take a long inhale through your nose. Exhale through pursed lips and let your belly and pelvic floor naturally settle back to their resting positions. Repeat for 5-10 breaths at a time.
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Happy baby: Lie on your back and bring your knees into your chest. You can hold your feet, your shins, or behind your thighs, whichever is most comfortable for you. Take a few deep breaths here and imagine your pelvic floor relaxing. Some people like to use the cues of their pelvic floor opening like a flower or melting to envision this. Stay here for 30 seconds to 1 minute.
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Child’s pose: Starting on your hands and knees, push your hips back so that your thighs rest on your legs. Open your knees wide if that feels comfortable. Take a few deep breaths here, imagining your back filling with air as you inhale. Just as with the happy baby, you can rest here for 30 seconds to 1 minute.
If you are suffering with pain during sexual intercourse, I would recommend performing these exercises for a few minutes twice per day. I like to tell my patients to take 2-3 minutes in the morning and then 2-3 minutes before bed to do these. It can also be helpful to perform these stretches before any sexual activity!
As simple as these exercises are, they do a great job of helping the pelvic floor muscles to relax, and therefore helping your pain with intercourse to reduce!
Of course there are many more strategies we can use to treat dyspareunia so if you are not finding relief with these, contact us for a consultation so that we can help you get to the root cause of your pain and help you get back to doing what you love!
