When Sex is a Pain

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When Sex is a Pain

If you’re a woman experiencing painful intercourse, you are not alone – so many women have discomfort (or worse) during sex, but very few ladies feel comfortable talking about it. As pelvic therapists, it breaks our hearts to think of you who suffer in silence, because there are so many ways we can help alleviate that pain.

There are a number of possible reasons for discomfort during sex – you could have a tight or imbalanced muscle in your pelvic floor; it could also be caused by dryness associated with breastfeeding or menopause. If your pain goes so far as to limit your ability to feel pleasure or achieve orgasm, it’s time to have a honest and open conversation with your therapist or healthcare provider – they can work with you to help you get your groove back through a variety of tools and techniques, and suggest a specialist if your unique situation requires a different type of care.

To help you get your bearings on the sexual map, here’s a quick review of the 5 stages associated with the sexual female response.

  1. Desire: thoughts or sexual desires.
  2. Excitement/Arousal: Increased blood flow is felt as pressure in labia/uterus. Clitoris enlarges, and vagina swells due to increased blood
  3. Plateau: Increased blood flow to genitals causes more lubrication. Other muscles in the body tense. Heart rate and breathing are increased.
  4. Orgasm: Increased activity of pelvic floor muscles, rhythmic, involuntary, pleasurable muscular contraction of the uterus.
  5. Resolution: Orgasm helps to disperse fluids collected in genitalia. Pelvic congestion is reduced.

Tips to alleviate pain and achieve orgasm

  • Communication: Open an honest dialogue with your partner; feeling understood and heard is a large part of a true connection. Plan date nights to help build desire
  • Exercise: Physical activity has shown to increase desire, so make sure to get that heart pumping!
  • Foreplay: Revving your engine is is very important part of preparing for intercourse – kissing, manual stimulation, massage, oral sex – even toys are a good way to get in the mood!
    • Fun fact: On average, it takes men 3-8 minutes to climax, and women 20-25 minutes to climax (from start of foreplay)
  • Lubricate: Be sure to use water based or natural lubricant (like olive oil). If you are experiencing dryness, you can use an oral syringe to put lubricant into your vagina as well as on your partner.
  • Mix it up: Try different positions. If you have pain with deeper penetration, try missionary position or spooning. If you prefer to be on top, you can place a pillow under your bottom; sitting in a chair with your partner kneeling will allow you to relax your pelvic floor muscles.
  • Breathe: If you have pain with initial penetration, before your partner enters you, take 5 deep belly breaths and focus on relaxing your hip, belly, and pelvic floor muscles.
  • Get comfortable: The most important variable in having pleasurable sex is to feel safe and supported, so a trusting relationship with your partner is key.

If you try all of these tips and continue to have pain with sex, a physical therapy consultation will help.  Your physical therapist will assess your spine, hips, as well as muscles in your pelvic floor.  Often, pelvic floor muscles can be too tight or overactive.  Your physical therapist will then guide your plan of care to reach your ultimate goal of pain-free and pleasurable sex.

*Reference: Lecture by Hollis Herman, DPT, PT, MS, OCS, WCS, BCB-PMD, Female Sexual Function, Women’s Health Summit, November 7-8, 2014, NY, NY

Blog written by Physical Therapist Kara Mortifoglio

By |2016-10-28T04:07:57+00:00April 29th, 2015|Pelvic Pain, Sexual Pain|0 Comments

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