December 7, 2020
Although not a topic many women are comfortable talking about with their friends—or perhaps even their doctor—pain during sex is a common and treatable issue. Let’s explore some potential reasons for pain and how physical therapy might help.
Reasons for Pain During Sex
Many factors can contribute to painful sex in women. One of the most common is not having had sex previously.
You might assume that when you first have intercourse, it is normal to hurt—and to some extent that is correct. The problem arises when the pain continues. Sex can continue to be painful because your body guards to protect you. It remembers the previous times sex hurt. Think of it like putting your hand on a hot stove. Your body remembers and is apprehensive to go near the stove again. This is the same reaction your body may have with sex, but you are often unaware of it.
Other reasons for pain during intercourse include:
- Vaginal dryness
- Falls or injury to the pelvis
- Some medical conditions such as post-chemotherapy, hormones suppression, frequent yeast infections, endometriosis, irritable bowel and interstitial cystitis
- Exercises that cause overall tightness of the hips and pelvic
- A history of sexual trauma or abuse
- Tearing with childbirth
- Menopause—hormonal changes cause changes in vaginal tissue
The Pelvic Floor and Physical Therapy
As you see, there are many reasons that can contribute to pain during intercourse. Pelvic physical therapy can help by strengthening the pelvic floor—a group of muscles that surround the anus and vagina. It can also improve the relaxation of those muscles which is just as important.
The pelvic floor muscles support the bowel, bladder and uterus, and prevent urinary leakage. Many people think about Kegel exercises, but sometimes doing too many of these exercises can tighten up the pelvic floor and contribute to pain. Physical therapy can help retrain those muscles.
If your doctor recommends pelvic physical therapy, know that unlike traditional physical therapy, you will receive care in a private treatment room. The therapist assesses the control and tightness of your pelvic muscles, and screens for bowel and bladder issues that might be related. They will also assess your upper extremity, lower extremity and core strength, range of motion, gait and functional stability, and posture.
Start the Conversation
If you are experiencing pain during sex, don’t suffer in silence. It is important to talk to your medical provider about causes that can contribute to painful intercourse to determine the treatment option that is best for you.