Jul 14, 2018

Pain. With. Sex. Yep, I said it out loud. Three words that no one wants to hear being put together. Why in the world would I want to talk about something so…shameful. Why would I even touch on that subject. Well, for one because it needs to be discussed. For two, I’ve experienced it. Yep, that’s right. I’ve had pain with sex. FOR YEARS. I’m just now getting up the nerve be more open about it. Thank you Women’s Health Specialty for helping me realize there is no need to be silent.
Approximately 75% of women have had some form of pain with sex….that is a LARGE number. This number does not insist that 75% of women has pain with sex ALL THE TIME. But, at some point, 75% of women have pain with sex. So, yes I plan to discuss it.
Honestly, answer these questions:

  1. Do you have pain with initial penetration of the penis during intercourse? Or insertion of the fingers into your vagina?

  2. Do you have pain with deep penetration?

  3. What about with the thrusting?

  4. Are there certain positions you notice more pain in?

  5. Are you finding yourself anxious or nervous prior to having sex?

  6. Do you feel uncomfortable talking to your partner about sex being…painful or not enjoyable?

  7. How long have you been dealing with this?

  8. Have you ever enjoyed sex or had sex without pain? What were the circumstances?

Okay, phew, that is out of the way. You do not have to share your answers. I urge you to send me a message though as I feel very strongly about being open on this topic and would love to chat with you about it. Once you have your answers, written, or engrained in your head, I want to tell you this:

You Are  NOT Alone and There is Help For You. You Can Get Help.

I am a pelvic floor physical therapist looking for ways to build my brand, form relationships, and get information out there about what I do and why I can help as well as obtain conversations with women like myself who have no other “safe place” to discuss these issues with.  So, if there are 75% of women suffering from pain with sex, you are damn right I’ll be discussing it.
Another statistic: 3 out of every 4 women have pain with sex. I do not know if you understand the relevance of that number. 3 OUT OFF 4. That’s almost ALL. This CAN be a long term problem. The clinical term for painful sex is dyspareunia. I will just call it painful sex for simplicity.
I have a frustration with this whole process though. When you look up pain with sex and try to find information, what pops up? PSYCHOLOGISTS. STUDIES IN THE PSYCHOLOGY REALM.
Let me just say something:

Pain with sex is not something you are making up. You are also not going crazy. Nor should you just assume it is normal and allow it to continue.

One of my biggest pet peeves is when the healthcare system is sending women with painful sex to a psychologist stating it is in their head. No. Of course, there can be psychological aspects that go along with it, especially if you have experienced any form of domestic or rape abuse. However, I would challenge that the majority of women having pain with sex it is more so due to the musculoskeletal system. Who the heck do you see for that?! A Pelvic Floor Physical Therapist!
Let’s talk a little bit about some reasons you might be having pain with sex:

  • Structural: Such as the opening of your vagina is actually small, or you have a small space.

  • You have sensation impairments. This can be caused by trauma, by childbirth, or nerve entrapment/impingements.

  • You have trigger points: These are “tautness” in the muscle belly which can become very sensitive and sore to touch (i.e. when a penis or finger hits the sore trigger point)

  • You lack flexibility. Your hips and your pelvic region do not have appropriate flexibility of the pelvic floor muscles to allow full range of motion necessary to allow intercourse to occur.

  • You are unable to down train or relax your pelvic floor or hip muscles to allow for insertion of penis or finger into the vagina. If you tense up a lot or have difficulty with pap smears or even inserting a tampon this may be you!

Now, I do not make these up. These are reasons that I have either heard a patient say, experienced myself, or have noted throughout endless hours of research. As usual, if you are having pain or discomfort during intercourse it is best to see a pelvic floor PT to obtain an absolute diagnosis and be able to progress you through an appropriate treatment. Nothing I say in this blog is to taken as medical advice.
If you are having pain with sex though you may want to try a few things:

  • Proper diaphragmatic breathing and training. I have in my previous posts posted a video from my Youtube channel specifically about this. Now remember though this is going to be used for relaxation to Allow sex to occur. You do not need to focus on this breathing pattern during sex.

  • Flexibility training. Go back to my previous posts and find the one “Pelvic Pain” and there are several stretches on there that I have pictures and description on how to perform for the stretches I find most likely to help.

    • Perform these stretches prior to and after having sex. 30 second holds at least.

  • If you have trigger points, you will need internal manual release. Occasionally you can get relief on your own with this:

  • Education on positioning during sex.

    • There are certain positions that can decrease your chances of having pain during sex.

      • The most important thing I remind my patients is:

        • If you are on top, you have control.

        • Try being on top, the try putting pillows under your hips while lying on your back, then you can try laying on your side with pillows between your knees.

      • This will be discussed further in another blog!

Hope I’ve answered your questions about having pain with sex. The most important thing to remember is you are not alone. Find help!
Connect with me so I can help you!


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