Painful intercourse can happen to anyone in any circumstance. It is quite common, but by all means not normal.
There are several causes as to why someone may experience pain with intimacy, but the good news is there are also several ways to help reduce and even eliminate this discomfort.
Common Causes of Painful Intercourse
Pelvic Floor Muscle Overactivity
Some people tend to hold tension and stress in their pelvic floor muscles similarly to how others will in their neck and shoulders. Overtime this leads to decreased flexibility and tight knots in muscles that can lead to pain with activity and stretch.
Scarring After Birth or Surgery
Scar tissue that accompanies muscle tearing or an incision is often less mobile and pliable than the healthy tissue that was there prior. If a scar is not properly moisturized and mobilized as it heals it can become more adherent and subsequently cause pain with movement.
Hormone Deficiency (Estrogen or Testosterone)
This can be common among postpartum mothers who are breastfeeding, as the body’s main hormonal focus is breast milk production consequently leading to more vaginal dryness and discomfort. Similar symptoms are experienced during menopause due to all of the hormonal changes taking place.
Secondary to Interstitial Cystitis (IC) or Endometriosis
Chronic pain accompanied by conditions impacting the pelvic organs and muscles can lead to muscle overactivity and tightening requiring lifelong self-care and treatment to prevent this from worsening.
Urinary Incontinence Leading to Skin Breakdown
Frequent and uncontrolled urination without proper care can lead to irritation and sensitivities of the skin.
History of Sexual Abuse or Psychological Trauma
It is very common for an individual's past trauma to play a role in the pain and feelings they may experience with future intimate and vulnerable situations.
5 Ways to Reduce Pain with Intercourse
Lumbopelvic Muscle Stretching
Inner thigh and hip muscles share a lot of connective tissue with the pelvic floor muscles. Check out this video and spend 60 seconds in each position prior to having sex.
Pelvic Floor Muscle Stretching
Most often it can be extremely helpful to use a tool like a pelvic wand or vaginal trainer to assist in pelvic floor muscle stretching. Check out this video to see how the pelvic wand by Intimate Rose is used to release muscle tension.
The practice of deep breathing has been shown to help calm the nervous system and aid in full body relaxation. This is a great technique to pair with lumbopelvic or pelvic floor muscle stretching prior to sex, as well as a helpful tool to try during intercourse to aid in reduction of any discomfort. Check out this video on how to facilitate proper diaphragmatic breathing.
Comfort is so important when it comes to reducing pain with intercourse. There are several options and it can depend on the couple and situation. If you are lying on your back, try placing a pillow or multiple pillows under both knees so that your lower body can fully relax. Someone else might prefer being on top, where they are in more control of the depth of penetration.
You definitely want to use some kind of medium on both partners to aid in the most comfort possible when it comes to sex. Here are a few I recommend:
- Oil based: Extra virgin coconut oil, Extra virgin olive oil (Yes, you can head to your kitchen for lube!)
- Aloe based: Desert Harvest Aloe Glide
P.S. Please stay away from most KY lubricants, especially those that emphasize a warming or tingling sensation. These tend to have fillers and ingredients that you don't want to put in your body, and can unfortunately make the pain worse.
Pain with intimacy is something that should really be discussed with your physician. It’s possible you may need a certain medication or treatment or they may feel you may benefit from speaking with a mental health provider depending on your medical and social history. However, the majority of individuals seeking care for painful intercourse experience great success with pelvic floor physical therapy alone.
Check out how pelvic floor physical therapy helped these two individuals:
“Dr. Hayley at Fuel Therapy was helpful, professional, knowledgeable and I would highly recommend her. I had some bladder issues and other discomforts with intercourse after giving birth. I thought those things were normal but after meeting with her, I now know there is a lot to be done about them and healing is possible. She gave me tips and tricks on exercises/therapy to work through and it has made such a huge difference. She made me feel so comfortable the whole time and I’m so thankful I met with her. If you are having any complications after childbirth it would totally be worth meeting with Dr. Hayley and checking on your pelvic floor.”
“Dr. Hayley was absolutely amazing! I was initially very nervous about going to pelvic floor therapy, but she made the experience wonderful! She made me feel safe, comfortable, and extremely cared for in every appointment. I only wish I would have gone sooner, and would recommend anyone considering pelvic floor therapy to go!”
If you have any questions or concerns about painful intimacy, please don’t hesitate to contact me at my number or email listed below.
P.S. - If you are interested in a private one-on-one consultation and evaluation you can schedule here or email firstname.lastname@example.org
Happy Valentine’s Day!
Dr. Hayley VanBeek, PT, DPT
Athlete & Pelvic Health Specialist
Fuel Physical Therapy & Sports Performance, LLC