Image credits: Freepik / PexelsExperiencing pain during sex can be distressing, both physically and emotionally. Though it's typically an uncomfortable conversation to have, it's much more prevalent than most people are aware of and can occur in both men and women at various points in life. The good news is that determining the cause is the first step towards successful treatment. Let's take a look at the most prevalent culprits behind this discomfort and what you can do to fix it safely.
Tightness or dysfunction of the pelvic floor muscles is one of the most common reasons women experience pain during sex. These muscles hold up the bladder, uterus (or prostate gland in men), and bowel, and play an important part in sexual function. If they are overactive or tense, penetration may result in stinging, burning, or aching pain. Also, emotional stress, trauma, or extensive sitting may lead to muscle tension. Pelvic floor physiotherapy corrects this by re-training these muscles to relax normally and behave as they should, minimizing discomfort over time.
In women, hormonal fluctuations, particularly following childbirth or menopause, cause vaginal dryness. Without lubrication, intercourse becomes painful due to friction. Other women suffer from thinning of vaginal tissues as a result of reduced estrogen levels, and the area is more sensitive. Natural lubricants or a visit to a healthcare professional for hormonal therapy can ease this condition, but it is also essential to keep the pelvic circulation and hydration going by doing some gentle exercises.
Vaginismus refers to an unintended contraction of the vaginal muscles that happens when penetration is attempted. It's usually associated with apprehension, fear, or prior hurtful experiences, which result in the muscles tensing automatically. Physiotherapy is of central importance to vaginismus treatment as it addresses desensitization, breathing exercises, and progressive relaxation training. Regular therapy enables women to regain comfort and confidence, making intimacy a pleasant experience once more.
Infections like yeast infections, urinary tract infections (UTIs), or sexually transmitted infections (STIs) may produce burning or stinging sensations during sex. Chronic inflammation due to diseases like pelvic inflammatory disease (PID) or endometriosis may also result in painful sex. These conditions need medical treatment and diagnosis, but might be aided by recovery through physiotherapy treatment for pelvic floor muscle tension that usually goes along with chronic inflammation.
Endometriosis, a medical condition in which tissue that looks like the uterine lining grows outside the uterus, is a significant contributor to deep pain during sex. The pain tends to be sharp or deep inside the pelvis and may be worse before or during a period. Likewise, pelvic organ prolapse, where organs such as the bladder or uterus move away from their normal position, can cause intercourse discomfort. In either situation, a combination of medical intervention and pelvic floor rehabilitation can be beneficial in achieving relief and enhancing the mobility of pelvic tissues.
Intimacy has both the mind and body involved. All pain during sex may be caused by anxiety, previous trauma, relationship tension, or body image issues. The body tends to respond to psychological distress by contracting the pelvic muscles, causing penetration to become painful. Combining mindfulness, relaxation, and pelvic physiotherapy can treat both the emotional and physical causes of this problem. Communication with your partner and therapist may also play a crucial role in recovery.
Following delivery, most women suffer from pelvic floor weakness, episiotomy scar tissue, or vaginal elasticity changes. These processes may result in pain with intercourse, especially in the initial postpartum period. Physiotherapy is beneficial by enhancing muscle strength, mobility, and coordination, whereas a gentle massage and a stretching technique release tension and restriction caused by scar tissue.
Some medical procedures or treatments, such as hysterectomy, pelvic irradiation, or prostatectomy, induce structural alterations or nerve hypersensitivity in the pelvis. In these instances, physiotherapy is directed towards the re-establishment of balance of muscles, mobility, and circulation, allowing natural recovery from post-surgical rigidity or nerve pain.
If you have pain during sex that doesn't go away with simple treatments such as lubrication or rest, professional assistance is indicated. Chronic pain can impact not only your bodily comfort but also your emotional status and sexual relationships. A pelvic health-trained physiotherapist can assess your situation, determine the cause, and create a customized program that may involve relaxation, stretching, manual therapy, and strengthening exercises.
Realizing that pain during sex is not "normal" is the beginning of healing. There are a multitude of underlying reasons, i.e., muscular, hormonal, emotional, or medical, but all of them can be addressed with proper counsel.
From my practice as a pelvic rehabilitation specialist, the combination of medical assessment with focused physiotherapy presents the best and most sustainable outcome. Through regular care, consciousness, and individualized treatment, individuals can recover ease, confidence, and satisfaction in their sex lives, informing everyone that no one needs to continue living in pain during sex.
