Pain with Sex…

By: Marin Cole

Why is talking about sex such a taboo??

I remember living in France when I was only 18 and being asked, why does it seem like all Americans are afraid to talk about sex? I never really had a good response to this until I was older and entered the world of pelvic floor physical therapy. People don’t talk about sex because we aren’t asked about it regularly by healthcare professionals and it is often viewed as an “inappropriate” and “personal” topic to discuss, so it is just swept under the rug. Maybe this is why people are afraid to speak up when something doesn’t feel right? Way too many men and women go years and years suffering in pain when they try to be intimate with their partner and think its’ NORMAL!  As a physical therapist one of the hardest things to hear is when a patient tells me that no doctor has ever inquired about their sexual health and they’ve never felt comfortable telling anyone about their pain because they didn’t think it was “that bad,” or they thought it was just the way it is.  

With it being pelvic pain awareness we want people to know that the pain you are experiencing is common but not normal! And we are here to help!!

Pelvic pain during intercourse is broad and we can organize your pain symptoms into various subcategories or diagnoses. A woman can experience dyspareunia, which is the fancy way of saying “pain with sex” without an underlying disease associated with it. Then there is vaginismus which is when a person experiences pelvic floor muscle spasms during intercourse (or a pelvic exam or tampon insertion), making it painful, difficult, or even impossible for penetration. Then we have vulvodynia which is chronic pain of the vulva, the external area of the genitals that can cause mild to severe pain with initial penetration. There is also pudendal neuralgia which is when there is irritation or damage to a nerve in the pelvis region that can also contribute to pain with intercourse. There are so many different types of “pelvic pain” that may result in pain or discomfort during intercourse and pelvic floor physical therapy can help! Oftentimes treatment of some of these conditions require a team of clinicians to ensure we are addressessing the person as a whole, but physical therapy is most often the first defense and most conservative method that is offered. 

Treatment can include anywhere from retraining how to use your breathing diaphragm to using a vaginal dilator or pelvic wand for further assistance to address the muscles internally. No two people experience the same symptoms, and no two people respond the same to treatment, each person’s story and experiences are unique and that is how we treat pelvic pain here at EYP. If you experience pain with sex, we encourage you to tell your doctor and reach out to a pelvic floor physical therapist, you will be happy you did.