Originally published on The Vagina Whisperer blog, written by Sara Reardon.
Sex should be enjoyable, pleasurable, and painless. It should not be painful… (unless you want it to be). If you experience pelvic floor pain during sex you may be wondering what’s normal, what’s not and what can help?
Painful sex is a common problem affecting 18% of people worldwide, regardless of gender. Dyspareunia (the medical term for painful sex) is often neglected due to various reasons. People may not know who to talk to or may not want to tell their medical provider about it. Or even if they do, they may not be taken seriously.
If you have pain during sex you’re not alone! Pelvic floor pain during sex is common, and luckily, treatable.
What could be causing pelvic floor pain during sex
There are many physical, psychological, and emotional reasons you may feel pain during or after sex.
Vaginismus is a muscle spasm of the outer third of the pelvic floor muscles. This condition prevents pain-free penetration into the vaginal canal. Pain occurs upon insertion of a finger, tampon, speculum, or during vaginal intercourse.
Inflammation and irritation to the vulvar and vaginal tissues can often be the first sign of infection. If you experience a sudden and new onset of pain with sex, check in with your medical provider to rule out the possibility of infection.
What are some things I can do to relieve pain during sex?
#1 Practice diaphragmatic breathing
Diaphragmatic breathing helps to calm the nervous system and reduce muscle guarding. It does this through good mobility, blood flow, and relaxation to the pelvic floor and abdomen. How to do it:
- Place one hand on your chest and the other on your abdomen and relax your jaw and shoulders.
- Take a slow, gentle breath, letting the abdomen and rib cage expand. You want your stomach and ribs to move the same in all directions. Blow like you are opening an umbrella with your rib cage. Then breathe out and let your abdomen fall back downwards.
#2 Use lots of lubrication
Moisture is important to reduce friction, tearing, and rawness during intercourse. Less estrogen can decrease self-lubrication. This can happen during breastfeeding, in or post-menopause, or when using birth control.
I recommend two water-based lubricants that rarely cause irritation. These brands are also safe with latex and non-latex condoms. They are Slippery Stuff & Good Clean Love.
You can also use natural oil such as coconut oil. But, oil and latex don’t mix – so if you use oil-based lubricant, avoid using a latex condom as it may tear.
#3 Check your C-Section Scar
C-section scars can often be the culprit of painful intercourse. Yes, even if you did not have a vaginal delivery. The vaginal muscles have decreased blood flow and may get tense causing pain with sex.
A pelvic floor physical therapist can perform external and internal massage. This will help the vaginal muscles relax and improve blood flow.
#4 Use Dilators or a Pelvic Wand
Our favorite brands for both dilators and pelvic wands is Intimate Rose. Pelvic wands look like a dilator with a curved tip at the end. These apply pressure to specific trigger points deep in the pelvic floor muscles. This helps the muscles relax.
Dilators look like a set of tampons, large in diameter. Inserting these into the vagina can help:
- Desensitize your vaginal tissues
- Relax your muscles
- Massage any scar tissue at the vaginal opening resulting from an episiotomy or tear
Pelvic floor exercises for painful intercourse
Here are some stretches that help the pelvic floor lengthen and relax. Add 4-5 diaphragmatic breaths to each stretch, and your pelvic floor will thank you. You can do these daily and immediately before intercourse.