Sex should be enjoyable, pleasurable, and painless. It should not be painful… (unless you want it to be). If you experience pain, you may be wondering what’s normal, what’s not and what can help?
Painful sex, also known as dyspareunia, is a common diagnosis with up to 18% of the worldwide population suffering with these symptoms (and affects ALL genders). Dyspareunia is often neglected due not knowing who to go to when this issue presents, not wanting to share these issues with medical providers, or not being taken seriously when they do report symptoms. People are then not getting the help they need, which can lead to mental health issues, relationship challenges, and an overall decreased quality of life. Fortunately, when diagnosed appropriately, dyspareunia can be managed and treated by a team specializing in pelvic health.
What are some things I can do to relieve pain with sex?
1. Practice diaphragmatic breathing every day and during intercourse
Diaphragmatic breathing helps to calm the nervous system and reduce muscle guarding by ensuring 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 in, letting the abdomen and rib cage expand. You want your stomach and ribs to move equally in all directions like you are opening an umbrella with your rib cage. Then slowly 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. For those breastfeeding, in or post menopause, or using birth control, reduced estrogen may decrease self-lubrication. However, not all lubricants are made the same!
- Some ingredients that we want to avoid in lubricants are: glycerin, nonoxynol-9, petroleum, propylene glycol, and chlorhexidine gluconate
- Some water-based lubricants that rarely cause irritation and are safe with latex and non-latex condoms are: Slippery Stuff & Good Clean Love or you can use a natural oil such as coconut oil. Just a heads up – oil and latex don’t mix well so if you use oil-based lubricant avoid using with a latex condom as it may tear.
- CBD Lube and Suppositories: These can be game changers for pelvic floor tightness. The CBD acts directly with the pelvic floor muscles to help them relax. There are many different brands out there with different ingredients and amounts of CBD, and you can even make your own! Our favorites are from Foria, Simple Solace CBD, Vella, and GoLove
3. Pelvic Floor Relaxation
Here are some stretches that help the pelvic floor lengthen and relax. Add in 4-5 diaphragmatic breaths to each of these stretches and your pelvic floor will thank you. You can do these daily and immediately before intercourse:
- Gentle single and then double knee to chest stretch
- Happy baby stretch
- Child’s pose
- Deep squat
- Butterfly stretch
4. Try Other Positions
Sidelying position, lying on your back with pillows supporting your knees relaxed open, or sitting on top of your partner may work better for your body and allow further pelvic floor relaxation and feelings of more control.
5. Use Dilators or a Pelvic Wand
Dilators allow for prolonged stretching of the pelvic floor muscles, massage scarring at vaginal opening, allow you to practice pelvic floor relaxation, and to practice intercourse. Pelvic wands can be used to find specific trigger points in deeper pelvic floor muscles and can be used anally or vaginally. One of our favorite brands is Intimate Rose!
6. Pelvic Health Physical Therapy
If you are feeling pain during sex and don’t know where to go, a pelvic floor therapist is the perfect person to start with and we will be able to point you in the right direction if you are requiring medication. In physical therapy, we focus on improving muscle tone, reducing pain, and optimizing pelvic health function with manual treatment techniques, neuromuscular re-education, and exercise!
Check out our post “What to Expect in a Pelvic Floor Physical Therapy Session” to learn more.
If you have pain in your parts, Download this free guide to find out if pelvic floor tightness might be to blame—and what to do about it.
Claire Schott, PT, DPT is NOLA-born and raised, graduating from Dominican and receiving her Bachelor’s of Kinesiology from LSU and Doctorate of Physical Therapy from LSU-HSC in New Orleans. Claire specializes in the treatment of men and women with pelvic health diagnoses. When not at work, she enjoys exercising, being outside, reading, cooking, and spending time with her husband and dog.