From Dr. Krystyna Holland, PT, DPT (she/her): Author of the Playbook for Painless Sex, CEO and Founder of Inclusive Care LLC.
What is Genito-Pelvic Pain Penetration Disorder?
In my pelvic floor physical therapy practice, I often see individuals seeking help for the all-too-common issue of pain during sex, also known as “dyspareunia.” This discomfort affects up to 40% of women in the United States and can be incredibly distressing. More specifically, genito-pelvic pain penetration disorder refers to pain in the vagina with penetrative sex.
Understanding Genito-pelvic pain penetration disorder requires us to challenge societal norms around sex and how we rank sexual acts. Penetrative intercourse isn’t just about penis-in-vagina (PIV) action! It can include any form of pelvic penetration, whether vaginal or anal, using a penis, sex toy, or finger. So why does society mostly focus on PIV sex?
PIV sex often gets hailed as the pinnacle, the home run of sexual encounters. But here’s the kicker: Most folks engaging in vaginal penetration don’t reach the finish line solely through penetration. Regardless of your relationship dynamics or the configuration of your genitals, many folks opt out of penetrative sex for valid reasons: pain, trauma, or simply preference. And guess what? That’s okay. Penetration isn’t the gold medal of sex—it’s not even the primary route to orgasm for most people worldwide.
Genito-pelvic pain penetration disorder doesn’t discriminate based on gender or sexual orientation. This includes cisgender women, nonbinary individuals, trans men, trans women, lesbians, and folks with diverse sexual preferences. Everyone has a pelvic floor!
Now, let’s acknowledge that plenty of folks do enjoy penetrative sex and want to experience it without pain.
Strategies for pain free sex with Genito-Pelvic Pain Penetration Disorder
#1 Prioritize arousal
In a world where everything moves at lightning speed, it’s easy to rush into penetration. But taking time for external play, also known as foreplay, can work wonders.
Remember, all genitals have erectile tissue, not just penises. Clitorises are more than just the little button under the hood! They extend into the surrounding labia, craving blood flow for arousal that touching of the clitoris and labia can provide.
#2 Try a toy
Short on time but eager for pleasure? Meet your new best friend: the vibrator. It’s like the microwave of sex, getting things heated up in no time.
Vibrators not only enhance blood flow but can also provide intense pleasure. Some are even designed for use during penetration.
In addition to vibrators, some pelvic floor devices like vaginal trainers (dilators) can be helpful to warm up prior to sex, and consider using the Oh-nut rings to vary the amount of depth and penetration.
#3 Take the lead
You know your body best, so don’t hesitate to direct the action. Being in control can ease anxiety and tension, particularly if past experiences have been painful. Whether it’s setting the pace or communicating boundaries, being in the driver’s seat can make all the difference.
Remember, pleasurable sex isn’t about specific acts but about mutual enjoyment and consent. And if you’re considering penetrative sex, regardless of your genital configuration or partner’s gender, remember that strap-ons come in all shapes and sizes! And always prioritize lube, listen to your body, and seek support from pelvic floor specialists if needed.
#4 Pelvic floor physical therapy
Relaxation strategies for painful intercourse will help you lengthen and relax those muscles to their normal resting state with breathing exercises, yoga and stretches and massage. With just a couple of easy stretches, you can majorly help your pelvic floor lengthen and relax.
Try the below stretches for Genito-Pelvic Pain Penetration Disorder.
Butterfly Stretch 
Sit upright with your back straight. Place heels together with knees out. Use elbows to push knees down towards the ground for a deeper stretch. Take 5 deep breaths.
Shin Box Position Stretch
One leg in front of you with shin at a 90 degree angle, the other leg behind you also bent at 90 degrees. Lean over the front knee with your back straight to feel the stretch in your hip. Take 5 deep breaths and switch sides.
Happy Baby Pose
Lying on your back, bring both knees to your chest and separate your knees wider than your shoulders. Hold on the inside of your ankles or place your hands on the outside of your feet and bring them above your chest. Hold for 5 breaths.
Add 4-5 diaphragmatic breaths to each stretch, and your pelvic floor will thank you.
You can do these daily and immediately before intercourse! There are a few additional simple stretches you can do to relax your muscles and relieve pelvic floor pain during sex.
If you feel ready for more exercises to transform your pelvic floor, check out the relaxation series inside my V-Hive Membership! Make sure to check out Dr. Krystyna Holland’s book, The Playbook for Painless Sex, for more.
