Let’s talk about something no one really talks about: when intimacy isn’t all that, well… intimate. If you’re dealing with pain during sex, you’re not alone. And while it might feel awkward to bring up, it’s worth saying (loud and proud!): it’s not in your head, it’s not “just how it is,” and—here’s the best news—it’s treatable! Let’s dive into why painful intimacy happens and how pelvic floor therapy might just be the hero your love life needs.
What is Dyspareunia and Why Does Intimacy Hurt?
Dyspareunia is the medical term for persistent or recurring pain during or after sexual intercourse. Sex is supposed to be pleasurable, but for many women, it’s more “ow” than “ooh.” Here’s why that might be happening:
Pelvic Floor Muscles: The pelvic floor is a group of muscles that support the bladder, uterus, and rectum. If these muscles are tight, weak, or uncoordinated, they can cause discomfort with penetration and even affect the strength of or ability to achieve orgasm.
Vaginismus: An involuntary tightening of the vaginal muscles, often associated with fear or anxiety around penetration.
Hormones: Decreased estrogen levels, especially during menopause or the postpartum period, can result in vaginal dryness and reduced elasticity.
Endometriosis or Other Health Conditions: A condition where uterine tissue grows outside the uterus, leading to inflammation, adhesions and pain.
Stress or Trauma: Previous trauma, anxiety, or relationship stress can contribute to painful intimacy.
Enter: Pelvic Floor Therapy
Pelvic floor therapy is like a spa day for your pelvic region—except instead of face masks, you get expert help to fix what’s making sex hurt. Here’s how it works:
Assessment and Education
The first step in pelvic floor therapy is a thorough evaluation of your pelvic floor muscle function. This includes discussing your symptoms, medical history, and any contributing factors. Education is a key component, empowering women to understand their bodies and the root cause of their discomfort.
Manual Therapy
Therapists use hands-on techniques to release tension, improve blood flow, and restore mobility in the pelvic floor muscles and surrounding tissues. This can address issues such as trigger points or muscle spasms contributing to pain. (Yes, this might mean some internal work—but don’t worry, they’ll walk you through every step.)
Biofeedback and Relaxation Techniques
Ever tried to relax your pelvic floor? It is definitely not intuitive and your pelvic therapist can give you feedback on your pelvic floor muscle tone and coordination. Different tools can help you become aware of your pelvic floor muscles, teaching you how to contract and relax them effectively. Relaxation techniques, such as diaphragmatic breathing, further reduces muscle tension.
Strength & Stretch
Think yoga for your pelvic floor. Strengthening and stretching exercises are key to making sure your muscles are flexible, coordinated, and not causing trouble. A tailored exercise program helps improve muscle coordination and strength while promoting flexibility.
Mind Matters
For some women, working with a counselor or therapist alongside pelvic floor therapy is beneficial. Combining physical and psychological support addresses both the physical pain and its emotional impact.
Why You’ll Love It
After pelvic floor therapy, you’ll be saying things like:
“Wow, I forgot sex could feel this good.”
“Hello, confidence—I missed you!”
“Why didn’t I do this sooner?”
Whether it’s pain-free intimacy, better bladder control, or just feeling more connected to your body, pelvic floor therapy is a game-changer.
Ready to Love Intimacy Again?
If pain has been the uninvited third wheel in your bedroom, it’s time to kick it out. Pelvic floor therapy is here to help you get back to loving—and loving it. Find a pelvic floor therapist near you, and start your journey to a happier, healthier, and way more fun intimate life.
Health & Happiness,
Dr. Carly
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