Help! Sex is Painful...

Written by:
Dr. Kylie Faildo
April 4, 2023

I would like to talk about a topic that's not always easy to talk about, but is so very important. Dyspareunia or painful sex is something that many women experience. Although it's not something that we just have to put up with. And no, just drinking a glass of wine and trying to relax is NOT the answer. 

There are things you can do to address the problem. One of the most helpful things is pelvic floor physical therapy.

What is pelvic floor physical therapy? It is a form of physical therapy that specifically addresses pelvic problems, including painful sex, pelvic organ prolapse, painful periods, incontinence, constipation, and so much more. 

When treating dyspareunia, I take a whole body approach by assessing your whole body from head to toe. I will ask questions about your lifestyle characteristics, including diet, exercise, stress, and sleep. Pain is complex and usually caused by multiple factors. 

So why do we have pain with sex?

When it comes to painful sex, tight muscles and an up-regulated nervous system can be major culprits. When the muscles in your pelvic floor are too tight, they can cause pain during sex. Think about it like a muscle cramp - it hurts! And it's hard to relax when you're in pain, right? This can make the muscles even tighter, which creates a vicious cycle.

But why are the muscles tight in the first place? It could be due to a variety of factors, like stress, trauma, or hormonal changes. Sometimes it's even because of things like constipation or wearing tight clothing.

Another factor that can make painful sex worse is an up-regulated nervous system. When you're feeling stressed or anxious, your nervous system goes into overdrive. You can think of it like a car alarm that goes off even at the slightest bump. This can cause your muscles to tense up and very difficult to relax, making sex even more uncomfortable.

So, what can you do to address these issues?

Pelvic floor physical therapy is a great place to start. A pelvic floor physical therapist can help you identify any problems with your pelvic floor muscles (i.e. layers of muscles between your pubic bone and tailbone), and then create a personalized treatment plan to address them.

Your therapist will examine your pelvic floor muscles through an internal exam (read this article to see what happens during an internal exam) and identify tense muscles that may benefit from deep trigger point release. Just like a tight shoulder muscle, your pelvic floor muscles can get tight and can benefit from a muscle release. 

Another thing they may do is teach you relaxation techniques, like deep breathing or progressive muscle relaxation, to help you relax your muscles before, during, and after sex. They may also teach you specific exercises to help stretch or strengthen your pelvic floor muscles.

Painful sex is treatable!

You're not alone in experiencing painful sex, and there are things you can do to address the problem. So don't be afraid to reach out for help. Your sexual health is important and deserves to be addressed.

By working with a pelvic health physical therapist, you should regain confidence and control of your body so that you can get back to a normal life. Speaking with a physical therapist over the phone is a good first step. Contact us to get started.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Dr. Kylie Faildo

Physical Therapist
Kylie Faildo is a Doctor of Physical Therapy (DPT) who specializes in pelvic health. She primarily works at Activcore in Denver, Colorado, located just one mile from the popular Cherry Creek Shopping District. Kylie believes that movement is medicine. She's very passionate about helping people reach their personal and fitness related goals. She loves working with the pregnant and postpartum populations, athletes, and anyone in need of pelvic health.
FULL PROFILE

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