By Christine Burke,PT,DPT,PRPC, MHA and
Alicia Meyer,PT,DPT,PRPC
We have heard the same response many times when we ask a woman whether she experiences painful intercourse. “Not any more than normal.”
At the Hoag Pelvic Health Program, we emphasize that no amount of pain with sex is normal. Temporary discomfort, particularly as a side effect of medication, during healing following childbirth, or due to hormonal shifts, is common, but not necessarily normal. If you’re experiencing persistent pain with intercourse, there could be multiple causes, including pelvic floor dysfunction. It is important to speak to a gynecologist or other health care professional to determine the cause of your pain.
Pelvic floor dysfunction is when the muscles at the bottom of the pelvis, also known as the kegel muscles, are not able to squeeze and/or relax properly. If pelvic floor dysfunction is the root cause of the pain with intercourse, treatments by a trained pelvic floor physical therapist can greatly improve symptoms. Pelvic floor physical therapy (PT) can relax and stretch pelvic floor muscles that may have been stressed by pregnancy, illness, trauma, or being overly tight and in spasm. PT can also help to increase blood flow to the pelvic floor. Pelvic floor physical therapists create individual treatment programs for each patient to address their specific needs, including exercises and stretches to be performed at home.
We all know that stress can cause a person to experience a tightening of the shoulders or neck muscles. Research has found that it is just as common for people to feel the effects of stress in the pelvic floor muscles. When this happens, blood flow is restricted through the pelvic floor to the genitals. This can interfere with the natural response to sexual stimulation and can inhibit normal physiological responses, making sex uncomfortable or even painful.
A specially trained physical therapist can help take a patient through what is known as “down training.” During treatment sessions a PT will teach how to relax and elongate the 12 muscles of the pelvic floor and then maintain those muscles’ increased range of motion.
One method involves diaphragmatic breathing. Placing one hand on the chest and another on the belly, a woman will be asked to inhale in such a way that the hand on the belly rises, but the hand on her chest stays put. This causes the pelvic floor to relax and lengthen, increasing blood flow to the area.
It is estimated that as many as 20% of women experience persistent pain during intercourse. Just because something is common doesn’t mean it’s “normal.” Painful intercourse is a problem, but there are ways to help.
Click here to learn more about Hoag’s Pelvic Health Program.
