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Judy Florendo, PT | Suzanne Badillo, PT

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Pain with Sex? Specialized Physical Therapy Can Help!

You’ve tried every lubricant under the sun, tried multiple vaginal moisturizers, and you have even done your kegels.  Yet, sex is still painful.  Guess what: you are not alone!  Three out of four women in the U.S. experience painful sex at some time in their lives.  For many, it is temporary, but for others, it can last for months or years.  For some, sex has always been painful.  Painful sex is common, but not normal at any point in a woman’s life.  Understandably, this can cause significant distress and anxiety in women and their partners. 

Sexual issues may be difficult to discuss with a partner, friend, or even doctor.  Many women have been socialized to assume that pain with sex is just something to “put up with” for reasons that are too numerous to go into in this article.  

What’s the cause?   The most common time for women to experience sexual pain is soon after having a baby, with either perineal tearing, an episiotomy, or with hormonal changes that occur with breastfeeding.  Other causes may include difficulty with arousal, vulvar skin conditions or with decreasing or lower levels of estrogen due to menopause or other conditions or medications affecting the reproductive organs.   

As specialized pelvic health physical therapists, we commonly treat women (and men) with sexual pain associated with pelvic floor muscle dysfunction.  Just like other skeletal muscles in the body, the pelvic floor muscles can be tight and painful.  So, similar to rehabilitation for other body parts, pelvic floor physical therapy can include muscle retraining, manual therapy, and flexibility exercises to improve function (including sexual function) in the pelvis. 

Next steps:  If you experience pain with sex, see your gynecologist or primary care physician to be evaluated for any medical causes for pain.  If there are no acute medical issues that are the cause (such as an infection), request a referral for pelvic floor physical therapy to evaluate the muscles and tissues in the pelvis. 

Published in Evanston Woman Magazine Volume 2 Issue 11 Available Here

https://www.acog.org/Patients/FAQs/When-Sex-Is-Painful

Allison Lock