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What to Do When Sex Hurts

Is sex painful for you? You are not alone. In fact, three out of five women experience pain during sex. Talking to your healthcare provider about it and getting an exam can lead to helpful and successful treatments for this common issue.

Pain can be sharp, or dull ache, it can feel like burning or that there is a “wall” not allowing penetration of the vagina during intercourse. It can occur due to gynecological disease (such as endometriosis or pelvic inflammatory disease), arousal problems and/or pelvic floor muscle issues. If you are experiencing pain with sex, see your healthcare provider or gynecologist for an exam.

If medical issues have been ruled out, physical therapy can help if problems are muscle related, such as the following:

  • Vaginismus: Pelvic muscle pain can occur with vaginismus, an involuntary contraction (tightening) of the muscles at the opening of your vagina. It can cause burning or sharp pain with intercourse, and it can feel like there is a “wall” that is stopping penetration. 
  • Childbirth: Women who have had an episiotomy or tears in the perineum during childbirth may have pain during sex.  

Pelvic floor physical therapists can help by assessing what structures are causing the pain—muscles, joints in the pelvis or nerves. A customized treatment plan is then designed to help alleviate the pain. 

Your partner is also included in the treatment and homework including relaxation exercises and desensitization techniques.  

Pelvic floor therapists can help you select the right lubricant, allow you to determine which sexual positions will be comfortable for you and your partner, give you exercises to allow for muscle relaxation and information on how to treat pain after sex.  

Some things you can do on your own to reduce pain with sex: 

  1. Use a good lubricant. Some new and natural lubricants are very good choices. Coconu, slippery stuff, good clean love and silicone-based maude Shine are good choices.  
  2. Relaxation, rest and regular exercise can help improve body image and sexual interest.  
  3. Non-sexual but intimate activities with your partner including non-sexual touch or massage. Even exercising together can help you connect, relax and improve sexual arousal.  
  4. Pain relieving activities such as taking a warm bath, stretching your legs and deep breathing. 
  5. Use an ice-pack on the perineum or take an over-the-counter pain reliever to relieve pain after sex.  

Sexual pain is a treatable condition—you can successfully overcome sexual pain and enjoy intimacy with your partner after undergoing treatment.  

If you are experiencing pelvic pain, schedule an appointment for an evaluation from your healthcare provider.

Sagira Vora, PT, MPT, WCS, PRPC, is a physical therapist with Overlake Outpatient Rehabilitation Services who specializes in women’s health and pelvic floor disorders.