Pain with sex? Here’s 5 reasons why
Causes of Pelvic Floor Dysfunction That Can Make Sex Painful
Pain during sex—known medically as dyspareunia—is more common than many realize and can be linked to issues within the pelvic floor muscles. These muscles support the bladder, uterus, rectum, and play a major role in sexual function. When they become tight, weak, or uncoordinated, it can lead to pelvic floor dysfunction and result in painful intimacy. Here are five common causes:
1. Childbirth Trauma
Vaginal delivery can stretch or injure the pelvic floor muscles, especially in cases of prolonged labor, large babies, or use of forceps. Scar tissue and weakened support structures may lead to chronic pain during or after intercourse.
2. Endometriosis
This condition causes tissue similar to the uterine lining to grow outside the uterus, often on or near pelvic organs. The inflammation and scarring it causes can irritate the pelvic floor muscles, making them tense and painful during sex.
3. Pelvic Inflammatory Disease (PID)
An untreated vaginal infection can ascend to the upper reproductive tract, causing PID. This leads to inflammation, adhesions, and hypersensitive pelvic tissues—all of which may contribute to pain with penetration.
4. Chronic Stress or Trauma
Emotional trauma, anxiety, or past sexual abuse can cause the pelvic floor to stay in a constant state of contraction. Over time, this "holding pattern" can create myofascial trigger points and hypersensitivity in the vaginal area.
5. Interstitial Cystitis or Painful Bladder Syndrome
This chronic bladder condition often overlaps with pelvic floor dysfunction. The urgency and pain associated with IC can lead to hypertonic pelvic muscles that make any vaginal penetration feel sharp or burning.
How Pelvic Floor Therapy Can Get You Out of Pain
Pelvic floor physical therapy is one of the most effective and evidence-based treatments for pain with sex related to pelvic floor dysfunction. Here’s how it can help:
Manual Release of Tension: Therapists use internal and external techniques to gently release muscle knots (trigger points), reduce spasms, and improve circulation in the pelvic muscles.
Customized Exercises: You’ll learn how to properly relax and engage your pelvic floor muscles, helping to restore balance and coordination.
Scar Tissue Mobilization: After childbirth or surgery, scar tissue can restrict movement. Pelvic PT helps soften and mobilize these areas to reduce pain.
Education & Empowerment: Understanding your pelvic anatomy, pain triggers, and self-care techniques (like diaphragmatic breathing and posture) can significantly reduce discomfort.
Trauma-Informed Care: Many pelvic floor therapists are trained to work with patients with a history of trauma, ensuring sessions feel safe, respectful, and collaborative.
Bottom Line:
If sex is painful, it’s not just “in your head.” Pelvic floor dysfunction has many physical, treatable causes. With the right support—like pelvic floor therapy—you can work toward a more comfortable and fulfilling intimate life.
Ready to get started? Book your appointment today!