Physical therapy provides options for minimizing pain during intercourse

Pelvic floor rehabilitation can help fix painful intercourse.

Pelvic floor rehabilitation allows you to experience pleasure, not pain, this Valentine’s Day  

If it’s true that sex should be about pleasure and not about pain, why do one in three women say they’ve experienced pain during intercourse? 

Is it normal to experience pain? Is pain just inevitable after menopause or post-partum?  Is sex naturally just painful and uncomfortable for some people? 

The answer is no. 

Cecile Gibbs, a physical therapist at ATI Physical Therapy in Elkton, Md., says pain during intercourse is treatable. Gibbs has treated hundreds of women (and men) who experienced pain during intercourse to help explain where the discomfort comes from and to work with them to achieve pleasurable, pain-free intercourse. 

“Sex is supposed to be enjoyable,” Gibbs says. “If it’s painful, it’s time to see someone.” 

Why pain occurs 

Pain during intercourse may occur if the muscles in the pelvic floor area spasm and become very tight. For women, this results in painful penile penetration either during or after intercourse. For men, this can result in penile pain during erection or ejaculation, or with daily activities. These spasms can occur for a variety of different reasons…

  • Strains, sprains, and joint dysfunctions: Because the muscles in this area are interconnected, strains or sprains in the hip, back, and groin area can subsequently cause pelvic floor muscles to spasm and radiate pain. 
  • Dyspareunia: Dyspareunia simply refers to pain during intercourse and often occurs as a symptom of another issue in the pelvic floor-area, such as endometriosis, vaginismus, or vulvodynia in women or chronic prostatitis in men.  
  • Menopause: Many post-menopausal women have dry vaginal tissue, which can cause intense pain during intercourse. 
  • Post-partum women: After giving birth, a woman may experience pain during intercourse. Gibbs notes that some discomfort is normal when returning to intercourse after having a baby, but if that pain continues or is very intense, you should seek medical attention. 

How physical therapy can help

In most cases, it’s possible to treat pelvic floor pain. Treatment occurs by focusing on four main components, says Gibbs.  

  • Aerobics: Anything cardio-related (biking, walking, jogging, etc.) helps increase blood flow to pelvic floor muscle assisting with relaxation.
  • Stretching: Stretching loosens up the muscles while increasing flexibility.
  • Core strengthening: Lower ab and core strength is key to improving functionality of pelvic floor muscles. 
  • Pelvic strengthening: Physical therapists use Kegel exercises to contract and relax the muscles.  

What to expect 

According to Gibbs, pelvic floor rehabilitation patients typically go to physical therapy one to two times a week for two to three months, depending on the severity of their case. In addition to rehabilitating and strengthening pelvic floor muscles, patients receive an at-home exercise program and other resources to help them after therapy ends.  

During therapy, Gibbs educates patients on how to reintroduce intercourse. Components of reintroduction include:

  • Positioning: Patients learn how to properly position themselves during intercourse to avoid pain.
  • Proper lubrication: Patients also receive education about what types of lubrication methods are available to achieve comfortable intercourse. 
  • Medications: In many cases, the therapist works with the patient and doctor to help them minimize pain through medicinal methods. 

“It doesn’t matter how old you are or how many kids you’ve had,” Gibbs says. “Pain during intercourse isn’t normal. However, it is treatable.” 

If you’re experiencing pain during intercourse, visit a certified women’s health specialist at ATI Physical Therapy. For a full list of clinics offering pelvic floor rehabilitation services, visit http://www.atipt.com/services/womens-health

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