Tips for painful sex
Sex should be pain-free and pleasurable. Too often are women writing off pain with sex as normal or something to just push through. Our society has a major lack of sex education, and the topic is often shameful to bring up. Sex ed taught me more about pregnancy prevention and STDs then it did about where the clitoris is or that only 1 in 5 women can climax via vaginal penetration alone. Painful sex affects 1 in 3 women in their lifetime! It is a complex issue, and typically has a combination of physical, social and psychological factors all at play. Here are some top tips from a pelvic floor PT on how to improve your sexual health if painful sex is part of your story …
1. Explore non-penetrative avenues for pleasure
If penetrative intercourse is where you have pain, then take that off the table for now. Forcing yourself to endure painful penetration is only going to make your pain worse. The more you have painful sexual encounters, the more you will start to create a fear-pain-cycle where you anticipate the pain and your body responds accordingly. My first piece of advice for those is to take the pressure of penetration off the table and use this time to explore other avenues of pleasure and intimacy. Can you foster an intimate and pleasurable sexual experience with your partner(s) that is pain-free while working on the physical limitations of penetration.
2. Process any trauma history, ingrained cultural expectations and subconscious beliefs around sex
Painful sex can sometimes stem from non-ideal early experiences with sex, traumatic events, cultural/religious influences, your upbringing and what you were taught (or not taught) about sex, and societal expectations. I highly recommend working with a mental health professional that specializes in sex therapy to explore these deep rooted beliefs and any trauma history. Trauma is stored in our physical body. This is also an opportunity to learn communication strategies with your partner(s) and strengthen your sense of safety as you explore your sexual self. I love Dr. UC Ossai’s statement that your orgasm is your responsibility, not your partners!
3. Dilator Therapy
Pelvic dilators can be a good place to start to treat painful sex. Dilators usually come in sets of different sizes and is a good way to gradually expose your vagina to penetration. If you have a condition called vaginismus, or increased tightness/pain around the entrance to your vaginal, they can be especially helpful. It’s important that you use the dilators in an atmosphere that fosters safety, relaxation and if possible, arousal. I recommend Intimate Rose Dilators and you can use code Amy71 at check out for $5 off you order!
4. Use More Lubrication
Sometimes, the answer is as simple as more lubrication. Baseline vaginal moisture varies a lot person to person, and there are a lot of factors that can contribute to vaginal dryness (postpartum or postmenopausal hormone shifts being a big one). When in doubt, use more lubricant. My favorite water based lubricant is a brand called Good Clean Love. There are also oil based and silicone based lubricants out there. Make sure the lubricant you’re using is pH balanced and not full of additives or fragrance. It may take some trial and error to find a type and brand that works for you!
5. Foreplay, Foreplay, Foreplay
Arousal is important for your vaginal tissues to have adequate moisture and elasticity. If penetration is your goal, take extra time on the prep!
6. Consider a lidocaine cream or a muscle relaxer suppository
If you have heightened tissue sensitivity around your vagina, using a lidocaine cream as a topical analgesic can help reduce the pain enough to be able to tolerate some touch, gentle massage or stretching. And if muscle tension is your primary issue, then a muscle relaxor suppository can help temporarily reduce tension. I encourage these as tools in conjunction with pelvic floor PT, not a stand alone treatment. Talk to your GYN about if a prescription is right for you.
7. Breath work, Relaxation, Stretching
Learning how to relax your pelvic floor is a huge part of treatment with painful intercourse. It’s all a part of breaking the pain-tension cycle. Learning how to breath into your pelvic floor, relax and reduce your overall stress levels are extremely helpful. We hold our stress in our pelvic floors the same way we do in our jaws and shoulders. By learning to connect our breath to our pelvic floors, we can help those muscles to relax. Hip and inner thigh stretching can also be extremely helpful as those muscles connect to your pelvic floor. Restorative yoga is a great place to hit all of these things!
8. Pelvic Floor PT
Of course, getting an in depth evaluation with a pelvic floor PT will help you understand your body and what’s going on for you. Painful sex is unique to every individual and takes an individualized approach to treating successfully. Your pelvic floor can help identify the tissue source of your pain, discuss psychological and social factors that may be contributing, and teach you exercises and stretches to help. A pelvic floor PT is also trained in manual techniques for your pelvic floor to help reduce pain and tension.