Painful sex—also known as dyspareunia—is more common than many people realize, yet it’s often misunderstood or brushed aside as “normal.” It’s not. Pain during intercourse can be both physically and emotionally distressing, and it often signals an underlying issue that deserves attention and care. One of the most effective, yet underutilized, treatments for this type of pain is pelvic floor physical therapy.
Here are four common causes of painful sex and how pelvic floor PT can help address each one.
1. Pelvic Floor Muscle Tension or Dysfunction
The Problem:
The pelvic floor is a group of muscles that support your pelvic organs and play a crucial role in sexual function. These muscles need to be both strong and flexible. When they’re too tight, weak, or not coordinating properly, they can cause significant pain during penetration.
How PT Helps:
A pelvic floor physical therapist can assess muscle tone and function, and work with you to relax overly tense muscles, retrain proper coordination, and build strength where needed. Techniques might include manual therapy, biofeedback, relaxation training, and personalized exercises.
2. Endometriosis or Chronic Pelvic Pain Conditions
The Problem:
Conditions like endometriosis, interstitial cystitis, or vulvodynia can lead to chronic pelvic pain, often exacerbated by sexual activity. These are complex conditions that affect muscles, nerves, and organs.
How PT Helps:
Pelvic floor therapists are trained in managing chronic pain. They take a holistic approach, incorporating myofascial release, neuromuscular reeducation, posture training, and gentle exercises. By addressing the muscular and neurological aspects of pain, therapy can significantly improve quality of life—and sex.
3. Scar Tissue or Trauma (Including Postpartum or Surgery)
The Problem:
Scar tissue from childbirth (episiotomy, tearing), gynecological surgeries, or pelvic injuries can reduce elasticity and cause pain during penetration.
How PT Helps:
Pelvic floor PT can include scar tissue mobilization to improve tissue glide and decrease hypersensitivity. A trained therapist can guide you through desensitization techniques and introduce safe, graded exposure to reduce pain and restore comfort.
4. Vaginal Dryness or Hormonal Changes
The Problem:
Hormonal shifts—such as those from birth control, postpartum recovery, breastfeeding, or menopause—can lead to thinning and dryness of vaginal tissues. This can make sex uncomfortable or even painful.
How PT Helps:
Pelvic floor therapists don’t replace the role of a hormone specialist, but they do help identify how tissue changes are impacting function. They may work in collaboration with your provider to address tissue health and teach techniques for improving blood flow, tissue mobility, and comfort during intercourse. They can also educate on lubrication strategies and gentle stretching techniques.
Final Thoughts
Painful sex is never something you just have to live with. Pelvic floor physical therapy offers a targeted, compassionate, and effective approach to treating the root causes of sexual pain. If you’re experiencing discomfort, don’t wait—talk to your healthcare provider or reach out to a pelvic floor therapist near you. Your comfort, pleasure, and health matter.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected].
