If sex feels completely comfortable in one position but painful when penetration is deeper or your hips are positioned differently, you may wonder why.
Pain with deep penetration is common, but it is not something you simply have to tolerate. The reason can be different for every person, and sometimes more than one factor is involved.
Your pelvic floor may be too tight
Your pelvic floor muscles are active during sex and help support the pelvic organs. If these muscles are tense or overactive, certain positions can place more pressure or stretch on them.
A pelvic floor that is constantly “on” can contribute to pain with deeper penetration, particularly when the hips are in certain positions.
Your hips can play a role
Your hip mobility and the position of your pelvis can change the angle and depth of penetration.
For some people, positions that allow more control over depth and movement are more comfortable. Positions where the hips are deeply flexed, extended, or rotated may increase discomfort.
That doesn’t necessarily mean there is something wrong with your hips. It may simply mean that your hip and pelvic floor muscles are working together in a way that increases tension or pressure.
Scar tissue can affect how things feel
If you’ve had pelvic surgery, childbirth, a tear, an episiotomy, or another injury in the pelvic region, scar tissue may contribute to discomfort.
Even when a scar has completely healed, the surrounding tissues may remain less mobile or sensitive to pressure and stretching.
Try changing the position and depth
If deep penetration is uncomfortable, positions where you can control the depth and speed of penetration may be more comfortable.
You may also find that keeping your hips in a more neutral position, using additional lubrication, and communicating about depth can make a significant difference.
Pain is a reason to adjust, not something you need to push through.
But sometimes deep pain is more than a pelvic floor problem
Deep pain with sex can also be associated with conditions such as endometriosis, ovarian cysts, pelvic inflammatory disease, or other gynecologic conditions.
If your pain is consistently deep, particularly if it is worse around your period, accompanied by significant menstrual pain, pelvic pain, bowel or bladder symptoms, or has recently changed, talk with your gynecologist.
A pelvic floor physical therapist can evaluate muscle tension, mobility, coordination, and other musculoskeletal contributors to your pain. Your gynecologist can evaluate for medical or gynecologic causes when appropriate.
You don’t have to choose between seeing your doctor and seeing a pelvic floor physical therapist. Sometimes the best approach is both.
Sex shouldn’t be a guessing game
If certain positions consistently hurt, that’s useful information. Your body is telling you that something about the position, depth, tissue mobility, or muscle response isn’t working well for you.
The goal isn’t simply to find the one position you can tolerate. It’s to understand why you’re having pain and address the factors contributing to it.
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]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.