Help for painful sex: pelvic floor physical therapy

As a women’s health physical therapist, I see many women devastated by pain during sex. Please know that there is hope, there is help—in most cases, there is even a cure.

You probably think of painful sex (dyspareunia) and vaginal pain (provoked vestibulodynia or vulvodynia) as gynecological problems. So you may be surprised to learn that physical therapy is a big part of the solution.

This isn’t traditional physical therapy, of course. It’s a specialized type called pelvic floor physical therapy, and it’s provided by specially trained physical therapists. Pelvic floor physical therapy can dramatically reduce—even eliminate—vaginal and sexual pain. Its safe, gentle techniques have helped countless women enjoy pain-free, pleasurable intercourse.

Why physical therapy?

When sex hurts, the problem is usually more than skin-deep. The culprit is often a web of interconnected factors involving the muscles, tissues, joints, bones, nerves, and skin.

Compounding the problem, some sufferers subconsciously guard against more pain by automatically tightening their vaginal and pelvic floor muscles during sex. Ironically, the result is muscle spasm and yet more pain. This phenomenon is called secondary vaginismus.

Pelvic floor physical therapy reverses this vicious cycle and unravels the web of pain. It increases pelvic blood flow, releases trapped nerves, and decreases pain sensitivity. It relaxes, balances, stretches, and tones pelvic and vaginal muscles, restoring them to health.

After completing pelvic floor physical therapy, most women feel much better and can begin to enjoy pain-free, pleasurable intercourse.

Manual Therapy Techniques for Pelvic Health

Your physical therapist employs manual therapy, such as soft-tissue massage, trigger-point release, and myofascial release, to alleviate tightness in your back, pelvis, abdomen, hips, and thighs. These techniques, applied externally and internally, enhance blood flow, restore mobility, reduce pain sensitivity, and address structural imbalances.

Pelvic Floor Relaxation and Strengthening Exercises

Learn pelvic floor exercises like pelvic drops, designed to relax and open your pelvic muscles. Biofeedback machines aid in training these muscles, allowing you to track your progress through a safe and painless process.

Stretching for Tight Hips, Back, and Legs

Discover stretches that target tightness caused by prolonged sitting or other lifestyle factors, helping to relax your pelvic floor and surrounding areas.

Post-Surgical Recovery Techniques

Manual therapy and advanced treatments like ultrasound or cold laser therapy are used to heal post-surgical adhesions and scars, such as those from hysterectomies, C-sections, or other pelvic surgeries.

Toning Pelvic Floor Muscles

Your therapist will guide you through exercises to tone your pelvic floor muscles, ensuring they are properly relaxed and stretched beforehand to prevent muscle spasms.

Dilating and Electrical Stimulation for Pain Relief

Learn how to use dilators and pelvic floor electrical stimulation (e-stim) to stretch, desensitize, and strengthen your pelvic muscles, providing relief from pain.

Enhancing Recovery at Home

Discover how to complement your therapy with home exercises, including stretches, pelvic drops, and the use of portable biofeedback and e-stim units. These practices are crucial for speeding up and improving your recovery.

Conclusion

By actively participating in pelvic floor physical therapy and following your therapist’s guidance, you can significantly improve your pelvic health and overall well-being.

Raquel Perlis