Painful sex can be a common experience for women. It’s especially common during the postpartum period and during menopause, but can happen at any point during a woman’s life.
Why?
Unless you get assessed by a pelvic floor specialist, we can’t 100% know why you are experiencing painful sex. But here are two common reasons and some ideas to help!
- DRYNESS
- A decrease in estrogen can create dryness in the tissues of the vagina and vulva, making sex more uncomfortable. This is common during postpartum and perimenopause/menopause.
- Solutions→
- Use lubrication: I recommend Good Clean Love to most clients! It is sold at drug stores and they have many options, including a “sensitive” one
- Consider a vaginal moisturizer. Good Clean Love has a vaginal moisturizer called “Restore” (Two others are: Replens and Revaree)
- Talk to your doctor about estrogen replacement. This can be done through oral medication or a cream inserted into the vagina.
- TIGHTNESS OF THE PELVIC FLOOR MUSCLES
- Tightness can happen for many reasons (see below), but what tends to happen is that the muscles become shortened and less flexible. This can lead to pain when the muscles are “asked” to stretch, such as during vaginal penetration
- Due to decreased estrogen mentioned above, the pelvic floor muscles can lose their “elasticity” meaning they can become less flexible.
- The pelvic floor muscles can become overactive and tight due to weakness in the pelvic floor itself or surrounding core and hip musculature.
- Association with pain or past trauma. This is essentially “muscle memory”. If you had pain in the past with intercourse or a history of sexual abuse/trauma the pelvic floor may tense up, even if what you are experiencing is a safe sexual experience.
- Tension in the pelvic floor/difficulty relaxing. Certain types of people are more likely to hold tension in the pelvic floor: women, Type A, and anxiety-prone individuals. If you commonly get headaches or neck pain due to tension, this may be you.
- Solutions→
- Learn to connect with your pelvic floor muscles so that you know what it feels like to relax them. Physical therapy is a great place to learn how to do this.
- Try these two exercises:
- Belly breathing
- Lay on your back, inhale and let your belly and rib cage expand like a balloon. Exhale and let your belly fall back towards your spine
- Happy baby: hold for 60-90 seconds, with deep breathing (see below)
- Belly breathing
- Tightness can happen for many reasons (see below), but what tends to happen is that the muscles become shortened and less flexible. This can lead to pain when the muscles are “asked” to stretch, such as during vaginal penetration
