Let’s Talk About Sex
A quick Google search reveals a statistic that we need to talk about:
“Pain during sex is a common problem for women. As many as 75% of women will experience pain during sex at some point, according to the American College of Obstetricians and Gynecologists. For many women, the pain is rare or happens only once, but for others it’s persistent.”
75%??!! Ladies (and gents), let’s talk about sex. In the pelvic health physical therapy world we are often working with women who are experiencing persistent pain with sex. For the women (or men) who experience the rare or one-time pain with sex, maybe some of the information below can help keep you out of that persistent pain group as well.
For women who are experiencing pain during sex, the majority of pain is occurring with penetration of the vaginal canal. Therefore, when we say “pain with sex” we are making assumptions about what sex means. Sex doesn’t necessarily need to include vaginal penetration, particularly if it is the penetration of the vaginal canal that is the source of pain. Many women experience pleasure and satisfaction from external stimulation of the genitals, and sometimes even more than with internal penetration of the vaginal canal. This has a lot to do with anatomy of the female genitalia. Therefore, taking the pressure off of vaginal penetration as the goal of sex can make sex a more pleasurable experience.
If a woman who experiences pelvic pain during sex is participating in penetrative intercourse, it can be helpful to consider different sexual positions. Often, having the woman on top of the man either facing toward or away can be more comfortable. It gives the woman more control over depth of penetration, angle/degree of entry into the vaginal canal, and speed of movement. Another position that may work better for others is laying on their sides and possibly using pillows to prop their legs. There is not one particular position that works better for everyone, it may take some time to find what works best for you and your partner. It is also important to note that there are products available to help decrease depth of penetration if pain is occurring with deeper penetration of the vaginal canal.
It goes without saying, for females it is also important to have appropriate lubrication of the vaginal canal. Having vaginal dryness is NOT necessarily an indication that the woman is not interested in sex. There are a lot of hormonal factors and individual factors that can affect the natural lubrication of the vaginal canal. There is great information in a book written by Emily Nagoski, Ph.D. called “Come As You Are” about arousal non-concordance, which is basically when what is happening in the brain about being “turned on” doesn’t necessarily match vaginal lubrication. It goes without saying though, having appropriate levels of lubrication will definitely decrease the likelihood of vaginal friction or pain from dryness. Not only should you consider using lubrication, but also educating yourself on the right kind of lubrication to keep your vaginal tissue healthy. Check out a previous blog ‘All About Lube’ that has important facts about lubrication and choosing the right one.
Clearly, we can blog about sex. We also can TALK about sex. We definitely NEED to talk about pain during sex and how pelvic floor physical therapy can help you get back to enjoying your sexual experiences. No topic is off limits in pelvic floor physical therapy, and we invite you to reach out if you are experiencing painful sex. We are here for you!
Written by: Renee Hancock, Pelvic Floor Physical Therapist
