By Iris Farrou
01 Sep, 2023
Lifestyle Tips, Menopause, New Moms, Peri-Menopause, Peri-Menopause, Postpartum, Prevention, Women's Health
abdominal, Childbirth, constipation, dysfunction, floor, obesity, Pain, painful sex, pelvic, Physical Therapy, pilates, Pregnancy, pregnant, PT, tailbone, weakened pelvic floor, Why is sex painful
When we hear about pelvic floor exercises, we often associate them with either older women, or pregnant women/women who have just given birth. This is a common misconception–older women and new mothers may see immediate benefits when engaging in pelvic floor PT, but everyone can benefit from it.
No matter your age or overall physical health, if you were assigned female at birth, knowledge is power when it comes to knowing what your pelvic floor looks like, and what it does:
- Imagine your pelvic floor as a hammock of support consisting of muscles, tendons, ligaments, nerves, and connective tissue. This hammock is between the tailbone and the pubic bone.
- First and foremost, your pelvic floor supports the bowels, bladder, uterus, and vagina; there are also muscular bands that pass through the pelvic floor that encircle the urethra, vagina and anus.
- All this, when it functions properly, plays a key role in bowel and bladder control. Your pelvic floor also helps you stabilize your pelvis and your spine, and assists with sexual function.
Who is at risk of Pelvic Floor Dysfunction?
Remember that the pelvic floor is mostly made up of muscles, and like any muscles in our body those–too–can weaken or suffer damage and lead to pelvic floor dysfunction. People who have experienced pregnancy, childbirth, chronic constipation, or obesity may be at higher risk as their pelvic floor has, and does, work harder to support their normal bodily functions and the bowels/bladder.
Some of the symptoms of pelvic floor dysfunction may include pain during intercourse, bladder pain, bowel or urinary incontinence, frequent urination, persisting pubic, tailbone, or lower abdominal pain, and constipation–to name a few. More serious issues may include pelvic organ prolapse: bowel prolapse, prolapsed uterus, and even endometriosis.
How can Physical Therapy Help?
Physical therapists are not just experts who help you walk better after an injury, they are medical experts in the functions of muscles, joints, and nerves, and have an in-depth and holistic understanding of human health. Just like any medical field, PTs have areas of expertise and you may want to work with someone who is trained on pelvic floor functions.
A PT will assess your whole body after consulting with you, not just the problem or painful areas. Your medical history, symptoms, and needs will of course be taken into account to create an individualized plan for your pelvic floor health. The exercises will, and should, be done with the physical therapist–unless they assign you specific exercises to do at home. Since our pelvic floor is basically holding everything in our body together, the center so to speak, don’t be surprised if some exercises are not directly working on the pelvic area; ask your PT to explain why they are assigning you an exercise, and how it will help you. Some soreness or aches are normal after your PT sessions, but this is not a “no pain, no gain” situation: at no point during PT should you feel acute pain or strain on your muscles/ligaments.
And for this subject, the saying “the sooner, the better” cannot be emphasized enough: do not wait until you’re older, pregnant, or have any painful symptoms to get started on strengthening your pelvic floor.
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Sexual intercourse should be a comfortable and mutually desirable experience for both individuals involved. If you are experiencing pain during sex, also known as dyspareunia, the pain you feel could result in greater complications or emotional distress between you and your partner. There are several factors that cause women to experience pain during sex. Speak with your OBGYN to determine if one of the following conditions is present:
- Insufficient lubrication – This is often related to a woman feeling anxious during sex. By relaxing, lengthening foreplay, or utilizing a sexual lubricant, this issue can be resolved and comfort can be increased.
- Vaginismus – This is a condition caused by the involuntary squeezing of a woman’s vagina muscles during insertion. The sensation can range from mildly uncomfortable to painful. There are exercises that a woman can do to help reduce the occurrence of the muscle spasms within only a few weeks.
- Vaginitis – This term encompasses various conditions that cause infection or inflammation of the vagina, including vulvovaginitis. Often resulting from a vaginal infection caused by such factors as bacteria, yeast, or viruses, vaginal infections can result in pain during sex.
- Cervical infection – Sometimes during sex the penis can reach the cervix when at maximum penetration. If the cervix is infected, a woman can experience pain.
- Uterine Fibroids – These benign lumps grow on the uterus, and can cause pain during sex among other symptoms.
- Endometriosis – This condition is caused by the development of uterine-lining outside of the uterus and causes abdominal pain, including during sex, heavy periods, and infertility. Treatment options include pain relievers, hormones, and surgery.
- Ovarian cysts – These cysts are closed, sac-like structures within the ovary that are filled with a liquid or semisolid substance. Ovarian cysts cause abdominal pain as well as pain during intercourse.
- Pelvic inflammatory disease (PID) – This disease occurs when tissues deep inside a woman’s pelvis become severely inflamed. The pressure of intercourse irritates the issue and causes deep pain.
- Ectopic pregnancy – An ectopic pregnancy occurs when a fertilized egg develops inside the fallopian tube, instead of the uterus. An ectopic pregnancy occurs in 1 of every 50 pregnancies. Symptoms include lower abdominal pain, sharp abdominal cramps, pain on one side of the body, and pain during sex.
- Menopause – During menopause, a woman’s vaginal lining can lose its normal moisture and become dry, leading to pain during sex.
- Sexually transmitted diseases (STD) – Pain during sex has been linked to such STDs as genital warts and herpes. If you are experiencing pain during sex, and think you may have an STD, speak with your OBGYN immediately.
- Injury to the vulva or vagina – An injury that causes pain during sex may include a tear from childbirth or an episiotomy. In addition, having sex too soon after surgery or childbirth may result in pain during intercourse.
Of course, if you are experiencing any of these symptoms, it’s best to discuss with your gynecologist. He/she can discuss ways to alleviate pain during intercourse. If you are looking for a new gynecologist and live in the Western New York area, please call our practice. We are accepting new patients.
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