Pelvic Physiotherapy for Painful Intercourse

PainWith Valentine’s Day around the corner, it is fitting to talk about human sexuality and how our quality of life can be affected when intercourse becomes painful. Human sexuality is defined as “ …the ways in which we experience and express ourselves as sexual beings. Our awareness of ourselves as females or males is part of our sexuality, as is the capacity we have for erotic experiences and responses. Our sexuality is an essential part of ourselves, whether or not we ever engage in sexual intercourse or sexual fantasy, and even if we lose sensation in our genitals because of injury…”1.

When intercourse becomes painful, it can take many different shapes. For women, it may include painful penetration, be experienced external to the vaginal opening, or internal beyond the opening. Some women may have painful orgasms, or have orgasms at unwanted times. For men, there may be pain experienced in the penis or testicles, and/or painful erection or ejaculation. For both men and women, pain may be experienced in the rectum, groin or above the pubic bone. For everyone, the quality of their pain may be sharp, dull, burning etc.

Persistent pelvic pain is prevalent within our society. However, it is not a subject that everyone is comfortable talking about. Often times, I will have patients say, “I thought this was a normal part of aging” or “I have just learned to live with it, I didn’t know there was anything that could help”. However, a staggering 1 in 4 women and 1 in 9 men have pelvic pain!

How Our Anatomy Plays a Role

Let’s take a step back and discuss anatomy to see how our tissues can play a role in pelvic pain experiences. Our pelvic floor is a group of muscle that sling from our pubic bone to our tail bone. These muscles widen in the middle and are attached to the sitz bones. These muscles are called the pelvic floor. They are hidden deep within the pelvis and cannot be palpated (touched) externally and play a vital role in sexual function. These muscles are no different than any other muscle in your body. They can get tight (trigger points or knots) that can cause an increase in pain when the muscles are further tightened or contracted, like during intercourse. For these folks, doing Kegels would make their symptoms worse.

How Physiotherapy Can Help

If you are experiencing pelvic pain aggravated with or without intercourse, pelvic floor physiotherapy may be the missing piece to resolving your pain. Please remember that Kegel exercises will often not resolve these issues, and sometimes can exasperate the problem. Everyone’s pelvic pain experience is different. If you would like more information, or have questions, please do not hesitate to call The Centre for Pelvic Health 519-624-8798. For your convenience, I am treating out of Vibrant Living on Tuesdays and Thursdays.

In good health,

Julia Fiorelli MScPT
Registered Physiotherapist

1)     Rathus, S.A., Nevid, J.S., Ficher-Rathus, L. & Herold, E.S. (2010). Human Sexuality in a World of Diversity (3rd ed.). (pp.3 )Toronto, ON: Pearson Education Canada.

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