Dyspareunia – Why Sex Might Hurt

unmade bed, why sex hurts

It hurts. Sex, intercourse, love-making – whatever you call it. So many women have pain during sex, but not many talk about it. Some feel ashamed, like there must be something wrong with them or somehow it’s their fault. Or, that it’s “normal.” Some tell their health care provider and are told to “just relax.”

Pain during intercourse is not normal. After all, sex is supposed to be pleasurable. So why does it hurt? There are many reasons that sex might hurt. One of the most common is because of tight muscles. That’s right, muscles.

Not because of all of those pelvic diseases and disorders that (admit it) you thought you may have because you hurt “down there.”  Don’t misunderstand, you still need to get your scheduled screenings for cervical cancer and, of course, discuss any symptoms and concerns with your physician. However, in the absence of any disease processes, tight pelvic floor muscles could be why sex is painful.

So, what exactly are the pelvic floor muscles? Your pelvic floor is a group of muscles at the bottom of your pelvis that run from pubic bone to tailbone and between the sit bones. They support your pelvic organs and play a role in bladder, bowel, and sexual functions. They are also a part of your “core” and are dynamically involved in posture. But, these muscles are like all the other muscles in your body. They can get tight, weak, spasm and you can stretch, strengthen, and massage them. If you have heard of a kegel exercise, that is simply a contraction of these muscles.

If you have tightness there, kegels are not the best thing to practice. If these muscles are in spasm, doing more strengthening can actually increase the tightness. Instead, try doing belly (diaphragmatic) breathing, focusing on letting your abdominal muscles and your pelvic floor relax. Doing some hip opening stretches can also help.

If you need more help, it’s out there! Pelvic floor physical therapists are specially trained to help women with this problem. They can evaluate your specific issues including your pelvic floor muscles and design a treatment plan that can help you get back to being pain free and enjoying sex.

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Amy Hoover

Amy is a physical therapist at Cleveland Clinic who specializes in pelvic floor disorders, including pre/postnatal rehabilitation. She has been working with the postpartum population for over 13 years. She lives in Medina with her husband and two children, two dogs and two horses.

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