Lets talk about sex (part 2)! Sex should not be painful

Sex should not be painful. Everyone involved in the sexual act should not only be consenting (#Metoo), but they should also be able to enjoy it.

Now, I get it. You recently (within a few years) had a baby. You are exhausted. Someone (a little helpless being) is constantly wanting and needing your body. The last time you showered was 2 days ago. The last thing you want to do is have sex. 

But, let me tell you why you should think of sex like working out. Sex is not only beneficial to help you feel bonded to your partner, but it also helps your body. It helps bring blood flow to your pelvis keeping your muscles healthy, it releases “happy” hormones, and it counts as a form of exercise! So, like working out, you might not want to do it, but knowing that it is beneficial for you and even healthy for you might help. Also, like working out, most of the time you might not want to do it in the beginning, but afterwards you are usually glad you did. 

If you tore or had perineal trauma (trauma anywhere to the area from your urethra to your anus) during the birth of your child, then it might feel really painful to have sex. Maybe you didn’t have anything happen to your perineum, but it is still painful. Sex does not need to be vaginal penetration. The benefits of sex happen when you achieve an orgasm. 

It is important to decrease pain that you have before having sex so that your brain does not associate pain with sex. 

There could be several reasons why you are having pain with sex. One could be that you had “trauma” to that area and now have a scar that is causing the pain. A second reason could be because your muscles are sitting in a shortened position and those are causing pain. 

If you had “trauma” to your perineum and now have pain with sex on initial insertion, it is likely from the scar. Doing a gentle scar mobilization can help decrease the sensitivity of the scar, and thus decrease the pain. 

If you have no reason to have a scar there, but it still is painful on initial penetration, it could be from the muscles being overactive causing them difficulty to relax. If this is the case, using something called a dilator can help “stretch” out the muscles and tissues to make sex less painful.

If you are experiencing pain on deep penetration, it could likely be from the muscles resting in a shortened position or have trigger points and thus, need to be stretched just like any other muscle. There is something called a pelvic floor massage tool that you can use to help lengthen the muscles and decrease the trigger points. 

Using diaphragmatic breathing can be very beneficial to help relax the muscles and decrease the pain. Doing this for 5 minutes before having sex and during sex can help. Watch this video to see how to do diaphragmatic breathing. Unlike in the video, perform this lying down. 

If you try these things and you continue to experience pain with sex, please see a pelvic floor physical therapist. Sex should NOT be painful. You should be able to enjoy sex no matter your history.