Is Sex Painful?

February 26, 2013 in Pelvic Floor, Post Partum, Women's Sex Issues

Do you have pain with sex?

You may be shocked to be asked this question but this problem is more common than you think, especially after having a baby.  Women usually just don’t talk about it because when they ask their OB/GYN they are told everything looks ok in there.

What women need to understand is that most doctors don’t understand the muscles and connective tissue problems of the pelvic floor area.  Their expertise is in the organs functioning.  While everything may look “normal” most doctors do not check the ability of the tissues to move and expand and this may be where your problem lies.

Do you realize there are three distinct specialty areas in the small, little vagina?  You have to see an urologist for any bladder issues, a gynecologist for your uterus and if you have issues with your bowel you need to see a proctologist.  Unfortunately vary few of these specialists fully understand how the connective tissue or fascia, and the pelvic floor muscles contribute to pain and problems in this area.  This is where a woman’s health physical therapist can help you.  They are trained to work specifically with the muscles and connective tissues of your pelvic floor.

Pain with Intercourse

Typically there are two types of pain with intercourse, pain with insertion and/or pain with deep thrusting.

Insertion Pain

Pain with insertion may be caused from tightness in the pelvic floor tissues.  Just like our shoulders can get a “knot” in them, the pelvic floor muscles can also develop increased tension that can cause low back pain along with painful intercourse.  Any tearing during childbirth creates scar tissue which can also inhibit the movement and stretching of the pelvic floor tissues to allow for penetration.   A couple of sessions of physical therapy can help to free up or relax the pelvic floor tissues to allow for more enjoyment during intercourse.

Deep Thrusting Pain

Deep thrusting pain may be contributed to the lack of motion of the cervix and uterus.  If the uterus isn’t able to move from adhesions or scarring from a c-section every time the penis hits the organ it will create pain.  All the organs in our pelvis need to have free mobility or deep thrusting may be painful.  A physical therapist trained in visceral manipulation and scar tissue release work should be able to help you free up your pelvic organs so deep penetration pain is no longer a concern.


Lynn Schulte-Leech is a physical therapist with more than 20 years of experience.  She specializes in Women’s health and Visceral Manipulation.  If you’d like to talk to her about your issue or set up an appointment please call her at 303-845-0604 or email her at