Pain with Sex

January 16, 2014 in Childbirth, Pelvic Floor, Women's Sex Issues

Sex Doesn’t have to be Painful!

When you think of having sex, what’s your initial reaction?  Is it one of fun, pleasure, and enjoyment?  For many women it’s not.  In fact it’s down right painful.  Their response is one of fear, pain and simple avoidance.  It’s sad that some women are not interested in ever having sex again.    It doesn’t need to be this way.

I”ve seen so many women in my practice who have gone to multiple doctors who all look at their vagina’s and say, “well, it looks normal in here.  There’s nothing wrong, must be all in your head, try a little bit more wine beforehand!”  And for most women suffering from pain with sex, all the wine in the world won’t help their situation.

What most doctor’s aren’t trained in looking at is the mobility of the tissues.  How can the vaginal, or pelvic floor muscles move and stretch?  They aren’t pressing around in there to find out.  So when they look at the tissues, it all looks normal and healthy.  Yet if they were to just press on the sides of your vaginal opening they would most likely find brick walls or tissues that don’t have the ability to expand or stretch.  We need our vaginal tissues to be able to move up and down and expand out in a circle in order to enjoy intercourse without pain.

There are two types of pain with intercourse, insertional pain and deep thrusting pain.  Insertional pain is a problem with the pelvic floor muscles being able to expand and stretch open to allow the penis to enter.  Deep thrusting pain is an inability of the vaginal tissues to move up and down.  The uterus or bladder may be inhibited from moving upwards so every deep thrust is like hitting a brick wall, creating pain.  Both of these issues can be healed by seeing a women’s health physical therapist.

Some common issues that can create painful intercourse for insertional pain are falls on your tailbone and buttocks, childbirth, and trauma from abuse whether physical or emotional.  Impact injuries to the tailbone area cause the muscles to tighten up to protect the area not allowing them to relax and stretch.  Any tearing to the pelvic floor area during childbirth creates scar tissue making the area less mobile.  Also I find many women’s pelvis are still in a childbirth position with their sit bones still splaying out to the side putting stretch on the pelvic floor tissues.  Helping them to come back together again relieves the strain on the tissues.  Emotional or physical abuse creates a subconscious tightening of the pelvic floor  area.   Helping women reconnect and reclaim this area and feel safe again can help  the muscles release this held tension.

C-section or any lower abdominal surgical scars or car accidents usually cause deep thrusting pains.  Scar tissue prevents the organs from moving up and down and creates a wall between the tissues.  Every time there is deep thrusting that hits this block, pain is created.  Massaging your lower abdomen and making sure your tissues can move freely upwards and side to side should help alleviate this pain.  I have a video on my website, How to Massage Your C-Section Scar that you can view for free.  It doesn’t matter how long it’s been since your surgery you can always get more mobility in the tissues with massage.

Please help spread the word to women so they know there is help for them in this area.  It really saddens me that women are not able to enjoy themselves fully.  A women’s health physical therapist can help you with this issue.  For the most part, I just need to see someone one time and they are back to enjoying intercourse again freely without pain.  Reach out, get help and enjoy sex again!  Good luck!

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 intuitivehandspt@comcast.net.

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