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5 Tips for Pain with Sex

Hi friends! Have you ever suffered through painful sex for the sake of your partner? It hurts but you don’t want to disappoint them or seem disinterested. Sound familiar? You are not alone. It is common for individuals to have pain with intercourse, especially those born with female anatomy, but that does not mean that pain with sex is normal!


Read below for 5 tips to help reduce pain with sex.


#1 Use lubricant (the right lubricant)

Lubricants are great for individuals experiencing vaginal dryness due to menopause, pain with intercourse with vaginal penetration, or anal intercourse (Kennedy, 2022). Lubricants are designed to decrease pain and discomfort by assisting with dryness during sexual intercourse. Lubricants work by reducing friction and therefore trauma to tissues and help to reduce pain and discomfort (Potter, 2021).


Lubricants with parabens, glycols, and preservatives (like chlorhexidine and polyquaternium-15) should also be avoided if possible as they can increase risk of infection and may contribute to cancer (Potter, 2021). Some of our favorite lubricants within the recommended range include Aloe Cadabra, Good Clean Love, Pre-Seed Fertility Lubricant, or even plain coconut oil!


#2 Stretch

Stretching the pelvic floor and hip muscles can improve sex. By stretching these muscles before intercourse, or preferably on a regular basis, can help improve the pelvic floor muscles ability to relax during penetration (which can reduce pain).



#3 Communicate with your partner

Let your partner know what feels good and what doesn’t feel good. No matter how well you and your partner know each other, they can’t feel what you do. Direct clitoral stimulation is too much for most people at the beginning. The clitoris has so many nerve endings in the area which can cause it to be very sensitive to touch. Starting to the sides of the clitoris can be a great place to warm-up until it can tolerate direct stimulation. A gentle vulvar/labia massage often feels great!



#4 Perineal stretching

A promising research study looked at women who suffered from dyspareunia and chronic pelvic pain. Each participant had perineal massage performed and showed less pain up to 24 weeks after treatment (Moirera de Silva, 2017). Perineal massage is a technique that helps the pelvic floor muscles to lengthen and relax during penetrative intercourse.


For the treatment, women had massage performed for 5 minutes, one time per week, for a total of four weeks (Moirera de Silva, 2017). That’s 4 treatments, or 20 minutes of total time, for less pain! Wouldn’t 20 minutes of your time be worth it to have less pain with sex, allowing you to enjoy that time with your partner?



#5 Use your breath to help relax your pelvic floor

During penetration, we need the pelvic floor muscles to relax and lengthen. We can use our voice and breath to help lengthen the pelvic floor. A deep breath in, or saying “grrrr” can help the muscles to relax.



If you continue to have pain with sex (or any other pain in your pelvic floor), that may be a sign that your pelvic floor muscles are not working properly. You may benefit from treatment by a pelvic floor physical therapist. A pelvic therapist will help to relax and strengthen the pelvic floor muscles. They often use a combination of hands on therapy like myofascial release, biofeedback, exercises, dilator training, and lots of education.


To learn more about your pelvic floor muscles, check out these great resources:



For providers, check out our online courses to help your clients. Consider joining our Ambassador Programand most of our courses are included with your membership!

  • A Fresh Take on Female Sexual Health with Dr. Lyndsey Harper, MD, FACOG, IF

  • Sexual Interviewing with Dr. Uchenna Ossai, PT

  • Female Sexual Function, Dysfunction, and Pain with Dr. Heather Jeffcoat, PT, DPT

  • An Overview of Female Sexual Function and Dysfunction with Dr. Heather Jeffcoat, PT, DPT

Written by Emily Reul, PT, DPT


References

  1. Kennedy CE, Yeh PT, Li J, Gonsalves L, Narasimhan M. Lubricants for the promotion of sexual health and well-being: a systematic review. Sex Reprod Health Matters. 2021;29(3):2044198.

  2. Moreira de Silva AP et al. Perineal massage improves dyspareunia caused by tenderness of the pelvic floor muscles. Rev Bras Ginecol Obstet. 2017;39(1):26-30.

  3. Potter N, Panay N. Vaginal lubricants and moisturizers: a review into use, efficacy, and safety. Climacteric.2021;24(1):19-24.

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