• Emily Reul, PT, DPT

Stress and the Pelvic Floor

Hello friends, happy (almost) Halloween! It’s that time of year when we like to have fun and get scared. We like to watch scary movies, go to (socially distanced) haunted houses, and other scary stuff.


Sometimes we like to watch a scary movie at night and have sex with our partners afterwards. While it can all be fun and games, stress and fear can cause pain or difficulty with sex. Another name for pain with sex is dyspareunia. You may also hear the term vaginismus which is tightening of the pelvic floor muscles which closes off the entrance of the vagina making penetration difficult or impossible.

However, let’s be clear that scary movies don’t cause pelvic floor problems for everyone, all the time, but it can cause symptoms and make symptoms worse in individuals who are already experiencing pelvic floor dysfunction.


Studies have shown that stress and fear can often cause the pelvic floor muscles to become tight and overactive. (Bo, 2015) When we are scared or feel defensive, we often get an involuntary contraction of our pelvic floor muscles which can cause pain or difficulty with penetration. (Bo 2015, van der Velde 2001) Tight pelvic floor muscles aren’t able to work the way they should. Imagine grasping your hand into a tight fist and holding it—it would be hard to use your hand the way it was designed to work!


Watch this short video from Jeanice to learn more about how tight or overactive pelvic floor muscles can impact all functions of your pelvic floor (peeing, pooping, and sex).


So, what can you do if you’ve been scared from that scary movie but now you want to have sex? Here are a few things to try.

  • Deep breathing exercises

  • Pelvic floor muscle stretches

  • Use a warm (not hot) heating pad on your pelvic floor for 15-20 minutes. This can help to increase blood flow to the area and relax the pelvic floor muscles.

  • Use lubricants to help with tissue irritation and pain. Some of our favorites are Good Clean Love, Aloe Cadabra, or even plain coconut oil! If you are using condoms, be sure to check the lubricant and condoms that you are using to make sure they are compatible.

  • Use techniques like “Grr” and “Eek” with penetration. Watch this short video to see how.

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.


Ready to have sex without pain? Here are some steps you can take now:

  • Watch a quick video to learn more about how your pelvic floor works.

  • Ask your healthcare provider for a referral to a pelvic therapist.

  • Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.