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.
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics: Learn where the pelvic floor muscles are, what they do, and how they work
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Visit our Instagram page for more on pelvic health.
Visit our Amazon Store for pelvic health products.
For healthcare providers, check out our course so that you can help your patients manage pain with sex. Consider joining our ambassador program, most of our courses are included with your membership!
Postpartum Pain with Sex by Jeanice Mitchell PT, MPT, WCS, BCB-PMD
Sexual Interviewing with Dr. Uchenna Ossai PT, DPT
Female Sexual Function, Dysfunction, and Pain with Dr. Heather Jeffcoat PT, DPT
Anxiety, Depression, and the Overactive Pelvic Floor with Dr. Jill Krapf MD, Med, FACOG
You can also watch our FREE videos on YouTube
Sex and Orgasms with Dr. Uchenna Ossai PT, DPT
Pain with Sex: How OBGYN and PT Work Together with Dr. Marta Perez, MD
Low Sex Drive with Dr. Staci Tanouye MD, FACOG/GYN
Sex Without Pain with Dr. Heather Jeffcoat, PT, DPT
What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.
Written by Emily Reul, PT, DPT
1. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidenced-based physical therapy for the pelvic floor bridging science and clinical practice. 2nd edition. 2015.
2. van der Velde J, Everaerd W. The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behav Res Ther. 2001 Apr;39(4):395-408. doi: 10.1016/s0005-7967(00)00007-3.