Pain during Sex- Is it Normal?
Pain during inctercourse is surprisingly common, in fact ACOG notes that 3 out of 4 women experience pain during intercourse at some point in their lives. For some people, this is a temporary issue- but for others it can be a longer-term issue. Many times when talking about pain during intercourse, it gets written off- like “oh it’s normal” or “just relax”... but is pain during sex normal?
First of all, there are many reasons, many times, and many ways one could experience pain during intercourse. This could be pain on initial insertion that goes away, deep penetration pain, or pain throughout the whole act. It could also present as pain that prevents sex- so even before insertion of anything. This is why it is SUPER important to have an evaluation by a qualified pelvic floor physical therapist, if you have access to one. You can find one in your area at pelvicguru.com. If you don’t have access to one, either due to financial or location barriers, please reach out to me and I can help you find someone who works remotely or give you resources to help you figure out next steps.
One of the most common times to experience pain during intercourse is in the postpartum period. While this is super common, it isn’t necessarily normal. During pregnancy the pelvic floor muscles are put under a tremendous amount of pressure. An automatic response for these muscles can be to hold more tension than usual to manage that pressure. During vaginal birth, these muscles experience lots of stretching and changing- which in some cases can be considered “trauma”. An automatic response for these muscles can be, again, to tense up and hold more tension. This is why it is common to experience pain with intercourse in the postpartum period no matter what kind of birth you had. More tension in the muscles mean they have more trouble relaxing and you’re probably also feeling a bit weary having sex after birth anyway- so these two things can cause some pain.
What do you do about it? I already talked about the first step- which is an evaluation by a pelvic floor physical therapist. Here are some other things you can do about pain during intercourse:
Learn what it feels like to relax the pelvic floor
Practice deep relaxation breathing to release the pelvic floor and calm the central nervous system
More foreplay to warm up the muscles
If your pelvic pain is a longer-term issue, talk to your doctor or PFPT about using dilators, which can help with pain on insertion
Check in with yourself mentally- often pelvic pain isn’t just a physical issue it can be very mental as well. Stress, insecurity, past trauma, how connected you’re feeling to your partner, and other things can cause an increase in pain during intercourse
This topic can be an uncomfortable one to discuss, but it is important to know that sex should be enjoyable for both you and your partner. If you’re experiencing pain during intercourse, know that you aren’t alone and there are things you can do about it- you don’t just have to deal, have a glass of wine, or “just relax”. Rarely is that advice helpful.
If you’re experiencing pelvic pain during exercise or daily life, these are things I talk about and help you work through in my programs- each tailored for a different stage in life. Check them out here.