What To Do When Sex Is Painful With a Paradise Valley Sex Therapist (In Training)
This one is for my ladies and vulva owners who are dreading penetration because it has been so painful and have previously just been trying to endure it rather than enjoy it. Perhaps you are not even able to experience penetration because your pelvic floor muscles are so tight, making it difficult even to insert a tampon. Maybe you are experiencing burning and stinging in your vulva area. You long to be sexually intimate in your romantic relationship, but every attempt to have penetrative sex leaves you feeling broken. You worry that this is just how sex is going to be from now on, and you are fearful of what could happen long-term if you are unable to meet your partner’s sexual needs.
Health Care Challenges
Vulva owners seeking medical care for pelvic floor pain are sometimes dismissed, misdiagnosed, or recommended interventions and treatments that fix the root cause. After reading this blog post, I want you to feel hopeful and empowered about your healthcare options. I want you to know that healing is available to you. You do not need to suffer through painful sex a second longer. Our bodies have a remarkable innate ability to heal, and it is simply about finding the right treatments to relieve the symptoms of painful penetration. You deserve all the pleasure that your body can give you.
So, let's get to it!
Pelvic Floor Basics
You may be as shocked as I was to discover that the pelvic floor consists of a group of muscles, ligaments, and connective tissues that span the bottom of the pelvis, forming a supportive hammock for the organs (bladder, uterus, and rectum), in the pelvis. The pelvic floor is crucial in many bodily functions, including urinary and bowel control, sexual function, and core stability. It is apparent that our pelvic floor plays a significant role in our health, and a lot of stress and tension can be held in this area, especially for women and vulva owners.
Pelvic Floor Dysfunction Symptoms
Urinary issues:
Frequent need to urinate (most people urinate 6-8 times a day)
Urinary incontinence (leakage)
Difficulty starting urination or fully emptying the bladder
Painful urination
Bowel Issues:
Constipation or straining during bowel movements
Fecal incontinence (involuntary leakage of stool)
A feeling of incomplete bowel evacuation
Pelvic Pain:
General discomfort or pain in the pelvic region
Pain during intercourse (dyspareunia)
Lower back pain
A sensation of heaviness or pressure in the pelvic area
Pain during or after sex
Inability to experience penetration (vaginismus)
Burning, stinging, irritation, or rawness (vulvar vestibulitis)
Muscle spasms in the pelvis
Difficulty relaxing the pelvic muscles
If any of these sound familiar, keep reading! You are one step closer to finding solutions that will work and not only have the ability to heal your pelvic floor but also your relationship with sex.
Pelvic Floor Physical Therapy
Pelvic floor physical therapy is available, and it is an absolute must if you are experiencing any of the symptoms listed above. Run, do not walk, to find a physical therapist who specializes in treating the pelvic floor near you! I cannot encourage this enough. Below is what you can typically expect from your first pelvic floor therapy appointment.
Comprehensive Medical History
The therapist will ask about your symptoms, medical history, lifestyle, and specific concerns. This might include questions about urinary and bowel habits, sexual function, and pain.
Physical Examination
The therapist will conduct a physical exam, which can include an assessment of posture, spine, and hip alignment, as well as an external and internal examination of the pelvic floor muscles. The internal exam helps the therapist assess muscle tone, strength, coordination, and any areas of pain or dysfunction.
Assessment of Pelvic Floor Function
The therapist will evaluate how well your pelvic floor muscles contract, relax, and coordinate with other muscles. Then, the physical therapist will establish a treatment plan based on your individual needs and concerns. Similar to healing any other injury, healing the pelvic floor takes time, consistent effort, and patience from you and your sexual partner. Your pelvic floor therapist may assign you some restorative yoga poses to help relax and stretch your pelvic floor muscles. Ready to take action?! Here are some exercises you can practice today that, over time, can help alleviate pelvic floor pain.
Basic Pelvic Floor Exercises
Deep Diaphragmatic Breathing
Set a timer for 10 minutes, and then begin by lying flat on your back on a comfortable surface. Place both hands on your lower belly and breathe deeply through your nose, ensuring your lower belly and rib cage expand with each inhale. Notice how, with each inhale, your pelvic floor expands like you blow air into a balloon and contracts back to a resting position with each exhale. Do this for 10 minutes a day, every day.
Legs Up The Wall
Set a timer for 1 minute, and then lay flat on your back on a comfortable surface. Then, place your legs up the wall, forming a 90-degree angle with your legs and torso. Use your deep diaphragmatic breathing while waiting for the timer.
Cat Cow Pose
If you have ever tried yoga, you may already be familiar with this pose, but if not, no worries; it is easy to do and relaxing. On a comfortable surface (cushion, carpet, or yoga mat), begin kneeling and placing both hands on the ground like you are about to crawl. On your inhale, arch your back by moving your head and neck toward the sky. On your exhale, round your back by moving your head and shoulders into a downward position like a cat. Repeat for one minute, arching your back on the inhale and rounding your back on every exhale.
Childs Pose
This is my personal favorite. Get ready to sink into this relaxing pose and have the ground hold and support you. Begin by kneeling and pointing your knees in opposite directions to create a V shape. Lean forward, keeping your buttocks on your heels, and rest your forehead on the floor with your arms outstretched in front of you above your head. Practice your deep diaphragmatic breathing for 1 minute.
Frog Pose
Move to a kneeling position. Spread your knees wide from all fours, with your shins parallel to your yoga mat. Bring your hips in line with your knees and rest your elbows and chest on a block or the ground. Breathe deeply again using your diaphragmatic breathing for one minute. When coming out of the pose, slowly move your body forward, dropping your stomach flat onto the ground.
When practicing any of these restorative yoga poses, the most important thing to remember is to meet your body where it is and modify these poses to meet your body’s needs. Yoga is for everyone, and don’t forget to breathe deeply!
When To See A Sex Therapist?
Painful sexual experiences can create a negative cycle where the anticipation or memory of pain causes anxiety and muscle tightening. This muscle tension restricts the blood flow to the tissues, reducing circulation, which leads to less lubrication and increased muscle tightness. As a result, the pain gets worse, perpetuating this cycle. The cycle of pain must be interrupted. Treatments to decrease pain are not instant and require patience and consistent effort. EMDR is an effective treatment for breaking the pain anticipation cycle.
While an enjoyable sex life has little impact on a couple’s satisfaction in the relationship, sexual problems have significant adverse effects. During this time, it is crucial that the couple maintains hope and finds other ways to maintain intimacy. A sex therapist can help you and your partner expand your sexual repertoire while simultaneously working on different treatments to decrease pain. I recommend finding a good lube and spending more time receiving foreplay-like penises, vaginas get erections, too. A couple’s sex therapist can also assist both of you in understanding your emotions that can get in the way of enjoying sexual intimacy and that leave you both feeling misunderstood and disconnected.
Dilators
Another resource that your pelvic floor therapist or sex therapist may recommend is dilators. Dilators are medical tools often used to help stretch or relax tissues, particularly in the vaginal area. They are commonly used to treat conditions such as vaginismus or vulvodynia. Dilators typically come in sets of different sizes, from small (about the size of a finger) to gradually increasing in diameter. This allows for progressive stretching of the tissues over time.
How To Use
I recommend using the dilators while taking a hot bath. This can help soften the skin, making it easier to stretch, plus it's super relaxing. Apply a small amount of lubricant on the dilator and begin to relax the pelvic floor with deep belly breathing. After a few minutes, insert the dilator into your vagina and leave it there for one minute. Practice this three times a week, working up to leaving the smallest size inserted for 10 minutes. Once you can insert the smallest size comfortably for 10 minutes, move up to the next size and repeat this process.
CBD Lube and Sexual Pain
Applying CBD-infused topicals to your genitals is a highly effective way to reduce pain and enhance pleasure. These topicals can provide relief without causing any psychoactive effects. CBD can help with sexual pain during penetration by relaxing muscles, reducing inflammation, and providing pain relief. It may also enhance lubrication, reduce anxiety, and improve blood flow, making the experience more comfortable and enjoyable.
Topical CBD products like creams or lubricants can be applied directly to the affected area for targeted relief. Everyone’s body responds differently, so it's best to start with a small amount and see how it works for you. If you're considering CBD, consulting a healthcare provider is always a good idea, especially if you have any medical concerns. It offers a gentle, natural way to improve comfort and enhance sexual well-being. Some of the most reputable names in CBD sex oils are Foria, Kush Queen, Quim Rock, and Velvet Swing. Foria is my favorite brand out of the four.
That’s All Folks
Taking an active approach to healing your pelvic floor dysfunction is essential for long-term progress. I hope you are feeling more seen and guided in your healing journey. Remember, like any other injury, recovery takes time, and every step you take can bring you closer to creating the vibrant sex life that you desire. Feel free to contact us at The Connection Couch if you have any other questions or need further guidance about our in-person and online sex therapy sessions. We also host free workshops every month to learn about how CBD can help with painful intercourse. Send email inquiries to find out when and where they will be hosted. Every body is different, and finding the right strategies and support is vital to your success.
Start your healing journey with sex therapy in Paradise Valley
At The Connection Couch, we understand how challenging painful sex and pelvic floor dysfunction can be. You are not alone in your pain. These issues can deeply impact your quality of life and intimate relationships. As compassionate sex therapists in Scottsdale, Arizona, we are here to provide a safe, supportive space for your healing journey. Begin today by following these steps:
Set up your first sex therapy appointment and take the first step toward change
Discover the positive effect sex therapy can have on individuals struggling with painful sex.
Additional Services Offered Within Scottsdale, AZ
As a sex therapist in Paradise Valley, I offer therapy for individuals and couples who are looking to improve their intimacy, as well as couples dealing with betrayal and infidelity. Additionally, I offer therapy services for those recovering from sexual trauma.
Sources:
Hertlein, K. M., Weeks, G. R., & Gambescia, N. (2020). Integrative sex and couples therapy: A therapist’s guide to new and innovative approaches. Routledge.
McCaffrey, K. (2019). Merry Jane: The CBD solution. Greenleaf Book Group Press.
Stein, A. (2009). Heal pelvic pain: A proven stretching, strengthening, and nutrition program for relieving pain, incontinence, IBS, and other symptoms without surgery. Echo Points Books and Media.
Resources Collected by a Sex Therapist in AZ:
Pelvic Floor Therapists in Arizona:
CBD Infused Topicals:
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