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Guest Blog By Kathryn Warr :: IvoryRose Physiotherapy For Her

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sex hurts

Talking about sex can be something women find uncomfortable at the best of times, but when sex hurts, the level of discomfort can become insurmountable. Often, women will deny pain to their partners (and sometimes to themselves), fearing they are not “normal”, and concerned that speaking up may be opening a door which leads to them losing their intimate relationships.

Painful sex (often referred to as dyspareunia) is something that is common throughout our female community – 1 in 5 to be exact. Causes of painful sex can vary, some of which include:

:: Infections (such as UTI’s, thrush, STI’s)

:: Dryness (or lack of natural lubrication which can result from breastfeeding or menopause)

:: Endometriosis (deep lesions or consequential pelvic floor overactivity)

:: Irritable bowel syndrome (IBS)

:: Skin conditions (such as vulval dermatitis, lichens sclerosis and lichens planus)

:: Scar tissue or irritation post pregnancy/birth (Note: both vaginal birth and caesarean section women can experience sexual pain post birth)

:: Scar tissue/tightness throughout your pelvic floor muscles post-surgery

:: Emotional factors such as stress and anxiety

What will it feel like?

For starters, pain with sex should never be considered the norm. Working in the field of women’s health and as a Physiotherapist, we are always a little shocked when women state they thought that their pain was a “normal” part of sex, and that they “didn’t want to complain” about it. Often it takes a big step to start to admit to both themselves and their partners, that sex is no longer, or in some cases, has never been pain free.

Descriptions of this pain can vary from “sharp”, “stinging” and/or “burning” pain on penetration (initiation of sex), to “deep” and “aching” sensations, which can last for hours or days after sex at the vulva, vagina or sometimes throughout their entire body.  Some women will find this pain improves whilst having sex, others find it dramatically increases to the point where they must cease intercourse or choose to never initiate in the first place.

… Moral of the story? PAINFUL SEX is NEVER NORMAL!!!

So what to do we do if our trip to the bedroom is making us cringe? Our top tips are shared below..

5 Top Tips if Sex Hurts

TIP 1: Warm up.

Sadly, often we find that gone are the days where the thought of our partner gently stroking our leg is enough to get the juices flowing. Esther Perel (expert in relationships and sexuality) once said a line that I will never forget…. “Sex is not a thing you do… it is a space you enter”. We know there are multiple factors that go into the female body being relaxed and “ready” for intimacy so talk with your partner about exploring your erogenous zones before he starts to attempt the final act.

TIP 2: Slow and steady wins the race.

It may seem pretty obvious that the faster you apply stretch to a living tissue, (particularly if that tissue has a reason to already have a poor motor pattern – let’s say every month when Aunt flow arrives, she brings with her some barbed wire and a set of knives resulting in EXTREME period pain), then logic would lead us to think that trying to penetrate quicker can sometimes lead to spasm of your pelvic floor. That is spot on correct, and this spasm can often be quite uncomfortable, sometimes limiting the ability for anything (including a penis) to penetrate entirely.

TIP 3:  Lubricant is your friend.

If tips 1 and 2 have not quite worked as you’d hoped, lubricant can also be of some assistance here. However, we all know shopping for lubricant can be a little daunting… Often we’re trying to get in and out as quickly as possible attempting to stuff the KY Jelly at the bottom of the trolley and praying we don’t get Jacob, the local teenage checkout-bloke at the supermarket.  I get it… So that is why our next blog instalment focuses purely on a little cheat guide to the best on the market – inclusive of pros and cons of each of course – You’re welcome 😉

TIP 4: Breathe.

Not only does taking some slow deep breaths promote the release of yummy calming hormones such as serotonin, but putting the brake on your respiratory rate will directly affect your nervous system and how you respond to pain. A high respiratory rate is associated with our body’s “fight or flight” response, so speeding up our heart rate and breathing can sometimes lead to harmful stress hormone production and consequently, an increased sensitivity to actual or perceived painful stimuli – No good.

BONUS – Your breathing muscle (known as your diaphragm) sits like a dome underneath our ribcage and works synergistically with our pelvic floor muscles (which rest at the base of our pelvis). Learning how to take a long deep breath, all the way into the base of your lungs can assist in the natural decent and recoil of your pelvic floor muscles throughout your day. Getting into the habit of slowing down your breath and allowing relaxation of these muscles is an absolute must (though very difficult to do if you are in a state of “spasm” or overactivity).

TIP 5: Ask for help.

And this leads us into our final piece of advice surrounding painful sex – REACH OUT TO SOMEONE WHO CAN HELP!! Many health professionals exist (including the team here at IvoryRose Physiotherapy For Her), who can assist you in navigating your way through an uncomfortable topic and a bloody painful experience. Believe it or not, Physio’s can help your sex life! Who-da thunk it?? In fact, research has shown we are one of (if not THE BEST) health provider that can assist in reducing pain with sex. We are excellent listeners, and we spend a lot of time helping you to relearn your systems here – and we are dam good at our job. We care about you and our goal is get you back to (or maybe even start you) on your journey for a playful, intimate and satisfying sex life – Winning!

So there you have it. 5 Top Tips if sex is painful.

If you would like more information, please visit our website at, or call us today on 0401569209 if you would like to have a chat and explore whether or not we can help. It’s time to start feeling good ladies.

-IvR xx

Adelaide’s IvoryRose Physiotherapy is focused on assisting & supporting the female body through various stages of life. Working closely with GPs, Surgeons & Specialists to care for women.

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