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Improving Intimacy: 3 Ways to Reduce Pain During Sex When You Have Pelvic Floor Dysfunction

Painful sex (called dyspareunia) is an incredibly frustrating and stressful issue for intimate partners. And while it’s important to know that many things can cause pain during intercourse, dysfunction of the pelvic floor is a frequent culprit. In fact, painful sex is a common symptom of several pelvic floor conditions, including vaginismus, levator ani syndrome, and endometriosis.

If you’ve been struggling with painful intercourse and suspect that pelvic floor dysfunction could be a factor, here are three ideas that may help.

Focus on Foreplay

To reduce or prevent discomfort during sex, wait to begin penetrative sex until you feel fully aroused. Why? According to sex therapists, foreplay promotes physical and emotional intimacy, encourages pelvic floor muscle relaxation, increased blood flow to the genitals, and even enhances natural lubrication in female partners.

So, talk to your partner about what helps you feel most “in the mood” and be sure to give yourselves plenty of time to explore those favorite foreplay activities. The idea is not to rush—enjoy the process and have fun!

In addition to foreplay, other “pre-sexual” rituals can help you prepare for lovemaking, such as drawing a warm bath, emptying your bladder all the way, or using a water-based lubricant.

Try Different Positions

Certain sexual positions, like missionary or from behind, can be particularly uncomfortable for people with pelvic floor dysfunction due to the angle of penetration and its effect on the vagina and uterus.

Of course, no single sexual position is perfect for everyone, so experiment with your partner to find the positions best suited for both of you. Here are some suggestions that may improve comfort and pleasure:

  • While lying on your back, place a few pillows under your hips to raise your pelvis
  • Try being on top, either facing toward or away from your partner
  • Lay on your side as the “little spoon” with your partner behind you as the “big spoon”


You can also skip penetrative sex and enjoy other forms of physical intimacy, such as mutual masturbation, oral sex, and sensual massages.

Work With a Pelvic Floor Physical Therapist

In addition to increasing foreplay and experimenting with different sexual positions, I strongly recommend consulting with a physical therapist who specializes in men’s and women’s pelvic health. A pelvic health PT can offer a range of treatments—including biofeedback, mind-body strategies, manual therapy, breathing techniques, and stretches and exercises—that will help restore your pelvic floor function and support a more-satisfying romantic life.

It is important to rule out hormonal, infectious or other physical issues that could be a factor in your pain or discomfort. So please reach out to a physician who specializes in pelvic health and sexual dysfunction. If you would like suggestions, please contact us at info@itrphysicaltherapy.com so we can recommend a knowledgeable and caring provider.

Also, realize that psychological and emotional elements influence sexual well-being, too. So, please reach out to a certified sex therapist, licensed mental health counselor, or couples’ counselor if you need more support and guidance.

Remember, pain during sex is common—affecting as many as 3 out of 4 women according to the American College of Obstetricians and Gynecologists—but not necessarily “normal.”

If you are one of the many women just trying to make it through your experiences of painful intercourse, don’t hesitate to seek help! You deserve to enjoy your intimate experiences with your partner!

Are You Looking for Pelvic Floor Physical Therapy in Bethesda, MD or McLean, VA?

If you’re concerned about pelvic floor dysfunction, contact ITR Physical Therapy today at 301-770-7060 to schedule an appointment with one of our pelvic health PT specialists. We provide professional, personalized, and private care in two convenient locations near the greater Washington DC area. Contact us today!