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Let's Talk About Sex, Baby!

Today I’m blogging about SEX . . . what else would I blog about on Valentine’s day, anyway? If you know me, you know this is one of my favorite topics. So here is your fair warning – I have no reservations talking about this topic.

Sex is awesome, right? It decreases stress, enhances intimacy with your partner, and even gives you an incredible endorphin rush. However, not everyone feels like sex is awesome. It’s actually SUPER common for people to feel like it’s NOT awesome. According to ACOG, “Pain during intercourse is very common – nearly 3 out of 4 women have pain during intercourse at some time during their lives. For some women, the pain is only a temporary problem; for others, it is a long-term problem.” What’s worse? It typically takes seeing an average of 5-7 doctors before getting to a pelvic physical therapist that can help you!

Guys, you can KEEP reading. Because, I’m going to debunk a myth for you right now! It’s not just females that can have pain or difficulty with sex . . . guys have pelvic floor dysfunctions, too. “Men have a pelvic floor?” you ask. Yes, and you most likely found your pelvic floor muscles at a very young age . . . you know those “elephant trunk lifts” you used to do in the mirror or to show off to all your friends? Maybe you’re still doing them? Yep, that’s your pelvic floor working . . . that is a male Kegel. Long story short, men have pelvic floors, too. The pelvic floor and tissues surrounding can get disrupted, and that can wreak havoc on your sex life.

Sorry for the Valentine’s Day buzz kill. But, hang in there and keep reading, because I’m about to bring you some better understanding and hope.

Where to begin? How about with the basic anatomy – we are all beautifully designed and have a combination of muscles, tendons, ligaments, fascia, nerves, bones, organs, lymph, arterial and venous flow that make up the pelvis. Any impairment within these structures can create dysfunction and therefore, pain, dryness, inability to tolerate penetration or to achieve an orgasm, erectile dysfunction, etc. Men and women can have dysfunction anywhere along the spectrum of sex: from arousal (or lack thereof), anything even touching “that area”, foreplay, intercourse, orgasm . . . and this “discomfort” can last for hours and even days after sex.

After hearing this, your natural question is typically – why does this happen? Common reasons I have seen: chronic infections, painful bladder syndrome, endometriosis, PCOS, lichen sclerosis, vaginismus, vulvodynia, constipation, prolonged sitting whether you sit at a desk all day or are an avid cyclist, a tailbone injury, a bad fall, a car accident, cancer, surgery, history of STDs, emotional, physical, or sexual abuse at any point in your life, and the most commonly thought of-pregnancy and childbirth-yes, c-section mamas have pelvic floor dysfunction, too. So, that’s why it might happen. There could be other reasons; these are just some of the most common reasons that I see in my practice.

Then the next question that comes in is – how do we fix it? Do we “just need more foreplay” or “just need a glass of wine” to work through these issues? How about a pill…is there a pill to fix this? Let me tell you . . . there might be a pill to fix the symptoms, but that is most definitely not a long-term solution. Besides, who wants to drug up on pain pills 20-30 minutes before you want to get intimate? And, hello opioid addiction and overdose crisis! Although I absolutely believe in a team approach and am a huge advocate of utilizing other healthcare practitioners for collaborative care, today, I’m going to focus on treating sexual dysfunction with PT (physical therapy). PTs address the physical dysfunctions (whatever doesn’t move – compressed tissues, irritated nerves, bony mal-alignment, decreased mobility, etc.). All of these issues feed into the vicious pain cycle. One of my favorite mentors always says “The body has an innate ability to heal itself, we just have to set the conditions right.” That’s the good news! So, what’s restricted or irritated? It can be one or more likely, a combination of all of these components. Specialized pelvic physical therapists are trained to navigate subjective and objective details to figure out the root cause and treat the problem.

And, some of my favorite questions – You do what?! How in the heck did get into this field?! Wait a minute, what kind of a physical therapist are you?! This could be a blog topic for another day. But, the short version is that I have a huge heart for people and want to be able to empower them in some of the most intimate areas of their life. It is a very rewarding job, and I want to help my patients just as much as I would my family and friends.

If you raised your hand when I said “pain with sex”, you would likely benefit from having a pelvic physical therapist sit down with you and figure out the root of the problem and help you get back to a great sex life! But, don’t feel left out if you feel like you can’t be intimate on Valentine’s day (or any other day of the week). Get naked and spoon, have a passionate make-out session, or maybe have your partner give you a massage with some romantic essential oils like ylang ylang, rose, or jasmine. There are plenty of ways to be intimate. You might just need to get a little creative until you can get back to “the real deal”. I will end with simple advice. If this article resonates with you, know that painful sex is common but not normal and it is treatable. I can help you get that spice back. And, if you’re not in the Indianapolis area, here’s a great resource to find someone who can:


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