Pelvic Floor
September 24, 2019

Vaginismus, Pelvic Muscle Tension, And Painful Sex

Painful sex is common, but it’s certainly not normal. Here’s what you could be experiencing—and what to do about it.
Written by
Louise Bourchier, MPH
Published on
September 24, 2019
Updated on
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Pain during sex is unfortunately quite common. That is not to say that it’s normal—pain is a sign that something needs your attention—but that pain is not rare in the bedroom. Nearly three in four women experience painful sex at some point in their lives. And, while it is more common among people with vaginas, people of any gender and genitals can experience dyspareunia (the technical word for painful sex).

There are a number of possible reasons why sex might be painful. Pelvic floor dysfunction is one such possible causes: If the pelvic floor is overly weak or overly tight it can cause pain during sex, especially during penetration.

Vaginismus: Pain With Vaginal Penetration

Vaginismus is a condition where vaginal muscles are overly tight, causing pain during penetration. When anything is inserted into the vagina, whether that’s a tampon, finger, or penis, the muscles spasm painfully. For some people, the condition may be so severe that vaginal penetration is not possible. Vaginismus can come about because of past damage or trauma, such as previous painful sex or sexual assault.

If the pelvic floor is overly weak or overly tight it can cause pain during sex, especially during penetration.

Pelvic floor stretches and breathing exercises may help strengthen the pelvic floor and eventually reduce pain. Ultimately, if you think you may have vaginismus, the best idea is to go see a doctor and/or a pelvic health physical therapist for professional help.

Pain During Anal Penetration

It’s not uncommon for anal play to feel a bit unfamiliar or slightly uncomfortable at first, but contrary to popular belief pain is neither a normal or necessary part of anal sex. Like vaginal sex, pain during anal sex is often due to tense muscles, which in turn may be caused by a number of factors: an overly tight pelvic floor, anxiety, or simply lacking the necessary warm-up!

If the muscles are not ready, trying to insert something into the anus can cause painful spasms.

If the muscles are not relaxed, trying to insert something (especially something on the bigger side like a penis or dildo) into the anus can cause painful spasms. To prevent spasms, start with something smaller like a finger or small butt plug, take plenty of time, breathe deeply with your belly, and use lots of lube. The parasympathetic nervous system controls the internal anal sphincter muscle, which you can’t consciously control, so you want to make sure that you’re very relaxed, otherwise that muscle will stay tightly clenched.

Caring For Your Pelvic Floor To Reduce Painful Sex

Pain is a sign that something is wrong and needs your attention, whether that means applying more lube, changing positions, or going to see a doctor. If you are experiencing frequent or severe pain during sex, you should see a health care provider. If the discomfort is minimal, you can experiment with sex positions where penetration isn’t too deep, or focus on external stimulation.

There do exist some toys that can ease sex-related pelvic floor pain. For example, the OhNut is a squishy ring that you put on the shaft of a penis. It allows you to control the depth of penetration thereby alleviating potential discomfort.

Pain is a sign that something is wrong and needs your attention, whether that means applying more lube, changing positions, or going to see a doctor.

Some people also use ice or heating packs on their vulvas before sex to prepare and relax the muscles. Be sure to frequently check your skin when using ice and heat, as they can both burn you!

If you have an overly tight pelvic floor it is important that you do not practice Kegel exercises (unless advised to by a doctor). Kegel exercises are valuable for those with a healthy or weakened pelvic floor, but are not recommended for those with an overly tight pelvic floor as they can make symptoms worse. Instead, exercises that relax and stretch the pelvic floor are recommended. Going to see a pelvic floor physical therapist is a good idea so that they can correctly assess your needs, and prescribe exercises to improve your pelvic floor health and improve your sexual satisfaction.

Sex shouldn’t be painful. If painful sex is casting a shadow on your sex life pelvic floor muscle tension might be the underlying problem. It may be time to consider seeking professional help in order to pursue the pleasure you deserve.

Reviewed for Medical Accuracy

Louise Bourchier is a sex educator and sex researcher with 8 years experience in the field. She teaches about sexual health, sexual pleasure, and communication in relationships through workshops, live-streams, and with written content. Using a sex-positive approach, a dash of humour, and bag full of fun props, Louise’s style of sex education for adults is not what you got in high school! Since 2011 she has taught over a hundred workshops to a wide range of audiences, from university students, to refugees, to medical professionals, to adult store clientele. She has a Masters of Public Health, and is currently a PhD candidate.

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