Pittsburgh Sexual Intimacy
Pain or Discomfort
Painful intercourse, or dyspareunia, is defined as pain with vaginal penetration and it’s more prevalent than you may have guessed, especially after birth. One study found that 23% of women – that’s more than 1 in 5 women – still experienced pain at 18 months postpartum. And having a c-section is actually a greater indicator that you may develop pain with intercourse, as c-section moms are actually more likely to experience intense pain with intercourse at 6 months postpartum compared to women who delivered vaginally.
Some factors that contribute to discomfort or pain with intercourse include tight or tender pelvic floor muscles, hormonal changes that lead to thinning and poor lubrication of the vaginal tissues, and scarring from perineal stitching after birth or from a c-section scar.
Common symptoms:
- Pain or discomfort at perineum
- Pain with shallow or deep vaginal penetration
- Pain with speculum exams with gynecologist
- Throbbing pain following intercourse
- Lower abdominal discomfort following intercourse
- Difficulty or pain inserting tampons
Treatment techniques that we use to help you get better:
- Pelvic floor muscle neuro re-education (slowly teaching your muscles to be able to tolerate penetration again) – may use a dilator or pelvic wand such as this
- Behavioral modification – recommendations for better lubricant and vaginal moisturizers, discussion of habits and emotions related to intercourse (ex – retraining your thoughts and habits leading up to intercourse to promote increased relaxation and better preparation for intercourse), use of external device such as Ohnut for reduced depth of penetration as warranted
- Relaxation training including pelvic floor muscles as well as supporting muscles and breathing for facilitating relaxation fo pelvic floro muscles
- Manual therapy including trigger point release of internal pelvic floor muscles for tightness or tenderness, fascia release of external pelvic area and abdominals/back muscles
- Tailored home exercise program to target your areas of weakness, including Kegel exercises as indicated
Pittsburgh Sexual Intimacy
Frequently Asked Questions
Why does sex hurt after having a baby?
Painful intercourse, also called dyspareunia, is pain with vaginal penetration, and it is far more common after childbirth than most moms realize. One study found that 23% of women, more than 1 in 5, still experienced pain at 18 months postpartum. C-section moms are actually more likely to report intense pain with intercourse at 6 months postpartum compared to moms who delivered vaginally. Common contributors include tight or tender pelvic floor muscles, hormonal changes that thin the vaginal tissues and reduce lubrication, and scarring from perineal stitching or a C-section. At Form and Function Pelvic Health in Pittsburgh, we help moms understand what is driving the pain and treat the root cause.
What are the most common symptoms moms notice with painful intimacy?
Symptoms can show up in a lot of different ways. The most common ones we see in our Pittsburgh practice include pain or discomfort at the perineum, pain with shallow or deep vaginal penetration, pain during speculum exams at the OB, throbbing pain after intercourse, lower abdominal discomfort afterward, and difficulty or pain inserting tampons. Any one of these is a sign your pelvic floor needs some attention, and the good news is these symptoms respond really well to treatment.
How does pelvic floor therapy treat painful intercourse?
Treatment at Form and Function Pelvic Health is personalized to what is actually causing your pain. Care often includes pelvic floor muscle neuro re-education, which slowly teaches your muscles to tolerate penetration again (sometimes with a dilator or pelvic wand), behavioral guidance around lubricants, vaginal moisturizers, and external tools like the Ohnut to reduce depth as needed, and relaxation training for the pelvic floor along with the supporting muscles and breath. We also use hands-on manual therapy, including trigger point release of the internal pelvic floor muscles and fascia release of the abdominals, back, and external pelvic area, plus a home exercise program built specifically for you.
I had a C-section, so why am I still having pain with intimacy?
This catches a lot of Pittsburgh moms off guard. Even without a vaginal delivery, your pelvic floor carried the load of pregnancy for nine months, and your C-section scar can pull on surrounding tissues in ways that affect pelvic floor function and sensation. Research actually shows C-section moms are more likely to experience intense pain with intercourse at 6 months postpartum than moms who delivered vaginally. Scar tissue mobilization, manual therapy, and pelvic floor retraining can make a big difference. You did not avoid the need for recovery just because you did not deliver vaginally.
How do I get started with pelvic floor therapy for painful intimacy in Pittsburgh?
Getting started is easy, and you are in good hands. First, book a free 30-minute in-person discovery session so you can meet your therapist, talk through what you have been experiencing, and see if we are a good fit. From there, you will schedule a full 60-minute PT evaluation and begin a personalized plan to help you feel like yourself again. This is one of the most common things we treat, so there is no need to feel embarrassed or unsure. We are here to help.
Getting Started Is Easy
Don't worry, you're in good hands. We've made the process super easy for you.
Step 1 - Book a free 30 minute in-person discovery session
Step 2 - Meet your therapist and see if we would be a good fit for each other!
Step 3 - Schedule your first 60 minute PT evaluation - and get ready to regain control and feel your best again.
