No Baby...Not Tonight.

Good evening Mother Lovers,

I recently met a woman, pregnant with her third baby. She was around 23 weeks and we started talking about the pains in our butts. Not people, literal pain, which lead to a lively discussion about my new found love for being a PT patient and how quickly it is helping me heal. She too had tried ALL the things for her butt/low/pelvic pain - massage, acupuncture, chiropractic, cupping. But she hadn't tried PT. By the end of the conversation, she was on her way to book her appointment with a PT as fast as she can. 

Guys. PT is so important for our bodies when we try all the things but we still have pain. Living with pain is NOT normal. And yes..those capital letters are my head screaming because it is the truth. Living with pain is not normal or tough.

We want you to live in the light and learn how to bounce back with resiliency. So tonight, we show up for you with part two of a three part simple series from our Vagina Whisperer Sara Reardon, PT, DPT, WCS and mother. Covering painful sex after birth, and how to take care of yourself.

Hold your loves close tonight. Thank you for trusting us with your heart!

Love you so BIG!

One in five women can experience pain with sex at some point in their lifetime.

Despite how frequently this occurs, women are often told to “just relax” or “drink a glass of wine” when they report it to their doctors.  This is bullsh*t. Sex is not supposed to hurt… at all.

It’s supposed to be pleasurable and enjoyable.

Because this pain is not accurately diagnosed and often goes untreated, women continue to unnecessarily suffer, experience pain, or avoid intercourse altogether. Their relationships become rocky; their partners get frustrated; they feel embarrassed, ashamed, inadequate, and like something is wrong with them.

It is not.

There are numerous physical, psychological, and emotional reasons where pain with sex may occur. From a purely physical perspective, the pain can be due to infection, hormonal imbalance, nerve entrapment, scar tissue, tense pelvic floor muscles, or a variety of other causes. I’m going to focus on one part of your body that is often overlooked, but commonly is a source of the pain: your muscles.

The muscles in your vagina, specifically.

These floor muscles are often not considered as a source of painful sex, while weak or untreated floor muscles can lead women to suffer for months or even years. By the time I see these women in my clinic, they are often exhausted, depressed, deflated, and even traumatized by what has seemed an endless journey to figure out why their vagina hurts.

Your pelvic floor muscles sit at the base of your pelvis and help support your pelvic organs, keep in pee and poop until you are ready to empty, and have a role in sexual activity. However, these muscles are like any other muscles in your body. They can get short and tight and go into spasm. This can cause vaginal penetration to be difficult and sometimes impossible.

Pain can also occur with deeper penetration, with orgasm, or even after intercourse is over. These muscles need to be lengthened and relaxed to their normal resting state. A pelvic physical therapist can help by guiding you through breathing exercises, yoga and stretching, performing massage, and educating on pain, posture, and returning to sex that is pain-free and pleasurable.

Here are some quick tips that may be helpful to start getting your muscle to let go and help decrease pain with sex:

  1. Practice belly breathing daily. Slowly inhale and puff your belly outward and exhale slowly let it fall. Performing this technique for 5 minutes once to twice a day can help your pelvic muscles relax and decrease overall tension in your body.
  2. Use lube. Lots of it.  I cannot repeat this enough. I recommend a water soluble lubricant (my fave is Slippery Stuff) or a natural oil (my fave is coconut oil) during intercourse.
  3. Get vaginal dilators. Dilators look like a set of tampons of increasingly larger diameter. Inserting these into the vagina can help desensitize your vaginal tissues, relax your muscles, and massage any scar tissue at the vaginal opening resulting from an episiotomy or tear. 
  4. Massage with a crystal wand. This looks like a dilator with a curved tip at the end. It can be used to apply pressure to the tender, tense muscles to help them relax. Pretty much a vagina massage.

These tips may help if muscles are a source of your pain.

Consult with a physician (and…a good one who listens to you) and a pelvic health physical therapist if you are having pain with sex and want to know if muscles are a piece of the puzzle.

Sara Reardon is a Doctor of Physical Therapy specializing in pelvic health, helping women across the lifespan optimize bladder and bowel health, sexual health, and pregnancy and the postpartum period. She is a practicing clinician, educator, and author in the field women's health physiotherapy. She helps fix what can go wrong with a woman's body, and she is passionate about focusing on what can go right. She is a momma, New Orleans native, and wanna be yogi.