When you've tried everything and sex still
So you’ve tried everything but sex still hurts.
- You’ve been to the doctor, nothing is wrong medically.
- You’ve tried using lubrication.
- You’ve tried pelvic floor physical therapy.
- Maybe you’ve even tried trigger point injections.
If you’ve tried steps 1-3 above and still have not found relief, keep reading. If you have not yet seen a doctor and a pelvic floor physical therapist, I highly recommend that as where you should start.
When sex still hurts....Emotional component of pain
Pain anywhere in the body can have an emotional component for sure, but this is especially true for pelvic pain, particularly pain with sex (also known as dyspareunia). Let me explain.
Just as we have different parts of our physical body that make up our anatomy, we also have different energy centers which relate to how we function in this world. The energy center that relates to our emotions happens to be located in the region of our pelvis. So it makes sense why emotions play such a huge role in pelvic pain and pain during sex. The energy center for our emotions is literally located right here!
Not only are your emotions going to be affected just from the fact that when you have pain in this area, it happens to be the same energetic area that our emotions stem from, but pain with sex can be seriously emotionally draining. This can be true for those of you who are in relationships or who are single. It can feel like a draining and isolating problem but I promise you that you’re not alone. And if you’ve already tried the steps that I listed in the beginning of this post without much relief, don’t worry, there are still other ways to address this issue.
But my pelvic floor muscles are still tight....
There are some people who experience tightness in the pelvic floor muscles that gets better after pelvic floor physical therapy or using dilators or using a pelvic wand and they are able to return to sex pain free. Then there are some people that do all of the above and the tightness in the pelvic floor does decrease, but they still can’t have sex without pain. And last, there are people out there who despite trying all these methods, still have a tight pelvic floor. Why is this happening?
While there could be another anatomical reason for this, hopefully you’ve been to a good physical therapist who has looked at your entire body because issues relating to your hips, lower back, and/or muscle imbalances could be a culprit. But another likely culprit is the mind body connection, so how the mind thinks about the pelvic floor and sex.
Why is it that you’ve tried all these methods but the pelvic floor is still tight? Is it that you’re holding emotional and mental tension in the pelvic floor? We all hold our tension somewhere in the physical body, while some people may hold tension in their neck and upper traps, others may hold it in the pelvic floor. If this is the case for you, teaching the pelvic floor muscles to relax can be helpful but it’s also helpful to identify ways to reduce stress so that you don’t go into this holding pattern.
Another thing that can happen is that your pelvic floor muscles are fine throughout your day, but then they tighten up right before penetrative sex. They remember that sex has hurt them in the past and they are trying to “protect” you by tightening up. This is common in those dealing with pain during sex particularly those with vaginismus. So it could be that it’s more of a response of your “mind” tightening up these muscles as opposed to the muscles actually being in a tightened state.
In either case, we need to break up this pattern. How do we do this? By looking at more than the muscles themselves.
Looking at more than the muscles
We are more than just our physical body so when working on healing, we have to look at more than just the physical body. Like we’ve been talking about throughout this post, this is especially true when you’re having pain with sex. This is even more true when you are the point where you feel like you’ve tried everything but sex still hurts.
Your mind could be playing a role in that it’s telling your pelvic floor to tighten up because it’s perceiving sex as a threat.
Your emotions could be playing a role by maybe associating sex with more negative emotions, which is understandable as you have been having pain with sex, but these negative emotions are not helping to allow sex to be pain-free.
Your energy could be playing a role because blocked energy can lead to physical dysfunctions in the body. If energy is blocked in the pelvic area, your energy won’t be open to sex and could cause issues like pelvic pain when trying to engage in intercourse.
This is why it’s so important to approach this issue holistically. Holistic healing means that you take into consideration your entire being when working on healing meaning the physical body, the mind, and the soul (or our energy). As I just said, we are more than just the physical body so we should always be looking at more than just the physical body.
So how do you apply this to pain with sex?
Even though the mind, body, and soul are all connected and work together, we’re going to break this down into the 3 parts to make this easy and to help you understand. So we’ll look at how to work on the physical body, how to work on the mind, and how to work on your energy in relation to when you’re having pain with sex. But just remember that everyone is different and that these are just general guidelines.
The physical body
In terms of the body, it’s still important to work on the physical body when having pain with sex. We want to keep the body in balance; basically we want a balance of flexibility, mobility, and strength. If the pelvic floor muscles are excessively tight, it is possible that they are making up for another area that is weak. For example, if certain hip muscles or the deep abdominal muscles are weak, the pelvic floor may become excessively tight to make up for this. This is just an example though, there isn’t one specific muscle that is always weak when the pelvic floor is tight, it’s just something to think about when working on the physical body.
I also find that it’s still beneficial to work with movements that stretch and relax the pelvic floor muscles because in these types of positions, you’re teaching the pelvic floor to relax. I’ve made a free guide on the best yoga poses to relax the pelvic floor when you have pain with intercourse which you can download right below. ↓↓
When engaging in intercourse, take it slow. Think of it like warming up before you workout so that your muscles are ready to exercise. The pelvic floor muscles need a little warm-up before jumping into sex, so don’t skip the foreplay. And remember to still use added lubrication. Lube is your friend and this is true for all women, not just those with pain, so don’t be afraid to use lube. Below are my two favorite lubricants, one is silicone based and one is water based.
My last suggestion in terms of the physical body is to think about the position you’re in when engaging in intercourse. Try different positions and find what works best for you. While some females may feel less pain when they are on top because then they are the ones in control, others may find being on the bottom better so that they can be more relaxed. There are many sex positions you can try, so don’t be afraid to explore to find what works best for you.
We need to break the cycle of perceiving sex as something that hurts you. Yes it has caused pain in the past, but it doesn’t always have to be this way. You can get to a place where you actually enjoy sex and keeping your mind open to this possibility is really the first step in healing.
You deserve to enjoy pleasure. Our bodies were made to experience sexual pleasure so allow your mind to be open to the idea that you deserve to be able to enjoy this aspect of your human experience.
If you’re in a committed relationship, approach sex as a time to connect with your partner. Focusing on this connection instead of the end goal of orgasm can be really helpful as well.
Some work that you can do out of the bedroom includes anything that’s going to work to down-regulate the nervous system and help you to feel more calm overall. So things like working with affirmations, meditating, or practicing calming breathwork are all ways to help calm the nervous system. Basically with these types of activities, you’re teaching the body and mind that you are safe. And the more you practice creating this space of safety and calmness in your everyday life, the easier it will be to carry this over to when you’re in a sexual space.
Remember earlier in this post when we were discussing the energy center that relates to your emotions and the pelvic region? This is called the sacral chakra. Working on the energy of the sacral chakra to bring it to a place of balance can be really helpful in healing from pelvic pain with sex.
There are many ways to work with this energy center but I think the easiest way to look at it is to look at the element it’s associated with. Each energy center is associated with an element. The sacral chakra is associated with the element of water. Water is all about flow so working to be able to start to let go and be a little more “go with the flow” can help you to work on this energy center.
Although this energy center is related to our sexuality, it’s also related to our creativity. So another way to work on this energy center is to tap into your own personal creativity. And creativity doesn’t have to be related to only art forms. For example, I tap into my own personal creativity through writing this blog and through gardening.
For a more movement based way to work on this energy center, you can work on hip opening. This makes sense as certain muscles around the hips are also pretty commonly tight when the pelvic muscles are tight.
It’s important to work on other energy areas of the body as well as it’s all about energy flow, but that would get very detailed and I want to give you guys tips that are easy and actionable. You can learn more about the other energy centers in our body here: What are the chakras?
As you can see in this post, even when you feel like you’ve tried everything but sex still hurts, there are other healing avenues you can explore. The reason you may have not found the healing you have been looking for is because you need to take a healing approach that works on your entire being.
Yoga is a wonderful practice that works on all of the areas we discussed in this post. I’m currently accepting new clients for private sessions where I teach you how to use yoga to holistically heal from pain with sex. If you’re interested in learning more about how yoga can help you specifically, feel free to book an intro session with me: Book Intro Session
Keep your mind open to the fact that you can heal and make the changes you want to make.