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Your pelvic floor muscles are directly involved in every aspect of sexual function: arousal, sensation, orgasm, and comfort during penetration. When these muscles are not working properly, the effects on your intimacy can be significant.
Pelvic floor dysfunction can show up as pain during penetration, difficulty reaching orgasm or decreased sensation, a feeling of tightness or a wall blocking entry, burning or stinging after intercourse, inability to relax enough for comfortable sex, and loss of interest in sex due to anticipation of pain.
Many women do not realize that their pelvic floor is the source of these problems. They may attribute the issues to their relationship, their hormones, their age, or their mindset. But in most cases, the pelvic floor muscles are a major contributing factor, and addressing them can be transformative.
Pelvic floor dysfunction means the muscles of your pelvic floor are not coordinating properly. They may be too tight (hypertonic), too weak (hypotonic), or uncoordinated (unable to contract and relax at the right times).
For sexual pain, the most common pattern is hypertonic or overactive pelvic floor muscles. These muscles are chronically tense, often without you being aware of it. Think of it like clenching your jaw all day without realizing it, except it is your pelvic floor.
Common contributors to pelvic floor dysfunction include chronic stress and anxiety, high-intensity exercise, prolonged sitting, a history of urinary tract infections, hormonal changes, past pelvic surgery or childbirth, and emotional or sexual trauma.
Many women feel anxious about seeking pelvic floor help, especially when the issue involves intimacy. Virtual removes that barrier. You are in your own space, fully clothed, working with a specialist who creates a warm, judgment-free environment. No commute, no waiting room, no clinic gown and access to specialized care regardless of where you live.
This is for you if sex has always been uncomfortable and you do not know why. If sex used to be fine but now it hurts. If you experience pelvic pain, pressure, or tightness beyond just during sex. If you have been told to do Kegels but they made things worse. If you have been diagnosed with pelvic floor dysfunction and want specialized help. Or if you are ready to stop guessing and start working with someone who does this every day.
At Hope For Your Pelvis, I take a whole-person approach to pelvic floor dysfunction and intimacy. Most approaches start with exercises and stretches. But if your body is in a state of protection — guarding against pain it has learned to expect — no amount of strengthening or stretching will override that. I start with your nervous system. When your brain learns it is safe, your muscles learn to let go.
Sessions focus:
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You have tried figuring this out on your own. You have Googled, you have done the exercises, you may have seen providers who did not specialize in this. If nothing has worked, it is not because your body cannot change, it’s because you have not had the right guidance.
Sex can hurt for several reasons, and the cause is usually physical, not in your head. The most common is tension in the pelvic floor muscles, which can make penetration feel tight, burning, or like hitting a wall. Other causes include hormonal changes that dry and thin the tissue, nerve sensitivity like vulvodynia, or scar tissue from childbirth or surgery. Because the causes overlap, identifying which one is yours is the first step toward treating it.
Painful sex is common, but common is not the same as normal or something you have to accept. Studies estimate it affects a significant share of women at some point, often underreported because it is rarely discussed. Occasional discomfort from dryness or a position is usually minor. But pain that keeps happening, or that makes you avoid intimacy, is a signal worth having assessed. It is treatable.
Common signs include pain at the vaginal opening during penetration, difficulty relaxing for insertion, pain that improves with certain positions but not others, and a history of pelvic tension or pain. A pelvic floor assessment can confirm whether your muscles are contributing.
Not always. If your pelvic floor muscles are already too tight, which is the case for most women with sexual pain, kegels can actually make things worse. Release and lengthening are usually more appropriate than strengthening.
Yes, for many women. Pelvic floor therapy is well supported for painful sex driven by muscle tension and guarding, and it is recommended by the American College of Obstetricians and Gynecologists as a treatment for pain associated with pelvic floor dysfunction. Because painful sex has several possible causes, the first step is identifying which one is yours, and some causes are addressed alongside medical care.
Yes. I work with women across the country through secure virtual sessions, so where you live is not a barrier. If you are not sure whether my services are the right fit for your situation, book a consultation and we will figure it out together.
No. I do not accept or bill insurance. This allows me to give you my full, undivided attention in every session, no visit limits, no rushed appointments, and no outside entity shaping your care.
Painful sex is more common than many realize. Learn the causes, treatment options, and how pelvic floor therapy can help restore comfort and function.
A pelvic floor therapist explains the real reasons sex can be painful and what your body may be trying to tell you.
