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Sex And Your Pelvic Floor

The pelvic floor plays a big part in maintaining our core strength, but did you know that a healthy pelvic floor is also important when it comes to sex?
Visit the pelvic floor health center for tips, exercises and a 6-week guide to better pelvic floor health!

Being able to contract and relax the pelvic floor helps make for pain-free vaginal penetration, optimizes the blood flow during sex to promote orgasm, and also helps to increase vaginal lubrication.

Unfortunately, many women experience a number of pelvic-floor-related problems during sex, and these can lead to a lack of interest in the activity altogether. Recognizing these problems and knowing how to address them can help you maintain a happier, healthier sex life. Read below for more information on the types of pelvic floor issues that can interfere with sex, and what you can do about them.

Problems That Can Occur During Sex


Many women experience pain with vaginal penetration, and this can lead to an unpleasant sexual experience. The pain may feel like a ripping, tearing, or burning sensation. This is common, affecting 20-50% of all women, and it occurs when muscles don’t relax completely, or if they contract when they should relax. Overactive muscles are painful to touch, and when muscles are already tightened, having an orgasm can be incredibly painful.  This may prevent a  woman from having sex altogether. Pain during sex is common in post-natal and peri-menopausal women because these are both times in a woman’s life where there is a decrease in estrogen (resulting in decreased blood flow to the vagina and decreased vaginal lubrication). It often leads to decreased libido and desire.

What to do: 

  • A physical therapist can help relax a tense pelvic floor and provide a treatment plan for patients who experience this often.

  • Pelvic floor relaxation exercises can be done at home.

  • Use lubrication to make penetration easier and more comfortable.

  • Hormone replacement therapy (as needed) If there is a hormonal imbalance, especially a decrease in estrogen, muscles can become more tense, there is decreased blood flow that impacts lubrication and contributes to pain with intercourse and ability to orgasm. Incorporating hormone replacement therapy may help.

Bladder Leakage

Some women experience bladder leakage during intercourse or with orgasm due to increased urgency, instability of the urethra, or poor muscle coordination. This can have a big impact on a woman’s sexual arousal, since she may be constantly worried about leaking during the act. Additionally,  many women who experience incontinence have a concern about hygiene and  vaginal odor, making them feel “unsexy.”

What to do: 

  • Retrain your bladder/bowel

  • Eliminate bladder irritants from your diet

  • Use the bathroom prior to having sex

  • Strengthen your pelvic floor muscles

  • Experiment with different sexual positions  to find one or more that work best for you

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when one or more of the pelvic organs (the uterus, bladder, or rectum) falls into the vagina. This is often caused by trauma or pressure placed on the pelvic floor, and it can occur due to things like childbirth or chronic constipation. Symptoms of prolapse include:

  • A bulging feeling or heaviness in the vagina

  • Feeling like the pelvic floor muscles are ‘tired’ all the time

  • Urinary incontinence

  • Actually seeing tissue coming out of your vagina

Women with prolapse can sometimes develop discomfort during sex, and they may have a poor body image because of their condition, and that can contribute to a  decrease in sexual drive.

What to do: 

  • See a physical therapist for a consultation on proper pelvic floor relaxation and strengthening exercise.

  • Experiment with different positions to learn what feels the most comfortable.

    Good positions for bladder or uterine prolapse:

    • Woman is lying flat on her stomach or in supported kneeling with partner entering vagina from behind

    • Woman is lying on her back with a pillow under her pelvis with her partner on top

    Good positions for rectal prolapse

    • Woman is lying on her back with her partner on top

    • Avoid partner entering vagina from behind

  • Use lubrication to make sex more enjoyable


If you experience any of these symptoms, why suffer with them? Help is available! Pain or bladder leakage during sex is not normal and should never be something that you ignore. Talk with your partner about what you’re experiencing, then talk with your doctor or see a physical therapist trained in women’s health for a complete evaluation of your pelvic floor. They will be able to address any issues you might be having and put you on a plan to help you make sex more enjoyable again. After all, you deserve it.

Have you checked out our new Pelvic Floor Health Center? It’s a great resource for those looking to improve their pelvic floor strength, or naturally take steps toward eliminating bladder leaks. Click here to check it out, and sign up for our FREE 6-Week Guided Program to Better Pelvic Floor Health!

Note: If you are experiencing any of the symptoms listed above, NAFC strongly advises that you get an examination from a  physician or trained physical therapist prior to performing any exercises related to the pelvic floor. Contracting pelvic floor muscles that are already too tight or tense may make your condition worse. A physician or physical therapist can provide a complete evaluation of your condition and help you formulate a workout plan that will address your specific needs.  


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