Let’s Talk About Sex, Baby
Pain with vaginal penetration, also known as dyspareunia, is an under-diagnosed condition that affects roughly one in four people in a lifetime. There are many contributing factors, some of which include:
- Overactivity of the pelvic floor
- Increased sensitivity of the nervous system
- Poor lubrication
- Postpartum trauma
For those experiencing dyspareunia, pelvic floor physiotherapy is a highly effective way to treat both pain and the underlying cause. This is achieved through a combination of approaches which can include:
- graded strength training
- down-regulating the pelvic floor
- targeted stretches
- relaxation techniques
- engaging other aspects of the inner core aka your abdominals, back muscles, and diaphragm
While you’re waiting for a pelvic floor assessment, here is some food for thought to assist you in the meantime.
Consider your bias, what does sex mean to you? Our understanding of sex is heavily influenced by:
- Our culture
- Our personal beliefs
- Our experiences
- Our partner(s) past and present
As you may be aware, countless societal, religious, and personal pressures have created a “gold-standard” for sex – often considered penis/vagina penetration. For my baseball fans out there, this is what society calls a “homerun”. In reality, however, sex takes on countless meanings because we have several erogenous zones. There are a multitude of options when it comes to intimacy, and pain with vaginal penetration needn’t limit you from having a fulfilling sex-life. If you need help getting started, here are some intimacy ideas that do not require vaginal penetration:
- Mind-Games
- Going on a date
- Eating aphrodisiacs (chocolate, oysters, chili peppers, strawberries etc)
- Sharing your fantasies
- Reading erotic fiction (together or alone)
- Watching erotic movies (together or alone)
- Non-Genital Touching
- Kissing
- Massage (with oil)
- Mindful Touch i.e. cuddling, hand holding, exploring one another’s bodies
- Genital Focussed
- Masturbation (together or alone)
- Vulva/clitoral stimulation
- G-spot, A-spot, P-spot
- Oral Sex
- Sex Toys
There may also be times when you don’t really feel like having sex, and that’s okay too! Many people feel they suffer from something called a “low libido”, and that they’ll never reach a consistent desire to have sex. The key phrase here is desire to have sex, as this is the definition of libido. Fortunately desire is fluid, and so is your libido, which means things are bound to change based on your internal and external environment. Just because someone has a low desire to have sex right now does not mean they’re cursed with a “low libido” and will feel this way forever. Rather, this person may be experiencing more barriers to arousal right now. The same statement goes for those with a “high libido”, as they are less likely to experience barriers to arousal and consequently appear to have a higher sex drive.
Here’s a metaphor to drive this point home – pun very much intended. Let’s imagine driving a car is your libido, and in this car you have brakes and accelerants. Life stressors and anything that activates your Fight or Flight are your brakes; and things that relax and activate Rest and Digest are your accelerators. It’s very difficult to drive your car down the road if you keep hitting your brakes, and the same goes for your sex drive. Therefore, the issue isn’t your libido, rather, it’s how many brakes you’re currently experiencing.
I encourage you to write down your accelerators and brakes on a piece of paper, and if you feel comfortable, consider reviewing them with your partner. Knowing your turn ons and offs is very important when it comes to a fulfilling and healthy sex-life, and you never know, some things you write down may even surprise you!
I hope you found the information in this blog helpful, and I encourage you to try the activities outlined as a great first step! To properly assess and treat what’s going on, please consider consulting a certified pelvic floor physiotherapist or a sexual health counselor if you suffer from dyspareunia.
By: Nicole Kirby, Physiotherapist, Pelvic Physiotherapist
References:
Pelvic Health Solutions, Dyspareunia (2019)
Sex and Pain Postpartum for Physiotherapists, Tynan Rhea (2019)
Tayyeb M, Gupta V. Dyspareunia. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.