Intimacy and Sex
Common symptoms include pain with penetration or intercourse, difficulty relaxing the pelvic floor muscles, vaginismus, vulvar or genital pain, reduced sensation, and discomfort during or after sex.

Pain with intimacy or penetration is common and treatable. Pelvic floor physiotherapy takes a whole-person (biopsychosocial) approach, recognising that painful sex can be influenced by pelvic floor muscle tension, sensitivity of the nervous system, past pain experiences, stress, fear, or trauma.

Treatment may include gentle pelvic floor muscle therapy, relaxation and breathing strategies, pain education, and graded support to help the body feel safe with penetration again.

By addressing both the physical and nervous system contributors to pain, pelvic floor physiotherapy can help reduce discomfort with intimacy, improve confidence, and support a return to comfortable, enjoyable sexual experiences.

Common Symptoms with Intimacy or Sex

Vulva

Stinging, burning or itching of the vulva in the absence of a skin pathology unprovoked (unprovoked vulvodynia)
Stinging, burning of the vulva when touched (prokved vulvodynia)
A history of recurrent thrush leading to increased sensitivity of the vulva
Stinging burning of the vulva and perineal body (vestibulodynia)

Vagina

Stinging, burning, sharp pain at the entrance of the vagina with touch from finger/tampon/penis/vibrator (superficial dyspareunia)
Deep burning/sharp pain in the vagina with penetration from finger/tampon/penis/ultrasound probe (deep dyspareunia)
A fear of sex due to pain, actively avoiding it (vaginismus)
Residual aching pain in the vagina following touch or penetration

Erection Pain

Difficulty in achieving or maintaining an erection due to fatigue or pain.
Pain during an erection in the perineum.
Pain with ejaculation in the penis/perineum (area between scrotom and anus) or low back.

Pelvic Floor Muscle Dysfunction

Involuntary contraction of pelvic floor muscle, deep pain
Intermittent spasm of pelvic floor muscle when inserting a tampon
Hard to relax pelvic floor muscle
Unable to maintain a pelvic floor muscle contraction

Pelvic floor muscle dysfunction