Sexual Health & Pelvic Floor Physical Therapy

Sexual health is an important part of your overall health and quality of life. Pain, pelvic floor dysfunction, hormonal changes, pregnancy, childbirth, surgery, and other conditions can affect comfort and sexual function.

At Core Pelvic Health & Wellness, I provide compassionate, confidential, and individualized pelvic health physical therapy to help you better understand the factors contributing to your symptoms and work toward more comfortable and confident sexual health.

You don't have to live with pain

Pain with sexual activity is common—but that doesn't mean you have to accept it.

Pain during or after sexual activity can have many contributing factors. Pelvic floor muscles may become tense or overactive, scars may restrict movement, or changes in the hips, pelvis, abdomen, or spine may contribute to discomfort.

Hormonal changes, pregnancy, childbirth, endometriosis, pelvic surgery, and other medical conditions can also influence sexual comfort.

Understanding why you're experiencing pain is an important first step toward finding an appropriate treatment approach.

What sexual health concerns can pelvic PT help with?

You may benefit from an evaluation if you experience:

  • Pain with penetration

  • Pain with intercourse

  • Pain after intercourse

  • Pain with attempted penetration

  • Difficulty with vaginal penetration

  • Pelvic floor muscle tightness

  • Pelvic pain during sexual activity

  • Pain with ejaculation

  • Pain following ejaculation

  • Pelvic pain associated with orgasm

  • Vaginal or perineal pain

  • Vulvar pain

  • Pelvic floor muscle dysfunction

  • Difficulty relaxing the pelvic floor

  • Sexual symptoms following childbirth

  • Sexual pain associated with endometriosis

  • Sexual discomfort following pelvic surgery

  • Sexual symptoms associated with menopause or hormonal changes

For men, you can also link to your Men's Pelvic Health page.

Why can sex hurt?

There isn't always one reason.

Sexual pain can have multiple contributing factors. Sometimes the pelvic floor muscles become tense or overactive in response to pain, stress, injury, surgery, childbirth, or other conditions.

Other factors may include scar tissue, hip or pelvic dysfunction, changes in mobility, breathing patterns, hormonal changes, or nervous system sensitivity.

Common contributors may include:

  • Pelvic floor muscle tension

  • Pelvic floor muscle weakness or poor coordination

  • Scar tissue

  • Childbirth

  • Endometriosis

  • Vulvodynia

  • Pelvic pain

  • Menopause

  • Pelvic surgery

  • Cesarean birth

  • Perineal injury

  • Hip or low-back dysfunction

  • Breathing and pressure-management patterns

Your symptoms are real, and you deserve to have them evaluated without judgment.

Pelvic floor muscles & sexual function

Your pelvic floor plays an important role in sexual health.

The pelvic floor muscles are involved in sexual function, sensation, arousal, orgasm, and control of pressure within the pelvis.

These muscles need to be able to contract, relax, lengthen, and coordinate appropriately. For some people, the problem is weakness; for others, the muscles may be too tense or have difficulty relaxing.

Postpartum sexual health

Your body may feel different after having a baby.

Pregnancy and childbirth can affect pelvic floor muscles, connective tissues, scars, hormones, and the way you move. These changes can sometimes contribute to pain or discomfort with sexual activity.

If sex has become painful after childbirth, you don't have to simply wait and hope it gets better.

Treatment may address:

  • Pelvic floor muscle tension

  • Scar tissue

  • Perineal discomfort

  • C-section scars

  • Breathing

  • Pelvic mobility

  • Hip and core function

  • Gradual return to comfortable sexual activity

Learn more about Postpartum Recovery

Endometriosis & sexual pain

Endometriosis can affect sexual health.

Endometriosis may contribute to pelvic pain and pain with sexual activity. In addition, persistent pain can cause protective pelvic floor muscle tension, which may further contribute to discomfort.

Pelvic health physical therapy can address musculoskeletal and pelvic floor factors that may be contributing to your symptoms while working alongside your medical care.

Learn more about Endometriosis

Menopause & sexual health

Sexual health changes during menopause are common—but help is available.

Hormonal changes during perimenopause and menopause can affect vaginal and pelvic tissues and may contribute to changes in sexual comfort. Pelvic floor muscle tension, weakness, or changes in mobility may also contribute to symptoms.

Pelvic health physical therapy may be part of a comprehensive approach to managing these changes.

Men's sexual health

Men's sexual health matters, too.

Pelvic floor dysfunction can sometimes contribute to sexual symptoms in men, including pelvic pain, pain with ejaculation, and certain musculoskeletal contributors to erectile dysfunction.

Treatment may include pelvic floor coordination and relaxation, hip and pelvic mobility, breathing, core function, and other musculoskeletal strategies.

Learn more about Men's Pelvic Health

What can treatment include?

Your treatment may include:

  • Pelvic floor relaxation

  • Pelvic floor strengthening when appropriate

  • Breathing techniques

  • Manual therapy

  • Scar mobilization

  • Abdominal and pelvic mobility

  • Hip and spine mobility

  • Core rehabilitation

  • Movement retraining

  • Education about pelvic floor function

  • Gradual desensitization strategies when appropriate

  • Home exercises

  • Strategies for comfortable movement and sexual activity

Treatment is never one-size-fits-all. The goal is to understand what is contributing to your symptoms and determine which approaches are appropriate for you.

What happens during your evaluation?

We start with a conversation.

I'll ask about your symptoms, medical history, previous surgeries or childbirth experiences, activity level, and goals. You can share as much or as little detail as you're comfortable with.

We evaluate contributing factors.

Depending on your symptoms, I may assess:

  • Pelvic floor function

  • Breathing

  • Abdomen

  • Hips

  • Spine

  • Pelvic mobility

  • Strength

  • Posture

  • Movement patterns

  • Scar tissue

Internal examination

Will I need an internal pelvic floor examination?

Not necessarily. An internal examination is not automatically required.

Depending on your symptoms and goals, an external assessment may provide valuable information. If an internal examination is recommended, I will explain why it may be helpful and discuss it with you beforehand.

You are always in control of your care, and your consent is required before any internal examination or treatment.