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Pelvic Floor Physiotherapy for Sexual Health

Sexual dysfunction is a common issue that can impact intimacy, self-esteem, and quality of life. Many sexual dysfunctions have underlying causes related to pelvic floor health, where the muscles, nerves, and connective tissues in the pelvic area may be too tight, too weak, or lacking coordination. Addressing pelvic floor dysfunction can play a significant role in improving sexual health, comfort, and pleasure.

Understanding Sexual Dysfunction and the Pelvic Floor

Types of Sexual Dysfunctions Linked to the Pelvic Floor

  1. Dyspareunia (Painful Intercourse): Pelvic pain during or after intercourse, often caused by tight or hypertonic pelvic floor muscles, nerve sensitivity, or conditions like endometriosis or vaginismus.

  2. Vaginismus: Vaginismus is an uncontrolled spasm of the pelvic floor muscles at the entrance to the vagina, preventing penetration. It can make even gynecological exams or tampon insertion difficult or impossible. It can feel as though there is a complete ‘blockage’ and attempting to get beyond this can produce feelings of extreme anxiety.

  3. Erectile Dysfunction (ED): In men, weak pelvic floor muscles can contribute to erectile dysfunction. Strengthening these muscles can support blood flow and improve erectile function and control.

  4. Pain With Anal Intercourse: Tight musculature, hyper-sensitive tissues and hyperreflexia can all lead to painful anal intercourse.

  5. Hormonal Changes: changes in hormones such as in pregnancy, postpartum, menopause and hormone/cancer therapies can cause changes that can affect tissue elasticity and lubrication making intercourse painful. 

  6. Low Libido, Arousal Difficulties, Anorgasmia: Pelvic floor dysfunction can cause discomfort or pain during sexual activity, leading to reduced interest or arousal due to fear of pain or discomfort.

How Pelvic Floor Physiotherapy Can Help with Sexual Dysfunction

Pelvic physiotherapy is always carried out in a private treatment room, always with the same physiotherapist, providing sensitive, professional treatment. It starts with a thorough conversation about your concerns and experiences. Detailed questions will ask about your pain, effects on your lifestyle, your medical history, questions about your bladder, bowels, diet and menstrual cycle.

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Your pelvic health physiotherapist understands that seeking treatment can cause significant anxiety, and will explain that a physical assessment will only move at a pace that you feel comfortable with: this may not be on the first visit. It may be more appropriate to start treatment with a focus on breathing, body scanning and ‘safe touch’ before moving to an internal exam.

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We will work at a pace that makes you feel safe, and will discuss treatment options and ask for your consent before implementing any new treatment techniques.

Treatment Approaches for Sexual Dysfunction

  1. Pelvic Floor Muscle Exercises (PFME): Specific exercises are designed to strengthen or relax the pelvic floor muscles, depending on your needs. These exercises can improve muscle tone, control, and sensation, leading to more comfortable and pleasurable sexual experiences.

  2. Manual Therapy and Trigger Point Release: Hands-on techniques can help release tension, address painful trigger points, and increase blood flow to the pelvic area, reducing pain and improving mobility.

  3. Pain Desensitization Techniques: For those experiencing hypersensitivity or pain, gradual exposure and desensitization techniques can help reduce pain, making intimacy more comfortable and enjoyable.

  4. Biofeedback Training: Biofeedback tools can help you learn to engage and relax your pelvic muscles correctly. This process can increase awareness, helping you regain control and ease in these muscles.

  5. Breathing and Relaxation Techniques: Deep breathing and relaxation exercises encourage blood flow, reduce anxiety, and alleviate muscle tightness, which is especially helpful for conditions like vaginismus and dyspareunia.

  6. Education and Behavioral Coaching: We offer education on posture, movement, and intimate care to address habits or behaviors that may exacerbate pain or discomfort. Understanding these factors can improve confidence and promote a healthy relationship with your body.

Benefits of Pelvic Floor Physiotherapy for Sexual Health

  1. Pain Reduction: Physiotherapy techniques can relieve pain, making sexual activities more comfortable and enjoyable.

  2. Improved Muscle Control: Increased muscle tone and control support sexual function, enhancing pleasure and sensation.

  3. Enhanced Confidence: Reconnecting with your body and learning ways to manage or eliminate discomfort can restore confidence and emotional well-being.

  4. Better Intimacy: Physical comfort allows for greater emotional intimacy, reducing stress and improving communication with partners.

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