For most people, sex is an enjoyable and even necessary component of romantic intimacy and connection. Unfortunately, for many people, sex can also be painful—sometimes prohibitively so. Especially if a woman has chronic pelvic pain, pelvic organ prolapse, endometriosis, or another pelvic floor dysfunction, she may feel like she needs to avoid sex because it is too painful.
Pelvic pain during sex is caused by a vareity of conditions. Women who experience painful sex (also called dyspareunia) should seek medical treatment, along with exploring a vareity of sex positions and sex acts which can allow them to remain sexually active. All women deserve to have a rewarding sex life.
Here’s how to move past your pelvic pain and into good sex.
Sex Doesn’t Have to Be Penetrative!
Repeat: sex doesn’t have to be penetrative! There are myriad reasons why our culture thinks strictly ‘penis in vagina’ when we think of sex—but this certainly doesn’t have to be the case. Oral sex, clitoral touching, and mutual masturbation can all be as much fun—or more so!–than penetration. Taking the focus off penetration and even orgasm can take the pressure off sex and eliminate pain, while staying just as enjoyable.
In fact, women who are experiencing deep sexual pain due to pelvic floor dysfunction and tight muscles should be counselled to avoid penetrative sex until their muscles are rehabilitated. 1
Meanwhile, if penetrative sex is painful due to tight pelvic floor muscles (as is the case with conditions like vaginismus), then working with a pelvic floor physical therapist can help you learn how to relex these muscles. This can be a critical first step towards penetrative sex.
Sex Positions To Reduce Pelvic Pain
For women who still want to engage in penetrative intercourse despite pelvic pain, it’s first important to note that there is no one sex position that is going to work for everyone (although reducing the depth of penetration in general is often helpful). Finding what works for you will require some trial-and-error, so try to have fun in the process! Adjusting positions, using good lubrication, and sex toys can all help.
When the woman is on top, she can control the depth, degree, and speed of penetration. This is true whether you’re facing your partner, or facing their feet (often called the ‘reverse cowgirl’). See if one of these works for you and your partner.
Many couples also enjoy spooning sex, where you’re both lying side by side, or using pillows to prop up either partner to create better angles. You might even find that sitting in a chair or standing up (as long as you’ve got something to lean on!) can all help.
The idea, ultimately, is to get out of the traditional missionary mindset. Treat it like a game, take your time, and be gentle with yourselves, and you’re sure to find something that works for you.
When To See A Doctor About Painful Sex
There’s a short answer to this question: you should always speak to a doctor if you are experiencing painful sex. This is because painful sex can often be the cause of an underlying condition, which can or should be treated. You can start by a visit to your medical practitioner or gynaecologist, or use our Physician Finder to connect with a doctor in your area who specializes in pelvic conditions.
Once you’ve ruled out and/or treated any underlying conditions, yoy can move on to the fun stuff—trying to find a sex position and approach to sex that works for you and your partner. Good luck, and have fun!