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.
Best Sex Position for Fibroids
For women with uterine fibroids, deep penetration might cause discomfort. Here are some positions to consider:
- Woman on Top: Allows the woman to control the depth, angle, and rhythm of penetration, providing the freedom to find a comfortable depth and pace.
Best Sex Positions for Vaginismus
Vaginismus is characterized by involuntary muscle spasms in the pelvic floor muscles, which can make penetrative sex challenging:
- Spooning: Both partners lie on their side, with the man behind the woman. This position allows for shallow penetration and can be more comforting for those with vaginismus.
- Side-by-Side, Facing Each Other: This position offers an intimate setting with the potential for shallow penetration.
Best Sex Positions for General Pelvic Pain
Though there’s no universal position guaranteeing comfort, a few general guidelines can be beneficial:
- Controlled Penetration: Positions where the woman is on top, be it facing the partner or their feet (like the ‘reverse cowgirl’), can be advantageous.
- Alternative Approaches: Spooning, utilizing pillows for better angles, or even standing positions (with adequate support) can sometimes alleviate discomfort.
Breaking away from the conventional missionary position and approaching intimacy with an open mind and experimentation can make all the difference.
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!