When Sex is Painful

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Thank you. Thank you for having us.

Thanks for being here. Yes.

This is actually Becky's second time.

That's right.

Yes.

She's an alum.

She's an alum. Cori's first time. That's right. That's right. Well, actually, before we started recording, I was just telling Becky, I said, becky, we have received so many good things, good feedback from you guys listening about her episode. And I want to say it was Expectations two.

Yes.

Okay, good.

Yay.

And so if you have not listened to that, please go back and listen. But on it, she talks all about the pelvic floor and some of the different issues that couples can have with sex.

But.

And today, we're going to actually dive a lot deeper. And so we're really excited to get more specific with, you know, the kind of help that couples can seek, but also things they can do. And so I'm so excited to have this conversation.

A lot of you guys write us. I'm so thankful you do, because this podcast, we want to be a safe place to just have conversations that are gonna help you in your marriage and your sex life and maybe topics that might feel awkward or intimate, but it doesn't have to be, because these are things that. That there are solutions for.

Right.

And specifically, we're gonna talk about when sex is painful, when it's uncomfortable. It doesn't have to be. It's not supposed to be. And there are almost always solutions. When you're experiencing discomfort with sex, you don't have to just live with it. There are solutions. And we've got two experts here today. I told y' all about them during the intro. Becky and Corey, or they're going to share with us. And so, ladies, just kind of start out with question number one. Is painless sex normal?

Great question. That's one of our faves. The Short answer is no. It's never normal to have pain. Painful sex, any sort of pain in general. So why would it be normal to have pain in your pelvis during intercourse? It can be common, so it can happen semi frequently, especially after things like birth. Whether it was cesarean section or vaginal birth or early on in a sexual relationship, early on in your marriage, it can just. It cannot meet your expectations of what you thought it might be. Right. But no, it's. It's never normal to have pain.

Right. So what do we do then? Like, I mean, because a lot of folks write us and they say, like, I'm embarrassed by this. I feel like something's wrong with me. But sex hurts. And I'm just trying to, like, get through it. And I don't know. I don't know what to do. Like, I don't know why it hurts, but. But it hurts. And so what. What are the first steps for somebody that's listening and they're like, oh, man, I didn't. I've never even voiced this, maybe. I mean, I'm listening to this podcast right now because I saw the title and I'm like, that's describing me. So for those folks listening, and we're so glad you're listening and watching, by the way, what are those first steps that they can do?

Yeah, I think the first step is always realizing when. That you're having pain, because a lot of people kind of even try to, like, glaze over, that they're like, it doesn't really, like, hurt her. It's just, like, uncomfortable. They're trying to normalize it. It's never normal. So it should never burn, it should never sting. You shouldn't be sore, like, during or after intercourse. And you shouldn't have pain in your pelvis or other places either. So your abdomen, low, back pain, other places like that can be common as well. Right. And then there's some pretty easy things you can change off the bat. And then really, the best advice we can give is just get an assessment from a professional. So a pelvic health pt, we're specially trained in this, and we love working alongside other providers too, like mental health resources, birth providers, OB GYNs, things like that, to kind of get to the root cause of anything that could be causing your pain. Right. So some of the easiest things are things like relaxing and breathing. So a lot of people are very tense while they're trying to have intercourse without even realizing it. So that's why the first thing we start every treatment session with is Assessing their breathing and their whole body, how it's moving, how you're relaxed, which sounds.

Silly because you're like, breathing, it's going to maybe help painful sex. And honestly, if you're breathing correctly with your diaphragm muscle, your pelvic floor and your diaphragm muscle, they work as a unit. And so when your diaphragm muscle is being used adequately, your pelvic floor muscles, which are the muscles at the bottom of your pelvis, they're being used during intercourse, they actually get to relax. Whereas if you're not breathing with your diaphragm, if you're not breathing with your diaphragm, they're just clenching, they're just stiff.

Right.

That's not a happy group of muscles if they're stiff. So we always start with breathing. And so that's one easy thing. Are you breathing with your diaphragm? Is your belly ribcage expanding when you inhale easily? Is it kind of just returning back when you exhale? You can just kind of put your hands on your belly and just assess that. You can just lay there and just assess that.

Yeah.

You know, Corey, I'd love to talk more about mental health. You talked about how you work kind of in partnership with other doctors, other providers. And I love how you mentioned mental health, because when I'm hearing you, Becky, talk about the tensing of the. The pelvic muscles and, and having trouble breathing, it reminds me of when I went through a time with anxiety and depression. And I remember even when it comes to sex, I mean, that that was kind of hard for me. When I think back on that, it was. So it all kind of relates. And you know, when you're talking about having trouble breathing, when you're anxious or maybe even having panic, and if, you know, if sex isn't going how they think, they automatically bring in that anxiety. And so. But then they're making themselves have pain. So tell us just a little bit more about that. I'd love to hear more about how you approach that with someone.

So you're 100% correct that like, the anxiousness affects the way you're breathing. And then like Becky said, the way you're breath affects your pain. So a lot of times there's kind of this disconnect of people in general, but particularly women thinking, like in, during intercourse, like all this other stuff that's happening in your life goes away, right?

Yeah, yeah.

But it doesn't. And so if you're struggling with anxiousness, breathing, tensing all throughout your day, whether that's at work, in your relationship with your kids, whatever. That doesn't just disappear when you go to be intimate with your partner. Right. So talking about mental health is huge because, one, we're going to give you, like, physical techniques and tools to work on relaxing your body.

Yes.

But if there's something deeper there that's causing that tension to be really everywhere all the time, you're not going to be able to turn that on and off like a switch. You have to get to the root problem of why do I feel this way in general, not just in my pelvic floor? Because you can't have tightness everywhere and then just magically relax your pelvic floor.

It doesn't work.

One thing we always say is, you're more than a pelvic floor. You're a whole body. So we're going to treat your whole body. Because you can't just pick and choose.

Yeah.

I love that it all interrelates. And actually, I wanted to talk specifically about this. I'm sorry. Sweet. I feel like I'm asking several questions, but this one, this is something. Well, we've talked about this because we've had people write us. We've actually had friends walk through this. And I want to talk specifically about a condition called vaginismus. And I was just telling y', all, like, I'm like, I don't even know exactly what it is. I know like a general, you know, kind of definition, but I would love for you to talk about that and tell us what it is and then also how you treat it.

Absolutely. So vaginismus is essentially, in the simplest terms, an involuntary contraction or smell spasming of the pelvic floor muscles with any attempt of vaginal penetration. Okay. So tampons can do it. Honestly, intercourse, trying to use dilators, which is a treatment for vaginismus. Anything that you're trying to insert vaginally, your pelvic floor muscles then go. And they clench. And you can't help it. You don't necessarily feel it happening. All you feel is that nothing can enter. It's a closed, really, door. A lot of women say it feels like their husband is hitting a wall. There's just no possible way. They come in and they tell us there's just. There's no hole. There's just nothing.

There's nothing.

Yes.

Okay.

Which has got to be frustrating for both.

Absolutely.

Well, and even it's involuntary. And you're like, I don't know, you know? So again, there's hope. Right. So if you're experiencing this, there's hope, there's. There's solutions. And so that's why we're having this conversation.

Yeah. Yeah. Well, and that's a condition, too, where a lot of people are given the advice, like, just relax. Have a glass of wine, take a bath, just relax.

Yeah.

But that's impossible for anyone going through that in particular, because there's a reason your pelvic floor is reacting that way. And again, we have to get to the cause of, like, why that is. So that can be a musculoskeletal issue. Like things that are going on with your joints and your muscles themselves and stuff you're doing in your daily life. You don't realize that is causing them to be more tense than they should be. Right. Or it can be because of a history of trauma. It doesn't have to be sexual trauma. A lot of people have had some sort of bad experiences with exams. Whether that was in childhood or maybe the first time you went to get like a pap smear or something like that, it was negative. Even things like that. Even though it's with a partner that you trust and you're trying to do everything in your power to just relax your pelvic floor is essentially saying, absolutely not. Right. And so again, we're going to talk about the breathing and the relaxation and mental health component with that, of course. But then, like Becky kind of alluded to a tool we use with those people a lot under the guidance of a pelvic floor. PT is called a dilator. And so they sound scary. They're really not under our guidance, and.

We help them not be scary.

Yes.

That's important.

Right, right.

Because if you're terrified, if you've had all these bad, painful experiences again and again and again, a really important part of that is breaking that cycle. Sure. So just something super important I want to not forget to mention is if you or your partner are having pain with sex, it's incredibly important to stop trying to have sex until you seek some professional help. Yeah. Temporary. Until you get some professional help to figure out why. Because if you just keep trying, which is a lot of advice that people do receive from caring individuals, it can actually, especially with a issue like that, it can perpetuate it, actually make it much, much worse.

And I want to touch on. There are plenty of ways to be intimate that doesn't include penetration. Sure. So we tend to encourage that, like external stimulation, intimacy without the goal of penetration for a short time until the muscles Are responding better that way your body's not inundated with pain. This is painful. This is painful.

This is painful.

And it's starts to solidify that in its memory, I guess.

Yeah, yeah, that's good advice. Really good advice.

Absolutely. And also, I think, I mean, do you find in the work you do with couples that are having pain that I don't know if they bring their partner sometimes, but do you see that the partner, like I'm sure there's all kinds of feelings because sometimes, I mean like even resentment. I mean, do you see that? How do you approach that? Because I know, I mean there's so many different. Like you said, there's the physical, there's the mental, there's the emotional. I mean, how, how do you deal with that with, with couples?

I think what I have experienced is, is if a husband comes personally, they have been just wanting to learn more. They've been supportive. They're there because they're supportive. It's been more rare that. That I've heard the partner is more resentful. I mean, maybe there's the one offs that's, that's got some deeper stuff going on in the marriage itself. Sure, yeah. For the most part, you know, whether the husband comes or not, the wife is generally telling me, he's so supportive, he wants to help me, he just doesn't know how. So it can be helpful for them to come honestly, just to give an anatomy lesson to the husband and say, look, this is what's happening. It's not because she doesn't love you, it's not because she wants this to happen. It's involuntary. And here are some other things and other ways that you guys can be intimate in the meantime, this is how I'm going to help your wife. This is, you know, it's gonna take some time, but these are the steps we're taking. Yeah, that goes a long way for both parties to just hope.

Yeah, well, and you feel like. Cause you guys provide some tools. And I think when you feel empowered like that we're not just doomed, you know. Cause I do think when somebody, I mean, I've heard especially from people facing vaginismus, something like that, they, they always say in the beginning they felt kind of doomed and they're like, oh my gosh, this is how it's gonna be for us. And I just didn't think this was gonna be a problem. And so you're providing that hope, you know, and the tools that they can do. And I just love that. I want to Talk about maybe some other things like what are some other reasons that women may have pain during sex? What are some things that like some other things that you treat.

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So I would say like tension in general doesn't have to be tight enough to be like vaginismus per se, but even if you just have like some hip stuff going on. Okay. And like you're a serious runner, a lot of former gymnasts, former dancers, people who have had falls on their tailbones, things like that will have just a lot of kind of dysfunction in the muscles down there. And it's painful when something is pushing and pressing in different directions. You're trying to sit in different positions and it can be painful and uncomfortable. Yeah. And then as well as making sure, like the skin down there is very healthy. So there's a lot of like misinformation about female cleanliness that is not helpful. Right. It can actually disrupt like the health of the skin down there, making things feel uncomfortable. So we do a lot of education about that and then also talking about lubricants. So a lot of lubricants on the market are not good. Yeah.

Blow that ky away.

Yes.

Do you find allergic reactions with that? Is that why you would say they're not good?

Stinky?

It might not be an allergy per se, but those things are filled with fragrances and parabens and all those other words that are glycerin, those chemicals that our skin in general doesn't need, but especially our vaginal opening. Yeah. That is so sensitive, ladies. And let's just throw that away. You want to look for water based lubricants that are fragrance free. You don't need the warming sensations. Your blood flow will do that for you. And so water based, fragrance free, paraben free, Free of all the things. And, and we can share some of those resources. We have a few brands that we like to recommend.

Yeah.

So one of my Favorites or a few of my favorites. I really like Slippery Stuff.

Great name. I know, I know.

Uber Lube and Good Clean Love. And then I don't know if you had another favorite. Were those your favorite?

Those are probably my top three. Yeah. Yeah.

That's cool.

Yeah, I love it. I mean, just get super practical because I know, you know, KY Jelly is just the one that you see on TV advertising or whatever that's been around forever. But that doesn't necessarily mean it's the best.

Right? Yeah.

And so, yeah, great marketing.

They do have really good marketing.

They do. That also applies to condoms. So if you're using latex, any kind of condom, you want to be wary of what is on the condom because a lot of them come pre lubricated. So that's another thing, too. I typically recommend to see Sustain the brand Sustain or Lola. Those are good ones.

Are they just more natural with. With the lube on them or is that what it is? Okay.

Yeah. So they just don't have that same nasty lubricant. You don't.

Okay.

Sustained.

Okay, Lola.

Okay.

These are good tips.

These are good tips by these brands.

No, but you guys, like, we love. Like we were talking before we started doing this recording, we were like, we just get. They said, we let. They love how honest the naked marriage is because they. They're like that too. And then Dave was like, well, we specialize in being aw. But we try to make the awkward. Not so awkward.

It doesn't have to be awkward.

We're going to talk about lube and condoms and all of it.

Yeah, yeah, yeah, yeah. You know, people, practical stuff.

They're going to be like, oh, I needed to know.

They're going to go look it up.

I'm serious.

Like, they will. And they're going to be like, I didn't even know that was. That's it. Like, that's the thing I need, you know?

Well, in so many people, like when you're, you know, newly married and you're going to grab your first products you need just for your honeymoon and stuff like that, and you grab something that's going to cause stinging and burning, of course you're going to think there's something wrong with you.

Absolutely.

Yeah. You're setting yourself up for a lot of unnecessary stress there.

Right.

And so this is, so. This is so good. I'm gonna ask about the guys real quick because we focus a lot on the ladies. The ladies, which is great. But pelvic floor, I'm learning, can also impact things for guys like not being able to sustain an erection, premature ejaculation, some of the main male issues related to sexual performance. And so how do you. How does a guy know if he's having some of these pelvic floor issues? Because he's just learning, like me, that he even has a pelvic floor.

Right.

So that's the first step. But then what do you do? Is that next step when you feel like maybe there's something off down there that's impacting sexual performance or maybe pain, but maybe one of these other issues that I don't know?

Yeah, for sure. So the pelvic floor affects all of those functions. Bowel, bladder, and sexual functions. So good signs that there's something off is that one or all three of those are being disrupted. And then for males, we're going to treat it not with dilators. Don't worry. We're going to work on the breathing, the posture, the movement, your overall health, your hydration. And a lot of those issues are related to controlling the pelvic floor, which most men don't even know they have. And then blood flow, lymphatic flow, and like, sensitivity of that area. So men can become too sensitive, just like women do, and they can also become under sensitive or have pain. And so it's really all the same things, just in a different way. Focusing on breathing, moving well, knowing how things should and shouldn't be. Because a lot of things that people think is normal are not. And a lot of things that people think aren't normal actually are like that. Everybody's different. Yeah, everybody takes a different amount of time to do things. Right. And men are typically told that they are, like, simple and women are complex, but really we're all complex human beings.

I'm very complicated.

I can tell.

Yeah, yeah. So everybody's complicated. And so some of it is just like figuring out what you're comparing yourself to and kind of busting those myths for men as well. So. And learning to breathe and relax and contract your pelvic floor, like, we all need to be able to do it.

It's good stuff, guys, I hope you're listening. We need this, too.

Yeah.

So that's good stuff.

Yeah.

And it's the guys that are struggling with constipation. They're in the bathroom for 45 minutes.

Yeah, yeah.

You know who you are. And they're peeing frequently, so, you know, more than every couple hours in the day. They tend to also potentially have some sexual dysfunction because it's coming back to that muscle, the pelvic floor muscles are dysfunctional, causing these things. They just might not tell you they're having sexual dysfunction. They might tell you they're constipated, but.

Right, yeah.

So a lot of times fixing those things also helps to fix the sexual dysfunction.

Yeah.

Which is huge. And I mean, even fixing those things will make their life better. I mean, that's, you know, because it's. You can't go, you know, number two. But you're going number one all the time. I mean, it infringes on your daily life. And so parents. Yes, number two.

And number one is like, we're, we're totally helpful kids.

We do, we do. Okay, but you know, when you. So when you see people, they come to you. Is there, I know you do things in office, but then are there exercises that people that you like, assign for them to do on their own?

Absolutely. So generally the way we describe the way that we treat at Genesis is we are going to spend our in office time on things that you cannot do by yourself at home. So we're going to do a lot of manual techniques. We're going to make sure you're doing your exercises correctly. That way then you can go home and actually do them.

Right.

We're going to do a lot of education. The exercises that we will tend to give are going to look, well, they're going to be different for everyone. That's the typical PT answer is that it depends. Right. But some of the common ones are actually a lot of yoga poses. So like child's pose, happy baby, stretching your inner thigh muscles, all coupled with that diaphragmatic breathing. Because those positions and just spending a few minutes a day in each of those positions is going to go a long way to improving blood flow of the muscles, improving movement of the pelvic floor muscles. And that is going to make a happy pelvic floor, which is going to decrease pain. So it's not like we don't necessarily tell everyone to go do yoga. We might, but not necessarily. But we are prescribing some of these yoga type positions to breathe in. A lot of exercises to improve hip mobility. So even just sitting on the floor and like windshield wipering your legs back and forth, that's an easy way to get your hips moving which gets your pelvic floor moving.

Really?

I mean, it, you know, when you say it, it sounds, it's like, it's kind of like an epiphany for people that they can do these things that. And then it could essentially help them to have a better Sex life. Like, I don't think we even realize that that's. Yeah. That we would make that connection. But I think it's so awesome. And I just want to say this really quick. I follow you on Instagram, and I love it. Can you give us that handle again? I know we had it in sexpectations.

Too, but I love that it's just Enesis PT wellness.

Yes. And she puts so many cool exercises and different things. Like, it's really practical, you know, And I love. I love the things you put out there. And it's just like, oh, my gosh, I can do this. Because I think when you have people come to you, I'm sure a lot of times it's been going on for a while and they get pretty desperate and they're like, please, I don't know what else to do. And I think just knowing, like, listen, there are things, you know, you can do is just a game changer. And it. Just having that hope and knowing, like, we can do this together. There's things that, you know, I can do with my body to help, you know, have a stronger pelvic floor. There's things you can do. It boosts the morale in a marriage. And I think, you know, we talk about all the time on the podcast here is that one of the worst things we could do is just make excuses and say, this is just it, and just act like, you know, there's nothing you can do. Because most of the time. Most of the time, there are things. And I love that, you know, you guys, as pelvic floor PT specialists, is that kind of. That's what you.

Okay.

I want to make sure I say that correctly. You know, that there's. There's so many things that they can help, you know, clients to do to improve not only their physicality, but what's going on in the bedroom. And so it really is. It's so huge what you were doing. And I know if you're in the DFW area, you actually can go see them at Genesis pt and you can see Corey and Becky and they can help you with these things. But if you're not, please follow them on Instagram @GenesisPT Wellness. Okay. And we'll make sure we put that in the show notes, but also look for one in your area, a pelvic floor PT specialist. Just Google that in your area and go and see them and get an evaluation and see what they can do. Because, again, there are things you can do. There is hope. You're not weird. You're not damaged. I think you know, that is just a lie from the enemy that he would love for us to believe and bust up our marriages over. But don't believe those lies. Get help and find amazing people just like the two you've heard from today, Becky and Corey.

So, ladies, thank you again for the work you're doing just helping change people's lives and marriages. And thank you for sharing with our audience today. I know it's been so meaningful. I mean, I've learned a lot.

I know, I'm excited.

Yeah, it's awesome.

Yeah, I've learned a lot. I'm gonna try that out.

You definitely need it. Everyone needs hip mobility.

Yes.

I love it.

And so there's so much, so much. So follow these ladies and continue to prioritize this aspect of your health, especially if you're experiencing discomfort of any kind in the pelvic floor or during sex because you don't have to live that way. And so hopefully giving you some tools here that that can help. And thank you again for listening, ladies.

Thank you again. Thank you all for having us.

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