Sexual health is an essential part of overall wellbeing, yet many people live with pain,
discomfort, or reduced pleasure without realising that help is available. Pelvic floor
physiotherapy plays a key role in the assessment and treatment of many sexual health
conditions, for both women and men. With the right approach, it is often possible to reduce
pain, restore confidence, and significantly improve quality of life.
Understanding the Pelvic Floor and Sexual Function
The pelvic floor is a group of muscles, connective tissues, and nerves that support the pelvic
organs and contribute directly to sexual function. These muscles are involved in arousal,
orgasm, vaginal or penile comfort, and continence. When the pelvic floor is not working
optimally, sexual symptoms can appear.
Importantly, pelvic floor dysfunction is not only about weakness. Many sexual health
problems are linked to overactive, tense, or poorly coordinated pelvic floor muscles,
which require very specific treatment.
Sexual Health Conditions That Pelvic Floor Physiotherapy Can Help
Pelvic floor physiotherapy can help with a wide range of sexual health conditions, including:
● Dyspareunia (pain during intercourse)
● Vaginismus
● Vulvodynia
● Persistent genital arousal disorder
● Pain after childbirth or pelvic surgery
● Endometriosis-related pelvic pain
● Pelvic pain associated with menopause
● Painful bladder or bowel conditions affecting intimac
While these diagnoses may sound daunting, many of them respond extremely well to a
structured, evidence-based physiotherapy approach
How Pelvic Floor Physiotherapy Helps Sexual Health
A specialist pelvic floor physiotherapist does far more than prescribe exercises. Treatment
always begins with a thorough and respectful assessment, which may include posture,
breathing, abdominal function, pelvic floor muscle tone, and movement patterns. When
appropriate, an internal examination helps identify muscle tension, weakness, trigger points,
or poor coordination.
Treatment is highly individualised and may include:
- Pelvic Floor Muscle Rehabilitation
Depending on the condition, this may involve learning how to relax the pelvic floor rather
than strengthening it. Many patients with pain during sex have muscles that are constantly
overactive. Gentle techniques help restore normal tone and control. - Manual Therapy and Myofascial Release
Hands-on techniques can reduce muscle spasm, release trigger points, improve tissue
mobility, and decrease pain in the pelvic region. - Breathing and Nervous System Regulation
Stress, anxiety, and past trauma can directly affect pelvic floor tension. Breathing techniques
and nervous system regulation are essential to reduce pain and improve sexual comfort. - Education and Body Awareness
Understanding what is happening in your body is empowering. Education about anatomy,
pain mechanisms, and sexual function helps reduce fear and improves outcomes. - Scar and Tissue Treatment
After childbirth, episiotomy, tearing, or pelvic surgery, scar tissue can contribute to pain
during intercourse. Physiotherapy can improve tissue elasticity and sensitivity. - Gradual Return to Comfortable Intimacy
For conditions such as vaginismus or long-standing dyspareunia, physiotherapy supports a
graded and respectful return to penetration, always guided by the patient’s comfort and
goals.
Pelvic Floor Physiotherapy for Sexual Health After Childbirth and
Menopause
Hormonal changes, childbirth, and menopause can all affect sexual health. Reduced
lubrication, tissue sensitivity, pelvic floor weakness or tension, and fear of pain are common
concerns.
Pelvic floor physiotherapy offers a safe, non-invasive approach to address these changes,
helping patients regain confidence, comfort, and pleasure at every stage of life.
A Holistic and Professional Approach
Sexual health is deeply personal. Seeing a pelvic floor physiotherapist provides a
confidential, professional, and non-judgemental space where symptoms are taken seriously.
Treatment is always patient-led, trauma-informed, and adapted to individual needs.
Many patients are surprised by how much improvement is possible once the pelvic floor is
properly assessed and treated.
When to Seek Help
If you experience pain during sex, avoidance of intimacy, reduced sensation, or ongoing
pelvic discomfort, you do not have to live with it. Pelvic floor physiotherapy is a first-line,
evidence-based treatment for many sexual health conditions.
Early assessment often leads to faster and more effective results.
Pelvic floor physiotherapy can change the way you experience your body and your sexual
health. With expert care, recovery and improvement are possible.
If you are struggling with sexual pain or dysfunction, consulting a specialist pelvic floor
physiotherapist is an important first step towards feeling comfortable, confident, and
connected again.
