Let’s talk about something that too many people suffer through in silence—pain with sex, tampon use, or with pelvic exams. If you’ve ever thought, “Maybe this is just how my body is” or “I guess I have to live with this”, here at Break Free Pelvic Health we want to tell you that pain during intimacy and pain “down there” is not normal, and you don’t have to just deal with it.
Dr. Gretchen and Dr. Kaleigh both specialize in treating pelvic floor dysfunction, a common but often overlooked cause of painful sex. Whether it’s a deep, aching pain, a sharp sting at insertion, or lingering soreness afterward, there is a reason behind it—and there is help available.
Common Causes of Intimate Pain & How Pelvic Floor Therapy Helps
1. Pelvic Floor Muscle Dysfunction
Your pelvic floor muscles play a major role in intimacy. If they are too tight, too weak, or unable to relax properly, they can cause pain with penetration, tampon use, and even routine pelvic exams. Some people experience vaginismus, where the muscles spasm involuntarily, making insertion extremely painful or impossible.
At Break Free, we focus on releasing tension, retraining muscle coordination, and improving blood flow to restore pain-free function. Through techniques like manual therapy, appropriate exercise and stretching prescription, and guided relaxation exercises, we help you regain comfort and control.
2. Breastfeeding – 4x More Likely to Have Painful Sex
Breastfeeding causes a natural drop in estrogen levels, leading to vaginal dryness, thinner tissues, and increased sensitivity. Studies show that breastfeeding women are up to four times more likely to experience painful sex due to these hormonal changes.
Pelvic floor therapy can help by improving blood flow to the pelvic region, enhancing tissue elasticity, and providing strategies for comfort during intimacy. We also educate on safe lubrication and moisture support for healing.
3. Post-Cesarean Section Pain
Just because you didn’t have a vaginal birth doesn’t mean you won’t experience pelvic pain. Scar tissue from a C-section can create adhesions that pull on surrounding muscles and nerves, leading to discomfort during intercourse.It also can delay abdominal healing which has an impact on pelvic floor muscle function. At Break Free, we use gentle scar tissue mobilization, manual therapy techniques, and appropriate exercise prescription to reduce restrictions and restore normal movement and sensation.
4. Menopause and Hormonal Changes
During menopause, estrogen levels drop, leading to vaginal dryness, thinning tissues, and increases the risk of an underactive or overactive pelvic floor. These changes can make sex feel painful or irritating, and without proper treatment, symptoms may persist.
Our approach includes pelvic floor strengthening or relaxation, blood flow stimulation, and gentle manual therapy techniques to ease discomfort and restore pleasure. We also work alongside medical providers if vaginal estrogen or other treatments may be beneficial.
5. Pain at Insertion – Tampons, Pap Smears, and Exams
If the moment of insertion—whether it’s a tampon, a speculum, or penetration—causes sharp, burning, or stabbing pain, you might have vulvodynia, vestibulodynia, or hypertonic pelvic floor muscles.
Pelvic therapy can desensitize painful areas, release muscle tension, and teach your body and nervous system to accept insertion without pain. We take a gradual, pain-free approach to help you feel comfortable and confident.
6. Deeper Pain During Certain Positions
Pain that happens only in certain positions is often linked to pelvic muscle tension or a deeper issue such as endometriosis, pelvic inflammatory disease and/or ovarian cysts. Through an examination of mobility within the hips, pelvis, sacrum and pelvic floor – we can identify areas of tension and pain that are contributing and treat through manual therapy techniques, appropriate exercise and prescription and education for positioning.
7. Pain After Sex
If you feel soreness, cramping, or burning after sex, it could be due to muscle spasms, inflammation, or nerve irritation. This type of pain often lingers for hours or even days after intimacy.
Our therapy focuses on calming the nervous system, reducing tension in muscles, and improving circulation to prevent post-sex pain and allow for full relaxation after intimacy.
8. Pain or Difficulty with Orgasm
Although we consider pain with penetration as the common sexual dysfunction – most women do not orgasm with penetrative intercourse. Most women (3 out of 4) orgasm with clitoral stimulation. Restrictions or pain at the clitoris can make the difference between sex without pain and sex without pain WITH pleasure. Orgasms are a result of rhythmic pelvic floor muscle contractions. An overactive pelvic floor can cause pain with orgasms or pain after orgasm. An underactive pelvic floor can cause orgasms to not occur or feel weak. Did you know that orgasm can be a great way to strengthen your pelvic floor?
Valentine’s Day Tip: Stop kegeling and start orgasming!
At Break Free Pelvic Health & Wellness, we take a different approach. Our goal is to never treat pain by causing more pain. Our process is gentle, respectful, and guided entirely by your comfort level.
- We never do anything you’re not comfortable with—every step is discussed beforehand, and you are always in control.
- We start from the outside in, ensuring that every step of treatment is at your pace.
- Evaluations are private and discreet, with a focus on making you feel safe and heard.
- Our techniques are designed to help calm your nervous system to allow manual release work to be effective without causing more pain and tension.
You don’t have to live with pain or unpleasurable sex. It’s common, but not normal. Help is here, and healing is possible. If intimacy has become something you dread instead of something you enjoy, we’d love to help you find relief.
Give us a call at 843-471-0351 or fill out the form here for more information on how we can help you today!
