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Pelvic Floor Physical Therapy for Intimacy

Pelvic floor physical therapy can be used to treat or help treat a number of sexual health problems. Pelvic floor physical therapy (PFPT) is a common treatment for urinary and fecal incontinence and pain after childbirth or pregnancy, but is also an effective treatment for:

  • urinary incontinence

  • fecal incontinence

  • endometriosis

  • pelvic pain

  • pain with sex

  • pelvic organ prolapse

  • vaginismus (muscle spasms during penetration)

  • vulvodynia (vulvar pain)

  • erectile dysfunction

  • constipation

  • interstitial cystitis

  • menopause symptoms

The pelvic floor is a group of muscles and fascia that form a sling which holds internal organs such as the bladder, large intestine, rectum, and reproductive organs. The muscles help protect the organs, as well as control the flow of urine and feces, support vaginal deliveries, and play an important role in sexual function in both male and female bodies.

When a person has a pelvic floor dysfunction, it generally means that one or more muscles in the pelvic floor is not working as intended. This can be because the muscles are too loose, or too tight, or the patient has trouble contracting and releasing the muscles appropriately. The muscles can also be damaged by child birth or medical treatments.

These dysfunctions can impact sexual health. In people with male bodies, pelvic floor dysfunction can cause erectile problems, premature ejaculation, and pain after ejaculation. In people with female genitalia, pelvic floor dysfunction can cause pain during or after intercourse, pain at the clitoris, and pelvic organ prolapse. As well, other pelvic floor dysfunctions such as urinary or fecal incontinence have shown to negatively affect people's sex lives.

Pelvic floor physical therapy treats these conditions without surgery, injection, or drugs. PFPT identifies the causes of the dysfunction and treats them non-invasively. Common treatments in PFPT include:

  • Education about the pelvic floor anatomy, function, and hygiene

  • Exercises designed to teach patients how to contract and release the pelvic floor muscles (while Kegels are a pelvic floor exercise, they are not appropriate for all types of pelvic floor dysfunction!)

  • Breathing exercises to help patients relax and improve the efficiency of the other exercises

  • Manual therapy which can include massage, stretching, or myofascial release

  • Biofeedback, a non-invasive, non-surgical technology that allows patients to see how and when the patient is contracting and relaxing their muscles, to provide feedback and guidance in exercises

  • Use of vaginal dilators to help patients learn how to relax the vaginal muscles.

These are not necessarily the only techniques a pelvic floor physical therapist may use depending on the conditions being treated, but they are very common interventions.

Pelvic floor physical therapy, like orthopedic or vestibular physical therapy, really works best when the patient is an active participant. For best results, it is important to follow the physical therapist's instructions regarding which exercises to do and how often, how often to be seen in the office, and any other interventions they recommend. Like all musculoskeletal dysfunctions, the body needs to be retrained to work as intended.

If you or a loved one is suffering from pelvic floor dysfunctions, we'd be happy to help. Call FlexPlus Physical Therapy at 508-650-0060 to set up your initial evaluation with a pelvic floor physical therapist today!

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