Let’s talk about something no one talks about
Painful sex—also known as dyspareunia—is one of the most common symptoms of endometriosis. And yet, it’s often the least discussed. Whether you’ve felt embarrassed, dismissed, or unsure how to bring it up, know that you’re not alone. We work with many people at Acumamas who carry this pain silently. Maybe you’ve come to expect discomfort during or after intercourse. Maybe you’ve stopped initiating intimacy. Maybe you’ve learned to endure it quietly. Whatever you experience, it’s valid—and you shouldn’t have to live this way.
Sex should never be something your body fears. And pelvic floor physiotherapy can be a powerful step toward reclaiming safety, comfort, and connection.
Why Endometriosis causes pain during sex
Endometriosis is more than a reproductive condition—it’s a full-body inflammatory disease that often affects the pelvis, reproductive organs, bladder, bowels, and surrounding tissues. Over time, chronic pain and inflammation can cause the pelvic floor muscles to tighten reflexively, forming a protective response to internal discomfort.
This protective bracing may be your body’s attempt to guard against pain—but unfortunately, it often creates a cycle of muscle tension, hypersensitivity, and pain that lingers long after your period ends.
Penetration (even light touch or tampon use) may trigger sharp, burning, or cramping pain due to:
- Overactive pelvic floor muscles
- Trigger points (tight knots in the muscle tissue)
- Scar tissue or adhesions
- Sensitized nerves around the vagina, vulva, or rectum
The longer this cycle goes unaddressed, the more disconnected or apprehensive you may feel toward intimacy—which is completely understandable.
What is Pelvic Floor Physiotherapy?
Pelvic floor physiotherapy is a specialized therapy that focuses on the muscles, fascia, and nerves of the pelvic bowl. It goes far beyond Kegels—in fact, for people with endometriosis, doing Kegels without guidance can worsen symptoms.
At Acumamas, pelvic floor therapy is tailored to help you:
- Understand the root cause of your pelvic pain
- Gently release muscle tension and fascial restrictions
- Improve circulation, elasticity, and mobility in the pelvic tissues
- Rebuild nervous system safety through breath, movement, and touch
- Feel empowered in your relationship to your own body
How it helps with painful sex
When pelvic floor muscles are overactive or guarded, they can create significant resistance to penetration and even prevent arousal due to discomfort or anxiety. Pelvic floor therapy works to:
- Reduce involuntary guarding of pelvic floor muscles
- Release trigger points internally and externally
- Desensitize nerve endings that have become hypersensitive to pressure or movement
- Increase blood flow and tissue mobility to the vaginal and perineal area
- Re-establish brain-body connection, helping your nervous system unlearn fear around touch or movement
Over time, this leads to less pain, improved physical comfort, and a renewed sense of ownership over your own body.
What kind of exercises will be given?
Pelvic floor therapy isn’t just what happens in the clinic—it’s also about building comfort and strength at home, gradually and safely.
Your physiotherapist may offer:
1. Breathwork and Nervous System Regulation
- Diaphragmatic (belly) breathing to relax the pelvic floor
- Coordination of breath with gentle movement
- Restorative positions that release tension (like supported child’s pose or reclined butterfly)
2. Pelvic Floor Relaxation Exercises
- Guided pelvic floor drops (the opposite of Kegels)
- Visualization techniques to support softening and letting go
- Use of heat, posture, and props to release gripping patterns
3. Gentle Mobility and Stretching
- Hip openers and deep hip muscle release (e.g., piriformis stretch)
- Lumbar spine mobility to support pelvic alignment
- Hamstring and inner thigh release to reduce compensatory tension
4. Desensitization Techniques
- External soft tissue massage around the abdomen, hips, or sacrum
- Vaginal dilator work (if appropriate and only with consent) to slowly build tolerance
- Education on sexual positioning, pacing, and lubrication options
All exercises are chosen to suit your symptoms, comfort level, and readiness. You will never be pressured into anything that doesn’t feel right.
What to expect at Acumamas
Your first session will include a detailed intake and education on how the pelvic floor is functioning in your body. You’ll have time to share your story, ask questions, and explore how your symptoms show up physically and emotionally. If and when you’re ready, an internal exam may be offered—but it is always optional and only performed with full consent.
Our physiotherapist works in close collaboration with the broader Acumamas team, so if acupuncture or naturopathic care could support your symptoms holistically, we’ll help you access those as part of your integrated care plan.
We specialize in working with people who have chronic pain, trauma, or complex reproductive histories. We understand how deeply this kind of pain can affect your identity, relationships, and mental health. You deserve care that is gentle, informed, and patient.
You are not broken
If you’ve come to expect pain during sex, it’s easy to start believing that it’s just part of who you are—or worse, that there’s something wrong with you. But none of that is true. Your pain is real. Your experience matters. And your body is still capable of comfort, healing, and connection. Pelvic floor physiotherapy won’t erase endometriosis—but it can help ease some of its most personal and isolating symptoms. It’s a quiet, powerful way to reconnect with your body on your t.
Ready to begin?
If you’re struggling with painful sex and want to explore pelvic floor physiotherapy in a safe, supportive environment, we’re here to help.
