It’s not normal for sex to hurt. (In fact, it’s not normal for your periods to hurt either, but that’s a topic for another day.) But, for women with vaginismus, endometriosis, chronic yeast or bacterial infections, ovarian cysts, fibroids, or birth or other traumatic injuries sex can be intensely painful.
If you suffer from painful sex, you are not alone. While the number of women who suffer from painful sex remains a mystery (because so many women suffer in silence), I have seen thousands of women who are suffering during my career as a women’s health physical therapist, and clinical nutritionist. The good news is that there is help available beyond the traditional recommendations of birth control pills, pain medications, and surgery.
1. Get Tested for Celiac Disease and Try an Elimination Diet:
In many cases, painful sex can actually be related to food sensitivities. Gluten can be a major problem for women with endometriosis, chronic pelvic pain, painful periods and painful sex. First, ask your doctor to test you for celiac disease (an allergy to gluten.) In one published study, a woman with celiac disease experienced complete relief from her pelvic pain, painful periods and painful sex after going on a gluten free diet (previously her symptoms had returned 6 months after a laparoscopy to remove adhesions in the pelvis1.) In another recent study, 75% of women with endometriosis who went on a gluten free diet experienced significant pelvic pain relief2. Gluten is not the only culprit, but it is the most studied and is a great place to start. Other common foods linked to painful sex: dairy, nightshade vegetables (like peppers and tomatoes), soy, and corn.
2. Optimize Your Gut Health:
Once you remove the pain producing foods from your diet, it’s important to optimize the health of your digestive and gut related immune system. Supplements like glutamine, probiotics, and digestive enzymes can help to stave off chronic yeast infections and the chronic inflammation that can make you want to hide from your partner for life.
3. Naturally Balance Your Hormones:
If you’ve just had a baby or are heading towards menopause, the vaginal tissues can lack moisture and can become very fragile. Optimizing the function of the entire endocrine (hormone) system can help to bring your hormone levels back to normal. Getting to bed by 10pm (to sleep for now), eating a high protein, high fiber breakfast within one hour of waking up, and turning off all electronics by 8pm are essential for healthy hormone balance. In the short term, using a water-based lubricant that doesn’t contain propylene glycol can help with lubrication while you’re nursing. Coconut oil is also very healing to the vaginal tissues if you experience a tear or episiotomy during delivery. See a women’s health physical therapist to take care of any scars after birth or surgery to relieve local, vaginal pain.
4. Support your Detox Organs:
It’s your liver’s job to get rid of too much circulating estrogen. Over time, after eating too much fast food, taking too many medications or even after being under too much stress, the liver’s detox ability can lose some of it’s punch. Support your liver with a whole foods cleanse every 4-6 months. Working with a qualified nutritionist, you may also find that supplements like active B-vitamins, or broccoli extract can get your detox machine back on track.
5. Find a physical therapist who specializes in taking care of women with pelvic pain:
Most of us can appreciate the value of physical therapy for the muscles of the neck to relieve neck, headache or shoulder pain. Did you know that your pelvic floor muscles could have muscle spasms just like the muscles in your neck? When the nerves or muscles in the pelvis and pelvic floor are irritated, in spasm, or otherwise injured you can feel severe burning, aching, or even sharp pains during sex. In some cases, the pain can even occur with simply sitting or wearing your skinny jeans. Specialized physical therapy treatment to the muscles, nerves and joints of the pelvis and pelvic floor is highly effective for the relief of sexual pain3.
If you are suffering right now from the devastating effects of painful sex, know that there is so much hope for your relief and healing. With conservative therapies like nutrition, lifestyle modifications, and physical therapy available to you, relief is in reach. It is my hope that all women can experience the full pleasure, intimacy, and connection of a healthy and pain free sex life.