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Intimacy and the Pelvic Floor

When it comes to pain or challenges with intimacy, the reasons (physical, mental, emotional, spiritual) can be endless and vary widely person to person. Some of the most common things that typically play a role in painful sex are excess muscular tension in the pelvic floor muscles, education (or lack thereof) about sex and our bodies growing up, sexual trauma or other trauma history, childbirth history, the messages we received about sex through childhood and adolescence, and if it has been going on for awhile the fear about having pain with sex actually increases the likelihood the person will experience pain during (thus reinforcing the fear).

In the book Come As You Are, sex researcher Emily Nagoski talks a lot about the idea of a dual control method for our sex drive- a brake and an accelerator. Brakes are things that make it less likely for a person to feel desire, wanting, and arousal, and accelerators are things that make it more likely for a person to experience those same three things.

So what is a brake and what is an accelerator? It is completely dependent on the person, for both. There are no universal turn off or turn ons, and the same thing that turns on one person’s brake can turn on another’s accelerator – this is why communication is so important!!!

Stress tends to be something that turns on the brakes for a good number of people (especially women), but there are still a large number who respond in the opposite way and stress turns on their accelerator. For the people who stress does turn on the brake, those stressors typically can’t be changed a ton (work demands, children/family needing things from you, maintaining household, etc). But with the dual control method, these people still have an opportunity to increase their arousal, wanting, and enjoyment of sex. How?

FOCUS ON THE ACCELERATORS! Finding things that do increase your desire and longing for your partner often has nothing to do with the things we normally think are sex related. Catching a whiff of your partner’s scent as they walk past you, your partner completing a task you didn’t want to do without you asking, holding hands, a deep conversation, a funny movie, the list is endless and completely depends on the person. Even if you don’t change the stressors (and the brakes) at all, increasing the number of things that turn on the accelerator is a really helpful place to start!

This is not to say that we should not try to decrease our stressors and remove them when able, but to give people hope that even when stressors are high there are still things you can do to help yourself.

If you have been/are struggling with painful sex, know that there is support for you out there. If you feel like you need assistance in your journey, I would love to help you get to ta place of pain-free and enjoyable intimacy!

Tanner Hampton, PT, DPT

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