If Sex hurts, pain, pleasure, intimacy and your bladder

As we mark World Sexual Health Day this week, I want to open an important conversation about painful sex and bladder problems, which are two difficulties that are often treated separately but may be closely connected. They are more common than most people think and if you are battling with them, you shouldn’t battle alone. There is help at hand!

Symptoms such as pain during intimacy, urinary urgency or frequency, bladder discomfort and difficulty emptying may involve both the pelvic floor and the nervous system. Let’s explore how...

The pelvic-floor connection

The pelvic-floor muscles support the bladder, assist with continence and need to relax and lengthen for comfortable sexual penetration as well as to release bladder and bowel contents and give birth.

When these muscles remain tense or overactive, they may contribute to:

• Pain during or after sex

• Urinary urgency or frequency

• Difficulty emptying the bladder

• Bladder or urethral discomfort

• Pelvic pressure, constipation or bowel symptoms

• Symptoms that feel like a bladder infection, even when tests are negative

  
  

Kegel exercises are not often the answer, even although people try them repeatedly. If the pelvic floor is already gripping, more tightening will worsen symptoms. These muscles need to learn how to relax fully before strengthening is introduced, if strengthening is needed at all.

The nervous-system connection

Stress, fear and previous painful experiences can make the nervous system more protective. The pelvic floor may brace, while ordinary bladder sensations begin to feel stronger, more urgent or painful.

This can create a cycle:

Bladder discomfort causes pelvic-floor tightening and possibly painful sexual intercourse which causes fear and further guarding which causes increased symptoms. And so, the cycle repeats and spirals upwards.

These symptoms are not in the mind, they do exist in the mind, but also in the muscles, the fascia, the nerves and in the nervous system as well as in the organs.

A whole-person approach

Recovery may include pelvic-floor rehabilitation, biofeedback, bladder retraining, mindfulness, pain education, nervous-system regulation and a gradual, consent-led return to comfortable physical intimacy. Dilator therapy may also be helpful when appropriate.

At Body Brilliance, I always look at the whole person. And at the whole person in the context of their life. We begin slowly, investigate all the factors that may be contributing and develop a plan that respects your body, boundaries and goals.

Medical causes such as infection, hormonal changes, prolapse or neurological conditions must also be considered. If another healthcare professional is needed, I work with a trusted network of doctors and therapists and can guide you towards the right support.

Painful sex and bladder problems are common, please don’t simply accept them. Get the help you need.

Recovery begins when we stop thinking about symptoms in isolation and start listening to the whole system. It begins when we stop minimising pleasure and make our own comfort and enjoyment a priority. This is your time to put your recovery first and get the help you deserve. Prioritise this crucial aspect of your wellbeing and give your sex life top spot. Get this problem out from under the carpet and recognise you have a right to pleasure and to intimacy and you have a right to the ability to enjoy all these wonders to the full.