Sexual Wellness, Pain With Intercourse, and Orgasms: What Medical Research Shows
Sexual wellness is an essential part of overall health — yet concerns like pain with intercourse or difficulty reaching orgasm are often dismissed, minimized, or normalized as something women just have to “live with.”
The truth?
Medical research shows these concerns are common, valid, and treatable — especially when the pelvic floor is involved.
This article breaks down what the evidence says, why these symptoms happen, and how pelvic floor physical therapy can help.
Sexual Wellness Is More Than Desire
Sexual wellness isn’t just about libido. It also includes:
Comfort during intimacy
The ability to relax and enjoy penetration
Sensation and arousal
The ability to reach orgasm
Feeling safe and confident in your body
Medical research shows that many sexual concerns have physical contributors, even when routine exams or imaging come back “normal.”
Pain With Intercourse Is Common — and Not “All in Your Head”
Pain with intercourse (often referred to as dyspareunia) affects women across all ages and life stages — from postpartum to perimenopause and beyond.
Common Contributors to Pain With Sex
Medical research shows pain with intercourse can be influenced by:
Overactive or tight pelvic floor muscles
Scar tissue from childbirth, surgery, or injury
Hormonal changes (postpartum, breastfeeding, perimenopause)
Endometriosis
Past injury, trauma, or repeated guarding patterns
When pelvic floor muscles stay tense or guarded, penetration can feel painful, restricted, or impossible — even when there is no infection or structural issue present.
Difficulty Reaching Orgasm Has a Physical Component Too
Orgasms rely on a coordinated relationship between:
Pelvic floor muscle function
Blood flow
Nervous system signaling
Relaxation and safety responses
When pelvic floor muscles are:
Too tight
Fatigued
Poorly coordinated
…the body may struggle to fully relax, sense pleasure, or build enough arousal to climax.
Medical research shows that improving pelvic floor coordination and reducing tension can positively impact sexual sensation and orgasm quality.
This isn’t about “doing more Kegels”, it’s about learning how your pelvic floor actually works.
How the Pelvic Floor Affects Sexual Function
The pelvic floor muscles play a direct role in:
Vaginal comfort and elasticity
Sensation and arousal
Orgasmic contractions
Relaxation during penetration
When these muscles are overactive or poorly coordinated, sexual activity can become uncomfortable, frustrating, or anxiety-provoking.
What Pelvic Floor Physical Therapy Can Help With
Even when sexual concerns feel complex or layered, pelvic floor physical therapy can help by:
Reducing muscle tension and guarding
Improving comfort with penetration
Restoring healthy muscle coordination and control
Supporting confidence and body awareness
Down-regulating the nervous system
Addressing contributing factors like bowel, bladder, posture, and breathing patterns
Care is always individualized — there is no one-size-fits-all approach.
No One Treatment Fixes Everything — and That’s Okay
Medical research consistently shows that sexual wellness improves most with layered, individualized care, not quick fixes.
Pelvic Floor Therapy Takes a Multifaceted Approach Including:
Movement and strength training
Nervous system regulation and breath work
Education around pain science and anatomy
Lifestyle and habit support
Coordination with other providers when needed
Progress doesn’t have to be linear — and improvement doesn’t require perfection.
When to Seek Help
If you’re experiencing:
Pain with intercourse
Fear or tension around penetration
Difficulty reaching orgasm
Pelvic pain that affects intimacy
…you deserve answers and support.
Early, informed care often leads to better comfort, confidence, and long-term outcomes.
You’re Not Alone
Many women delay seeking care because they feel embarrassed, unsure, or unsure if their symptoms are “serious enough.”
They are.
Medical research shows these concerns are common — and help exists.
Ready to Learn More?
If you’re wondering whether pelvic floor physical therapy could help your sexual wellness concerns, we’re here to guide you.
Schedule a free consultation to learn if pelvic floor therapy is a good fit for you.