When Pain Gets In The Way of Sex


There area lot of ways in which pain can get in the way of sex. Health issues, pelvic pain disorders, STIs, and injuries can all make it difficult to relax and feel good. But recently, I got a question from someone that inspired me to do a little research.

It’s pretty common for people to tighten different muscles during arousal. I’ve heard some experts suggest that it’s because it can heighten the level of sensation and excitement. Some folks will hold their breathe or squeeze their legs or hips, or grab and pull on the sheets, or arch their backs. And if you do that consistently, over time, you might develop some habits around that. A few people have told me that they’d been doing that for so long that it was difficult or even impossible for them to orgasm without it.

But what happens when you can’t do that anymore? I know one person who had a neck injury and had to learn how to not tense her neck during sex because it would cause migraines. And I know another person who developed arthritis in his shoulder and found that he had a habit of tensing his shoulder muscles during sex that he couldn’t do anymore without causing pain.

I have a suspicion that one reason that many people stop having sex as they get older is that they get stuck in a pattern that doesn’t work for them, but they don’t know how to get out of it. Of course, it’s easy to say “just try something different,” but as anyone who has actually tried to do that can tell you, it’s not as simple as that. So I did what any good sex educator would do- I asked some experts.

The first person asked was Feldenkrais practitioner Brandee Selck. Feldenkrais is a method of education and movement practices that help people develop more awareness of how they move. As self-awareness expands, pain can diminish and movement becomes more fluid. Plus, it’s a great way to learn how to shift old physical habits that don’t work anymore.

Brandee points out that perturbing a pattern creates an opportunity to interrupt it, which gives you a chance to change it. And sometimes, it’s more effective to magnify or exaggerate the habit than to fight it because that gives you useful information about how it works.

To get started, set the intention to not try to orgasm. Instead, your goal is to get a better understanding of how you work. If that seems too hard, then spend a while exploring the pattern before you try to reach orgasm. When you do, here are some suggestions for shaking it up and seeing what happens. They may seem simple, but that’s what makes them effective. You don’t have to do all of these in one session- mix it up and see what happens.

1) Notice what muscles you are contracting and how you’re doing that. Then do the same thing, but increase it by 10%. Then, decrease it by 10%. Repeat, but at 20% or even 30% By turning the volume knob up and down, you get better at seeing the distinctions and learn more control over your body. That gives you more choices than always being at one level of contraction.

2) Slowly contract your muscles, then gently let them go. Make sure you let go all the way so the next time, you’re starting fresh. Take a few deep breaths and repeat, but change it up a bit. Do it on an inhale v. an exhale. Or shift your position slightly. Pay attention to a different part of your body and see how it feels. When you give your nervous system some variety, you’ll find more options. Over time, you might be able to find a way to contract your muscles that’s a bit more comfortable or easier.

3) When you contract your muscles, pay attention to whatever else is going on. Are you holding your breath? Breathing faster? Are you clenching your toes or your fingers? Do you hold your head in the same position? What about your eyes or face? Are they squeezing? Can you let them soften? As you focus on theseĀ  other parts of your body, see if you can notice changes in where or how you’re tensing or how your overall sensations feel.

4) Another possibility is to see how you breathe when you tighten muscles, and then play with that. Try coordinating your breath with the contraction, holding your breath, and breathing into your abdomen vs your chest. Then, see if you can let your breathing be continuous and undisturbed as you contract your muscles.

5) Visualizing changes in your body can sometimes make them happen more easily that trying harder. First, take a few moments to feel the length of your spine from the tailbone all the way through to the top of the head. Each time you inhale, imagine that your spine lengthens a little. Do the same when you exhale. You don’t have to try to make anything happen- just think about the idea of lengthening. After a few breaths, slowly begin to contract your muscles and notice where you shorten in your spine. Experiment with maintaining length and ease in your spine as you contract your muscles.

These are all really useful tools for tuning into your patterns and learning to play with them, but they aren’t the only ones. I also sat down with Ada Lusardi, a really amazing yoga teacher, to get her input.


One of the things Ada pointed out is that the first step is letting go of expecting a particular destination when you have sex. A lot of people assume that it’ll always lead to orgasm or to orgasm in a particular way, and sometimes, the more we strive for the goal, the more we get in the way. When we stop engaging in that habit, we can start paying attention to the sensations we’re actually experiencing, which can make it easier to learn new ways to enjoy sex. So start by agreeing that there is no outcome and instead, enjoy the experience.

Pelvic floor pain and dysfunction is quite common, especially as we get older. Sometimes, we have injuries that affect the pelvic floor. Or muscles spasm from too much sitting and stress. Or they lose tone, especially from childbirth or aging. And although a lot of people are familiar with Kegel exercises to tone the PC muscle, not as many are aware that you also need to learn how to relax the muscle to avoid spasms. This is useful because a lot of people clench the pelvic muscles during sex, which can cause imbalances and pain.

Another way that yoga can help is by making it easier to be able to relax your muscles. Contrary to common belief, relaxing takes practice, especially in this overstimulating, always-on world. Through yoga and other practices, you can learn how to mindfully relax your body, and not only can that help during sex, it can make those long days at your desk less painful, too. Plus, they can teach you different ways to move your body, which is useful when you’re experiencing pain with a particular motion.


I was fortunate to review an advance copy of Healing Painful Sex, an amazing book for female-bodied folks who experience pelvic pain. Although it’s more focused on intercourse than I think it really needs to be, it’s a fantastic resource and one of the best on the topic. And while it doesn’t address the issue of painful patterns of holding in other parts of the body, if you do experience pelvic pain, it’s a good resource.

Unfortunately, most medical doctors don’t really understand how pain works or offer pointless suggestions like “try a glass of wine before sex.” But at least there are some folks out there offering more useful tips.

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