Painful Sex, UTIs, Trauma and Pelvic Health Physiotherapy

In 2021, I struggled significantly with chronic urinary tract and yeast infections. Although I struggled with yeast infections in my past sexual relationships with women (I would almost always get a YI after sex), the experience of a UTI was new for me when my male partner and I began to have sex. I have written about my struggles with UTIs in one of my Patreon essays, Redefining Sex, Reclaiming Power and Reaching Subspace.

The impact on me from UTIs was not limited to the physical pain and discomfort they caused. They also led to significant emotional impacts of me feeling broken, damaged and as though I was being punished for enjoying sex (thanks to my lovely Catholic upbringing).

As I called my doctor with my forth UTI in seven months, frustrated and angry, she asked me why I was being so hard on myself. “This is just something that happens to some women due to friction during intercourse”. She prescribed me a low dose antibiotic to take after intercourse to prevent a UTI from starting. This felt like a band-aid solution to me. I did not understand why sex was painful, why it felt like I was being scratched from the inside during penetration and I didn’t understand why I just had to settle with “…This happens to some women”. I also didn’t understand why I could not urinate after sex, which is known to be a main way for those with vaginas to prevent UTIs. Every time I tried, it felt like all my muscles were tense and couldn’t relax enough to urinate.

Frustrated and overwhelmed, I shared my experience with a friend of mine who asked if I had heard of pelvic floor therapy. I had not. What I did know however, was that I had gone to my doctor a number of times, as well as, my naturopath and I was still in the same position. I decided to give it a shot and scheduled an intake with a pelvic floor therapist.

I was in a full depressive episode during the intake. I felt hopeless and that this was a last shot to try and figure out what was happening. However, it appeared that after doing the internal exam, the therapist seemed optimistic. She shared with me that my pelvic floor was extremely tight and that I had an immense amount of redness and irritation. She shared with me basic information such as; using unscented soap in the shower, rinsing my vuvla with water after I washed my hair, switching to unscented laundry soap and dryer sheets, increasing water intake, using a very simple and water based lubricant during sex and using coconut oil to soothe my irritated skin. She provided information on bladder training to try and help me need to urinate less and demonstrated a posture to use for urinating after sex. The biggest and most influential help however, was learning how to relax my pelvic floor.

During the second appointment, my therapist completed an internal process in which she helped me learn how to relax my pelvic floor muscles. As women, we are taught that it is better and more desirable for penetration, for us to be “tight”. Unknowingly to me, all of that stuff I heard about doing kegal exercises (in order to achieve “tightness”, was actually causing a lot of harm for my already extremely tight pelvic muscles. When I would do kegal contractions during sex (thinking, thanks to our patriarchal society) that it would make things feel better for my male partner, I was actually creating more pain and tightness for myself.

WHO KNEW?!

But wait – why did I have a chronically tight pelvic floor to begin with?

Enter, childhood developmental trauma (hello old friend).

A study was completed in 1998 by Vincent J. Felitti Et. Al. titled, Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults The Adverse Childhood Experiences (ACE) Study. This study identified 10 forms of child abuse or neglect that have been linked to a number of health issues seen in adults with abuse histories as children. Several studies have demonstrated the link between ACES and pelvic floor issues. These findings were further confirmed by my pelvic floor therapist, as well as, friends of mine who work with trauma. Whether it is due to a child being in a chronic state of fight or flight, which tightens the low back and pelvic muscles, or the body attempting to protect a survivor who had experienced childhood sexual abuse, the correlations are undeniable.

This was yet again, another area in which I needed to reteach my chronically heightened nervous system and body that I was safe and did not need to be tensing my muscles in order to avoid further harm.

This process included tuning into my pelvic floor several times throughout the day, breathing and releasing it (as it was often tight), practicing stretches for my pelvic muscles (such as cat/cow and pigeon pose), manual internal stretches that I do in the shower or before bed and NOT DOING KEGALS.

Within a month of these changes, I was able to stop my frequent urination and I was beginning to be able to pee after sex! When I felt pain during sex, I would tune into my pelvic floor and would often notice it would be tight. I would breathe and relax and the pain would decrease or even, subside completely. My partner and I also got diligent about using LOTS of lube during sex (water based, no glycerin or complex additives, hyper sensitive).

I feel like I have answers I did not have before and taking part in pelvic floor therapy truly helped me feel more in control of my body and my sexual health. I believe that all vagina owners should have access to this service.