Pelvic Floor Tightness Causes Painful Sex: How To Find Relief

Having sex is a fun and intimate way to get closer to your partner(s). But if you're experiencing pain, it can make sexual activities less enjoyable and more unbearable. One possible cause of pain during sex is pelvic floor tightness.

Pelvic floor tightness, or hypertonic pelvic floor, is when your pelvic muscles are in temporary or constant contractions. When you cannot coordinate or relax your pelvic floor muscles, it can cause challenges with urinating and having bowel movements, alongside other symptoms of pain and discomfort. 

"The pubococcygeus, iliococcygeus, and puborectalis are the main muscle groups that provide support to the pelvic organs," says Stephanie Hack, M.D., a board-certified obstetrician and gynecological surgeon and the founder of Lady Parts Doctor. "These muscles can tighten and become stiff from trauma and overuse, similar to other muscle groups after a workout."

In addition, pelvic floor tightness can lead to sexual dysfunction and painful intercourse.

Painful sex, known as dyspareunia, is recurring or persistent genital pain1 that can occur before, during, and after sexual activity, according to a 2022 review. Hack mentions that dyspareunia can "lead to an inability to orgasm" and cause women to "develop a fear of sex due to discomfort," which could cause vaginismus—another sexual health condition causing vaginal muscles to suddenly tighten from the fear of penetration.

Although both conditions cause the pelvic floor muscles to tighten, vaginismus should not be confused with pelvic floor tightness. "Vaginismus is a type of pelvic floor dysfunction during which the vaginal muscles spasm involuntarily," Hack says. "This is different from pelvic floor tightness, in which the muscles are constantly contracted."

Pelvic floor tightness is a treatable condition; it's totally possible to regain control of your pelvic floor muscles. One treatment Hack notes for treating pelvic floor tightness is targeted pelvic floor physical therapy (PFPT).

As reported by a 2019 review, PFPT is a first-line treatment2 for pelvic floor dysfunction. The goal of PFPT is retraining pelvic floor muscles to relieve painful symptoms and encourage muscle relaxation.

"Targeted pelvic floor physical therapy can treat pelvic floor tightness and provide a cure for many," Hack adds. If PFPT isn't effective, Hack mentions additional treatments for pelvic floor tightness, such as "​​nerve stimulation, trigger point injections, or additional specialist care."

Here are a few more strategies for minimizing painful sex with pelvic floor tightness.

Try vitamin D supplements: Taking certain supplements may also lessen the chances of painful sex with pelvic floor tightness. According to a 2022 review, vitamin D effectively supports musculoskeletal health, and a 2017 review suggests insufficient vitamin D levels3 may negatively affect your pelvic floor muscles. It can be difficult to get enough vitamin D from food or sunshine, so consuming vitamin D supplements is necessary for many people. By getting your vitamin D levels in check, you may improve pelvic floor function, thus making sex less painful. Here are seven of the best vitamin D supplements to check out, hand-picked by the mindbodygreen team.

Set the stage for a comfortable sex life: If you have pelvic floor tightness, it's important to communicate this condition with your partner(s). It's best to have understanding partners willing to make adjustments to ensure you're comfortable throughout physically intimate moments. Hack says that "selecting a patient partner and having lubricant available" are must-have components of having enjoyable sex with pelvic floor tightness.