Pelvic Pain and Sexual Dysfunction
Pelvic pain and painful intercourse is common but doesn’t have to define you. Pelvic physiotherapy can help to reduce symptoms, improve awareness and give you greater control and confidence when it comes to your sexual and pelvic health.
What I Treat
At Base Pelvic Health, I work with people experiencing:
Painful intercourse (dyspareunia)
Vaginismus or difficulty with penetration
Painful tampon insertion
Persistent pelvic or low back pain
Painful periods / Dysmenorrhea
Endometriosis
Vulvodynia (vulvar pain)
Vestibulodynia (pain at the vaginal entrance)
Pelvic pain following surgery (hysterectomy, prostatectomy, or other procedures)
Pudendal Neuralgia
Coccydynia (tailbone pain)
You Shouldn't Have to Just Live With It
It is not uncommon for me to see patients who have been unable to achieve penetration, or have been living with pelvic pain with intimacy for years before seeking help. Whether their symptoms were dismissed, they felt shame around seeking help or it was assumed that their symptoms were “normal” - I’m passionate about showing my patient’s another way.
Pelvic pain can and is often multifactorial, meaning there can be many causes for it. The pelvic floor muscles can play a role in pelvic pain - persistent tension in the pelvic musculature, difficulty relaxing these muscles or guarding after injury (such as childbirth, surgery or trauma) can contribute to persistent, ongoing pain. Identifying and addressing the state of these muscles can help patients better manage their symptoms.
What to Expect
Your first session starts with a thorough conversation about your history, your symptoms, and what you hope to achieve. The physical assessment is tailored to your comfort level. As a pelvic physiotherapist one of the tools in my tool box is to be able to complete an internal examination of the pelvic floor musculature. However, with pelvic pain I’m mindful of the role that our nervous system can play in our symptoms. When we feel safe, heard and in control our body our nervous system responds in kind. Respecting what your body and tissues are telling us helps to ensure that you feel comfortable and supported throughout your assessment. Every step is explained clearly so you choose what's happening and know why it might be helpful.
The goal is to have you leave your first appointment feeling more informed and confident about how we move forward.
You Deserve a Life Without Pain
Painful sex, chronic pelvic discomfort, and related symptoms affect intimacy, relationships, mental health, and quality of life. Pelvic physiotherapy can help you move toward a life that isn't defined by pain.
New patients in Cambridge, ON are typically seen within a week. Virtual appointments are also available across Ontario.
Book your appointment today.
Frequently Treated Conditions
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Non-specific pain or discomfort around the vulva (external genitals) or vaginal vestibule (opening of the vagina) in the absence of any physical findings. Often described as burning, stabbing, stinging or itching.
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The inability to have penetrative intercourse due to spasms of the pelvic floor musculature. You may not be able to insert a tampon or undergo a physical exam (with a speculum) with your doctor. It is often described as feeling like hitting a wall.
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Painful sex in the absence of any disease. This may be at the vaginal entrance, deeper internally or anywhere in the pelvis or lower abdomen.
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Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows in other areas of the body, such as the ovaries, fallopian tubes, and pelvic cavity.
Unlike the typical uterine lining, this misplaced tissue has no way to exit the body during a menstrual cycle. This can lead to:
Chronic Inflammation: Irritation of the surrounding organs.
Adhesions: The formation of scar tissue that can cause pelvic organs to bind together.
Significant Pain: Often manifesting as severe menstrual cramps, chronic pelvic pain, or discomfort during activity.
Endometriosis is a complex systemic condition. While it is often characterized by painful cycles, its impact can extend to fertility, digestive health, and overall quality of life, requiring a multi-faceted approach to management.
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Pain around the coccyx (tailbone) which may worsen after prolonged periods of sitting. This may have started after a trauma (direct fall onto the buttocks) or may occur without a specific cause.
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Compression or entrapment of the pudendal nerve which causes pain and dysfunction in the pelvis, groin and perineum. The pudendal nerve is responsible for sensation, muscular control around the pelvis as well as function of the organs of the pelvis.
A spasm of the pelvic floor muscles can cause compression of the pudendal nerve and cause any of the above symptoms.
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Any surgical intervention around the pelvic region may cause pain or discomfort. Post-operative patients we have worked with include but is not limited to:
Prolapse repair
Cesarian Section
Hysterectomy
Endometrial ablation
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Low back pain that is persistent, more sinister causes have been ruled out but has failed traditional physiotherapy may stem from the pelvic floor. If you find physiotherapy/chiropractic has failed to resolve your low back pain, a pelvic floor muscle assessment may be appropriate
Frequently Asked Questions about Pelvic Pain and Painful Sex
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Pelvic physiotherapy doesn't treat endometriosis itself, but it can play a meaningful role in managing the pain and symptoms associated with it while improving your quality of life. Through pelvic floor muscle training, manual therapy techniques like myofascial release and visceral mobilization and targeted exercise, pelvic physiotherapy addresses the muscle tension and tissue restrictions that often contribute to your pelvic pain. Just as importantly, it helps you understand what's happening in your body and gives you practical strategies to manage flare-ups and stay active. A pelvic physiotherapist is one valuable member of a multidisciplinary team — working alongside your Gynaecologist, Family Physician or other specialists to support your overall care.
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When you've been living with chronic pelvic pain, pain with sex, or pain during medical procedures, it's completely understandable to feel hesitant about booking an appointment for fear that it might flare your symptoms. This is something we take into consideration throughout your assessment.
When someone has been in pain for a long time, the nervous system becomes part of the picture. The goal is to work with your tissues not push through pain. That means minimizing discomfort, listening to what your tissues are telling us, and moving at a pace that feels safe for you.
Every assessment is adapted to what your body is ready for on that day and that can change from one appointment to the next. Nothing is done without your full consent, and everything is explained before it happens. Many patients are genuinely surprised by how gentle the process is.
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Pain doesn't always mean tissue damage - and the absence of findings on a scan or during an examination doesn't mean your pain isn't real. Chronic pelvic pain often involves sensitization of the nervous system, meaning your body’s alarm system is overactive. Understanding this is often one of the most validating and useful things that comes out of a pelvic physiotherapy assessment