Sex is a very personal issue and one that we don’t tend to discuss much. Sex is important to many couples and brings fun and intimacy to their relationships. For couples where one partner experiences PGP, sex can be problematic, mainly because it may be painful and difficult to move comfortably during sexual intercourse.
To reduce pain during intercourse try taking pain medication beforehand and explore together positions where you do not have to open your legs too far apart or support your partner’s weight, for example, ‘spoons’.
Painful intercourse may not be just due to painful joints but due to spasm of the pelvic floor muscles which is felt as pain and extreme tightness in the lower vagina on penetration (vaginismus). Manual pelvic floor physiotherapy may relieve the spasm. If this difficulty persists it may also be helpful to see a psychosexual therapist.
Some women avoid sex because they are afraid intercourse will damage their pelvis or worsen their PGP. This is understandable, but with mutual goodwill, good communication and a little imagination, there is no reason why you should not enjoy a good sex life with PGP.
Alternatives that do not involve penetration, such as kissing and cuddling, sensual massage, arousing each other through touch, can be just as much fun and will enable you to maintain feelings of closeness and intimacy. It might be helpful to think about sexual behaviours as a ‘menu’; intercourse is only one item on the menu and variety can enhance your relationship rather than deplete it.
Feeling guilty about what you can’t do does not help you to enjoy what you can do.
Communication is the key
Communication is the key, enabling you to share your feelings and fears, dispel unhelpful assumptions about each other and problem-solve together in a creative way. Women with PGP may feel they are letting their partners down or that they are not attractive any more as their partners are avoiding initiating sex. Partners may avoid initiating sex for fear of inflicting pain or because the woman seems exhausted, but may similarly feel frustrated and rejected. If you can talk openly and honestly a lot of these difficulties can be resolved and prevent a negative effect on your relationship.
If you do think sexual issues are adversely affecting your relationship, you may wish to seek the advice of a professional relationship and psychosexual therapist. The following websites will enable you to find therapy: Relate and COSRT.
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