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Stress and chronic pain can impact nearly every part of your life. They can make it difficult to work, exercise, and even enjoy otherwise fun activities. They can even impact your relationships, particularly when it comes to intimacy.
When you regularly feel frazzled—the way we all are during this global pandemic—your body’s sympathetic nervous system (SNS), which controls the fight or flight response, is constantly being triggered. That alone can make enjoying interpersonal relationships difficult. One reason: When the body is in a heightened state of stress, you might find it difficult to relax enough to enjoy intercourse.
But when chronic pain effects the pelvic area, it can adds an additional layer of disruption to your sexuality and relationships, says Allyson Brooks, MD, the Executive Medical Director of the Women’s Health Institute at Hoag Hospital in Orange County, California. Common chronic syndromes, such an interstitial cystitis, vulvodynia, endometriosis and hormone-related issues can cause pain during sex, or make it difficult to achieve orgasm.
Chronic pelvic pain can also “set up a cycle of low sexual desire, tension in the relationship, depression, avoidance and guilt,” says Brooks. Pelvic health issues affect millions of women each year, and if you’re among them, it’s nothing to be ashamed of, Brooks stresses. Still, many women suffer in silence because of the stigma around seeking help. “[These conditions tend] to result in self-blaming, shame and guilt if left undiagnosed and untreated,” says Brooks.
The good news: There are ways to manage these mental and physical struggles.
Help is available
Experimenting with self-pleasuring activities and products before sex can help reduce anxiety and pain. You might want to try out different lubricants to find one with a comfortable texture and consistency. Or you could use a vaginal dilator or vibrator to prepare your body for the sensation of penetrative sex. There are even hormonal creams your doctor can prescribe to restore lubrication and elasticity to the vulvar/vaginal tissues.
Sex and intimacy go beyond penetration and orgasm, so when you’re with your partner, explore alternatives to intercourse. Cuddling, massage with essential oils, kissing and other physical interactions, use of visual and visual stimuli may help you feel arousal, orgasm and emotional connection without pain.
Seeking support from experts and clinicians can also alleviate the physical, mental, and emotional suffering tied to these conditions. Sexual medicine specialists, psychologists and counselors, pelvic floor physical therapists are essential to helping explore ways of being intimate, communicating about sexual needs and limits, overcoming communication barriers, managing anxiety and treating depression.
Developing a yoga practice can help.
In addition to clinical support, your yoga practice can also help improve both your physical and mental wellness, says Brooks.
Kathleen Lombardo, Doctor of Physical Therapy at the Irvine Hoag Hospital Center For Wellness says that breathing increases parasympathetic action to shift the balance of the nervous system and reduce the overall stress response. Functional MRI studies show that when you inhale, the diaphragm and pelvic floor descends. When you exhale, your diaphragm and pelvic floor lifts. To release tension in the pelvic floor try this visualization: On an inhale, imagine creating space in the pelvic bowl as the pelvic floor descends and widens. As you slowly exhale, imagine releasing tension and tightness in this area. Practice this breathing and visualization for 2 – 5 minutes anytime you are experiencing pelvic pain.
Or, try a body scan. As you inhale and exhale, scan your body for areas of tension. Direct your breath into those areas to promote relaxation.
Practicing asana can also reduce chronic pelvic pain in women, because it introduces conscious breathing, relaxation, and body awareness, says physical therapist Kathleen Lombardo of the Irvine Hoag Hospital Center For Wellness.
Poses that stretch the pelvic floor and the surrounding hip and back muscles are particularly beneficial. Twists offer lengthening of the spine and hips to also reduce abdomino-pelvic discomfort, says Lomabrdo.
Incorporate these poses into your practice. Modify as needed using props or variations.
- Child’s Pose
- Happy Baby
- Spinal twist
- Thread the Needle
- Warrior II or Low Lunge
- Wide-Angle Seated Forward Bend
- Supported legs-up-the-wall
- Corpse Pose
The bottom line: Chronic pelvic pain is common, but seeking treatment and communicating with your partner about your sexual needs and limits will help you have a satisfying, comfortable and ageless sexual intimacy. Ultimately the relationship with yourself is the most important one that requires compassion, love and non-judgment.
Anusha Wijeyakumar is a Wellness Consultant at Hoag Hospital in Orange County, California, and author of Meditation with Intention.