Intimacy With A Dysfunctional Core

by Gillian Sukachevin, MSPT

Sexual dysfunction is painful, disruptive and debilitating in so many ways and can arise from many different issues. But think about it. Even if you don’t have a debilitating condition, who wants just so-so sex? Sex is supposed to be something amazing—-something we look forward to. A simple weakness in one part of the core or pelvic floor muscles can cause misalignment in the spine and pelvis that affects the whole body, resulting in the lack of response or interest. That can be frustrating for both ourselves and our partners.

Regardless of whether we are already experiencing sexual dysfunction or looking to prevent future issues, it is easy to see how caring for our core and pelvic floor muscles can help with enhancing our sexual experience.

There are many sources claiming to have the answer with positions, medication, exercises, creams, supplements, tools and toys, not that it is wrong to have a prescription for a pill or a treasure trove of gadgets and gizmos. The fact is that there is a market for people who want better sex. But what if the solution was actually more simple than that?

Many women struggle with the lack of libido or orgasm. Men deal with sexual dysfunction as well. Let’s first look at some common conditions that affect sexual activity.

Painful Intercourse

Over the years, I have seen women who wait years before seeking help for sexual pain and dysfunction. Dyspereunia, vestibulitis, vulvodynia and vaginismus are different disorders that describe pain with sex in women. There are many different factors that can contribute to these conditions.

Pelvic Disorders & Disease

Pelvic floor disorders can come from injury, trauma or mechanical conditions that have led to weak or misaligned muscles. Any kind of infection or inflammatory condition can also easily create an environment that snowballs into pelvic floor dysfunction. Frequent urinary tract or yeast infections, prolapse of internal organs and urge or stress incontinence are common issues that accompany or can lead to pain with sex. Structural restrictions and adhesions can also occur from surgeries, injuries, repetitive strain, digestive issues, restrictive clothing, pregnancy and poor posture. This can lead to decreased blood supply and lymphatic flow that affect our libido or ability to have an orgasm.

Mental Mindset

Some women have come to believe that they will never be able to experience an orgasm or think that sexual satisfaction wanes with age and after childbirth. Some women think it is the lack of experience or perhaps anxiety about it that is affecting their dissatisfaction. While it is true that there are many factors that can lead to sexual dysfunction, many of these conditions and situations are preventable and highly treatable.

Erectile Dysfunction

Mild to moderate erectile dysfunction (ED) affects about half the population of men. Our sexual organs need blood flow for engorgement for sexual performance and pleasure. If the pelvic floor has compromised blood flow, engorgement of these areas of stimulation will also be insufficient or will not happen at all. Decreased blood flow, overcompensating or weak muscles can also be a cause of premature ejaculation. Prostatitis (the inflammation of the prostate gland) is also a fairly common male disorder. It affects libido and can cause impotence. Did you know that 95% of its symptoms are nonbacterial and are most likely to be caused by pelvic floor dysfunction? Studies have shown promising results for men who have received appropriate rehabilitation for their core and pelvic floor muscles.

Our pelvic floor is made out of muscles, ligaments, tissues and nerves that are crucial to sexual performance and pleasure. Our core muscles are also very important in order for our pelvic floor to be engaged appropriately. Assessing the condition of our core and pelvic floor will help us understand how to achieve the stimulation for arousal and more satisfying climax we desire, while keeping our sexual organs healthy and vital. After all, an orgasm is made of muscle contractions.

Functional core strengthening can help with decreasing and eliminating the disorders that are provoked by the collapse or prolapse of the bladder, uterus or rectum into the pelvic floor. Addressing the weaknesses and restrictions in those structures with purposeful movement and skilled manual therapy can help restore nourishment and healing to our muscles and joints.

Our core and pelvic floor muscles consist of two kinds of muscle fibers—-fast twitch and slow twitch. Fast twitch muscles are built for quick forceful movements whereas slow twitch muscles are built for endurance. The transverse abdominis muscle that helps keep you upright and prevent you from having back pain is primarily made out of slow twitch muscle fibers. The pelvic floor diaphragm that stabilizes your pelvis and support your organs also consists primarily of slow twitch muscle fibers. With that in mind, we can work on training appropriately to gain stronger and more resilient core and pelvic floor muscles so that we can experience the intensity and longevity we desire. Doesn’t that sound lovely?

So next time you see an advertisement about sexual dysfunction reminding you to ask your doctor if a pill is right for you, it might be worthwhile to ask about physical therapy for core and pelvic floor rehabilitation. Healthy and satisfying intimacy is an important part of our sexual relationships. The solution to the intimacy we desire may not be as expensive or time consuming as we think. It may be a matter of working on healthier, more functional core muscles.

About Gillian:

Gillian is a physical therapist with over 20 years of experience. She is a core rehabilitation and pelvic floor specialist and the co-creator of Floor of Your Core, an online core and pelvic floor rehabilitation program, with The Tummy Team. Gillian has a passion for helping people build a better relationship with their own bodies so that they can enjoy caring for their families and marriages without suffering. She also uses Holistic Pelvic Care™ and  visceral manipulation in her practice. Gillian is a mother of 2, loves a good cup of tea, enjoys playing the piano and practicing tai chi. You can follow her on Instagram and Facebook (@FunctionalPelvicFloor).