"Your tests are normal." For many people experiencing pain during sex, these words are both reassuring and incredibly frustrating. On one hand, it's good news that there isn't an infection, tear, or serious medical condition. But on the other hand, you're still left wondering: "If everything is normal... why does it hurt so much?" The reality is that pain during sex is common, but it's not something you should simply put up with. And importantly, normal test results don't mean your pain isn't real. In many cases, pain during sex is related to how the muscles, nerves, and tissues are functioning—not just how they look. Is it normal for sex to hurt? No. While temporary discomfort can happen from time to time, pain that is ongoing, recurrent, or causes you to avoid intimacy is not considered normal . Pain during sex can affect people of all ages and may occur: at the entrance of the vagina with deeper penetration during certain positions after intercourse or even for hours afterwards. No matter where or when it occurs, persistent pain deserves assessment. Why can everything look "normal" but still hurt? Many conditions that cause pain don't show up on scans, blood tests, or routine examinations. Think about a tension headache. Your brain scan would usually be normal—but that doesn't make the pain any less real. The same can happen with the pelvic floor. Your muscles may be: overly tight difficult to relax sensitive to touch uncoordinated protecting the area after previous pain, injury, childbirth, or surgery. These changes are about function , not necessarily structure. The pelvic floor's role in painful sex Your pelvic floor muscles form a supportive sling at the base of your pelvis. For comfortable penetration, these muscles need to: relax lengthen coordinate with breathing respond appropriately to movement. If they remain tense or become protective, penetration may feel: sharp burning stretching like "hitting a wall" or simply impossible. This doesn't mean the muscles are weak—it often means they're working too hard. Stress can affect your pelvic floor Stress doesn't just affect your mind—it affects your body. When we're stressed or anxious, we often unconsciously: clench our jaw tense our shoulders hold our breath tighten our abdominal muscles brace our pelvic floor. Over time, this constant muscle guarding can contribute to persistent pelvic tension and discomfort. That doesn't mean the pain is psychological. It means your nervous system and muscles are closely connected. Other factors that may contribute Pain during sex is often influenced by more than one factor. These may include: previous painful experiences childbirth pelvic surgery hormonal changes endometriosis bladder pain bowel dysfunction constipation menopause skin conditions nerve sensitivity persistent muscle tension. A thorough assessment considers all of these—not just one possible cause. "It's all in your head"—a harmful myth One of the most upsetting things people hear is that because their tests are normal, the pain must be psychological. That's simply not true. Pain is always real. Even when scans or examinations don't identify a structural problem, your nervous system, muscles, connective tissues, and movement patterns can all contribute to ongoing symptoms. Understanding what's driving your pain is the first step towards improving it. How can a pelvic floor physiotherapist help? A pelvic floor physiotherapist doesn't just look for weakness. They assess how your pelvic floor muscles: relax contract coordinate respond during breathing and movement contribute to your symptoms. Depending on your individual needs, treatment may include: education about pelvic pain breathing and relaxation strategies pelvic floor muscle down-training gentle manual therapy where appropriate movement and stretching exercises bladder and bowel advice strategies to reduce muscle guarding. If another condition is suspected, your physiotherapist may also work alongside your GP, gynaecologist, or other healthcare providers to ensure you receive comprehensive care. Frequently Asked Questions Can tight pelvic floor muscles cause pain during sex? Yes. An overactive or tight pelvic floor can make it difficult for the muscles to relax during penetration, contributing to pain or discomfort. A pelvic floor assessment can determine whether muscle tension is playing a role. Why do my scans keep coming back normal? Many causes of painful sex relate to how muscles and nerves function rather than changes that appear on imaging. Normal scans are reassuring, but they don't rule out pelvic floor dysfunction or other functional causes of pain. Should I keep having sex if it hurts? Persistent pain during sex shouldn't be ignored. Continuing to push through pain can sometimes reinforce muscle guarding and fear of pain. It's important to seek assessment so the underlying cause can be identified and managed appropriately. The Bottom Line Pain during sex is common—but it isn't something you have to accept as "normal." If you've been told that everything looks fine but intimacy is still painful, know that your experience is valid. Many causes of painful sex involve the way your muscles, nerves, and tissues are functioning, and these issues often won't show up on routine tests. A pelvic floor physiotherapist can help identify the factors contributing to your symptoms and work with you to develop a personalised treatment plan, so you can move towards comfortable, confident intimacy again. You deserve answers—not just reassurance that your tests are normal. If pain during sex is affecting your quality of life or relationships, book an assessment with one of our pelvic health physiotherapists to take the first step towards understanding and treating the cause.

Understanding Mastitis & How Physiotherapy Can Help Mastitis is one of the most common challenges faced by breastfeeding women — and it can be incredibly painful and distressing. But the good news? With the right support and early intervention, recovery is usually quick, and breastfeeding can continue comfortably. What Is Mastitis? Mastitis is inflammation of the breast tissue, often caused by milk not draining properly (known as milk stasis). When milk remains trapped, it can irritate the tissue and lead to swelling, pain, and sometimes infection. Common signs and symptoms include: Localised breast pain, tenderness, or burning A firm, red, or hot area on the breast Swelling or lumpiness Fever, chills, and flu-like symptoms Feeling generally unwell or fatigued It’s important to seek help early — untreated mastitis can worsen quickly and may require medical treatment such as antibiotics. How Physiotherapy & Ultrasound Therapy Can Help Many people are surprised to learn that women’s health physiotherapists can play an important role in managing mastitis. Alongside medical care and lactation support, physiotherapy can help reduce pain, inflammation, and improve milk flow — especially when using therapeutic ultrasound. What Is Therapeutic Ultrasound? Therapeutic ultrasound uses gentle sound waves to help soften and disperse blockages within the breast tissue. The treatment is non-invasive, painless, and supported by evidence for its role in improving symptoms and promoting recovery. Ultrasound therapy can help to: Break down blocked ducts Reduce inflammation and swelling Improve milk drainage and flow Relieve pain and discomfort Support faster healing Sessions are typically short and safe to continue while breastfeeding. Beyond Ultrasound: Comprehensive Care At your physiotherapy appointment, we’ll do more than just treat the symptoms. We’ll look at the whole picture — what may have contributed to the blockage, and how to reduce the risk of it happening again. This may include: Reviewing your feeding or pumping techniques Recommending gentle self-massage and drainage methods Providing positioning advice for better milk flow Teaching preventative strategies for future episodes Every treatment plan is tailored individually — because every feeding journey is different. When to See Your GP If you experience fever, chills, or flu-like symptoms, or if your symptoms do not improve within 24–48 hours of treatment, it’s important to see your GP. Antibiotics may be needed alongside physiotherapy. The Takeaway Mastitis can be painful — both physically and emotionally — but it’s also very treatable. Early intervention and the right combination of care from your GP, lactation consultant, and women’s health physio can make a world of difference. Ultrasound therapy is a safe, gentle, and effective part of that recovery — helping you get back to feeding comfortably, confidently, and pain-free.

The Role of Pelvic Floor Physiotherapy After a Hysterectomy A hysterectomy is a significant surgical procedure, and while it can be necessary for a range of medical conditions, recovery requires careful consideration. The pelvic floor and core do not automatically restore their previous function following surgery. Regardless of whether the procedure was performed via an abdominal, vaginal, or laparoscopic approach, targeted rehabilitation is often essential. Pelvic floor physiotherapy provides evidence-based strategies to optimise healing, restore function, and support long-term pelvic health. Below is an outline of how a physiotherapist may assist across the different stages of recovery. Early Recovery (0–6 Weeks) Focus: Education, Protection, Gentle Awareness During the initial post-operative phase, the priority is to protect healing tissues and establish safe movement patterns. A physiotherapist may provide: Pelvic floor education — guidance on how surgery has altered pelvic support, biomechanics, and bladder/bowel function. Breathing and core coordination — gentle diaphragmatic breathing techniques to reduce tension, support circulation, and minimise swelling. Safe movement and postural strategies — instruction on bed mobility, transfers, and walking to avoid unnecessary strain. Scar and tissue healing advice — information to optimise scar recovery, reduce the risk of adhesions, and monitor for signs of complications. Mid Recovery (6–12 Weeks) Focus: Activation, Strengthening, Confidence Once surgical healing is established, rehabilitation progresses to restoring muscle activation and movement control. This may include: Pelvic floor muscle retraining — graded internal or external exercises focusing on coordination, endurance, and strength. Core muscle activation — re-education of deep abdominal muscles, particularly the transversus abdominis, in synchrony with the pelvic floor. Postural alignment and movement retraining — addressing compensatory patterns or protective guarding to optimise pelvic loading. Scar mobilisation — manual therapy to improve tissue mobility, circulation, and sensitivity. Later Recovery (3+ Months) Focus: Return to Function, Fitness, and Lifestyle The longer-term phase of rehabilitation supports a safe return to higher levels of activity and addresses ongoing pelvic health needs. This may involve: Exercise progression and return-to-sport planning — individualised advice for safely resuming walking, lifting, gym training, Pilates, or sport while minimising risk of prolapse or core dysfunction. Bladder and bowel retraining — management of urgency, leakage, or constipation, which may present post-surgery. Support for intimacy and pelvic pain — rehabilitation for dyspareunia, vaginal tightness, or scar-related discomfort. Prolapse prevention and long-term pelvic health — strategies to manage intra-abdominal pressure and maintain pelvic organ support. Why Consult a Pelvic Floor Physiotherapist? Pelvic floor physiotherapists are trained to assess not only the muscles, but the integration of breath, core, scars, posture, and daily movement patterns following surgery. This holistic assessment allows for a tailored rehabilitation plan to support both short- and long-term recovery. Importantly, it is never too late to commence pelvic floor physiotherapy. Whether a patient is six weeks or six years post-hysterectomy, physiotherapy can assist in improving function, comfort, and quality of life.