Healthy Beginnings

Want to enjoy optimal sex? A healthy pelvic floor is essential

Women can relax a tight pelvic floor by trying yoga’s happy baby pose (a.k.a. the Ananda Balasana pose) prior to sex.

I am often asked the question, “What is pelvic health?” Usually the person asking thinks that I am saying “public health,” so I see myriad surprised looks when I begin an explanation of the sling of muscles located between the pubic bone and tailbone that have a sexual role, responsible for sexual arousal, sexual function and orgasms.

Other responsibilities of the pelvic floor include controlling urine, controlling feces and gas, and supporting internal organs and support of the spine and pelvis. The pelvic floor is the unconditional source of human power and vitality, affecting many aspects of our lives — a significant area being our sexual health.

When our sex lives are fulfilling, and everything works as we think or know it should, we don’t question it. But what happens when sex doesn’t work correctly or the way it had for you or your partner in the past — or if sex has never worked for you, with or without a partner?

Problems that may occur range from painful sex to an inability to achieve orgasm or an erection, among others.

The pain may occur with deep penetration, with erection, after orgasm, with entry or preventing entry, and the pain may linger for hours to days. Many problems that cause pain with sex have a physical component affecting the pelvic floor muscles, and it’s important to know that relief is possible.

Tightness or injury in the lower back, hips or pelvic floor and/or muscular trigger points in these areas can lead to pelvic pain and sexual difficulty.

Trigger points are those “knots” within a muscle, tender when touched and can create pain when untouched. Trigger points are known for referral patterns to other areas, contributing to muscular shortening, spasms and tightening, and non-muscularly to vaginal dryness and other sexual difficulties.

Sexual health is an integral component of wellness and it impacts our overall wellbeing through its involvement in our physical, emotional, mental, social and spiritual dimensions.

Achieving orgasm is more complicated in women related to pelvic floor activity, physical anatomical variations and the nervous system, and although achieving orgasm does not have to be the outcome of every sexual encounter or for intimacy, a healthy pelvic floor will improve the strength of orgasms.

If your sexual and pelvic health are both in peak condition, maintain a continued focus on healthy sexuality that changes as you change. This involves familiarity of the physical aspects of sexual anatomy and the pelvic floor, as well as the multi-factorial aspects of sensory, emotional, psychological, intellectual, social, cultural and spiritual.

If you experience pain or difficulties with sex, it is vital to rule out other causes, such as cyst or infection, through visiting your physician. Clear, positive communication and respect are key to healthy intimacy and sexuality.

Support your partner in sexual challenges by working together to gain an understanding as you work with an expert and address all your concerns immediately for quick resolution.

Use a team approach of a physical therapist specializing in pelvic health, a physician and a counselor or sex therapist. Pelvic health is possible and everyone deserves a satisfying and vibrant sex life.




  1. Relaxation of a tight pelvic floor prior to sex:
  • Women can try the yoga happy baby pose — lie on your back, bring knees to belly, grasp outside of feet with hands, open knees slightly wider than torso and bring knees toward armpits. Shins should be perpendicular to the floor.
  • Deep diaphragmatic breathing during initial entry or other times of sexual discomfort will help to loosen a tight pelvic floor.
  • A side-lying position with partner behind you allows leg muscles to relax.


  1. Stronger orgasms:
  • Lying on your back, knees bent, feet flat on the floor — contract the pelvic floor muscles by pulling up and in vaginally for women and rectally for men.
  • Hold 10 seconds maintaining a consistently strong contraction, then rest for 20 seconds. Repeat 10 repetitions. Perform 2x/day every other day. Then perform quick full contractions with immediate relaxation as fast as you can. If unable to hold for 10 seconds, start with 5 seconds.
  • If difficulty contracting or if the muscles are tight, contact a physical therapist specializing in pelvic health.

Dr. Karla Moore, DPT, OCS

Dr. Karla Moore is a Doctor of Physical Therapy, Board Certified as a Clinical Specialist in Orthopaedic Physical Therapy, specializing in Pelvic Health and solutions to persistent pain conditions. She is the owner of NeuroFit Wellness & Physical Therapy in Reno. Contact her at or 775-863-8766. Visit to learn more.