- Hip Pain and Sex: Staying Intimate
- What It Means If Your Body Aches After Sex
- 1. Your pelvic floor needs a workout.
- 2. You’re putting too much strain on your back.
- 3. You may be dry down there.
- 4. But it could also be an indication of something serious.
- 5. It may all be in your head.
- 6. Things got a little too intense.
- 7. You’re dehydrated.
- 6 Sex Positions Worth Trying When You Have Arthritis
- Face down, legs together
- Face down, bottom up
- Standing up, facing a wall
- Straddling sitting up or laying down
- Pull out the toy box
- Keep Reading
- Hip Pain and Sex: Care Instructions
- How can you care for yourself at home?
- 8 Sex Positions For Truly Inflexible People
- 1. Modified Open-Legged Spoon
- 2. Downward Dog
- 3. Lotus
- 4. Elevated Doggy-Style
- 5. David Copperfield
- 6. Sit To Stand
- 7. Lifted Missionary
- 8. Standing Doggy-Style
- Medical Notes
- Remember: Sex Isn’t Only About Penetration
- Initial Tips to Reduce Pain
- Sexual Positions for Different Types of Chronic and Acute Pain
- Sex Positions for Back Pain
- Sex Positions for Knee Pain
- Sex Positions for Hip Pain
- Sex Positions for Arthritis/Osteoarthritis
- Make Sex Pleasurable For Both Of You
- Positions for an Aching Back
- Bad Knee? Take a Seat
- Hips Don’t Lie
- For a Pain in the Neck
- Woman on Top
- Positions for Pregnant Moms
- Sometimes Size Does Matter…
- … But Not All the Time
- Positions for a Small Vagina
- Positions for Larger Body Size
- Too Tall or Too Short?
- Additional Tips
- What Do YOU Think?
- 1. You skipped the foreplay (or lube).
- 2. Your session was especially long or frisky.
- 3. Your birth control is to blame.
- 4. Your pelvic floor muscles are tight.
- 5. Your skin is reacting to products.
- 6. You have a medical condition.
- Back and Hip Problems That Can Make Sex Hurt
- How physical therapy can help
- Pelvic Congestion Syndrome
Hip Pain and Sex: Staying Intimate
Hip pain makes it hard for you to walk and get through your day, and that means it may also be interfering with your sex life. But you can enjoy sex with less pain, both before and after hip replacement surgery.
Hip Pain and Sex: Discussing the Problem
Hip pain has long been recognized as an obstacle to sexual intimacy. In the 1970s, a survey found that one in four people with osteoarthritis of the hip believed hip pain was causing problems with their marriages, and two-thirds wanted advice about having sex despite hip pain.
Yet decades later this issue still remains difficult for patients to talk about, says Amy Humphrey, DPT, a physical therapist at Body Dynamics, Inc. in Arlington, Va., and spokesperson for the American Physical Therapy Association.
Women may have even problems undergoing a gynecological exam for a pap smear, so the difficulties are not limited to the bedroom, says Humphrey.
Hip Pain and Sex: Finding Solutions
“Hip pain can interfere with your sexual intimacy,” says Humphrey, explaining that women with hip pain typically won’t be comfortable in the traditional missionary position (lying on their backs) because of the abduction movement it requires of the hip. She suggests the following positions for patients with hip pain:
- Try lying on your good side; a side position is actually better because that hip doesn’t have to be in an extreme range-of-motion position, says Humphrey.
- Avoid positions that force you to rotate your legs outward or cross your legs.
- Use pillows or a bed wedge to cushion your body, if that helps. “Set up with pillows or support in different places to make it a more comfortable experience,” she says.
Hip Pain and Sex: After Hip Replacement Surgery
Although very rare, it is possible for a new hip to be dislocated during sex and require another surgery. Your orthopedist will probably tell you to avoid sex for up to eight weeks after surgery. Make sure to ask about this before surgery and at your six-week post-operative appointment. But even after you are given the go-ahead, take it slow.
Sexual activity should be less painful than it was before the operation. Women and men who have had hip replacement can lie on their backs during sex with pillows for support as they gain strength and endurance.
“After hip replacement surgery, you do have hip precautions depending on what kind of surgery you had. You may be told not to cross your legs or internally rotate your legs,” advises Humphrey.
You will also have to be mindful of certain movements after hip replacement surgery, whether during sex or while participating in other activities.:
- Do not bend at the waist.
- Don’t lift heavy weights (such as your partner).
- Keep a pillow between your legs when on one side or the other.
- Avoid twisting at the waist.
Whether you are experiencing hip pain or recovering from hip replacement surgery, you can maintain an active sex life. Be creative, have patience with yourself, and remain open to new positions.
What It Means If Your Body Aches After Sex
We’ve all been there.
We’ve all been there. You just had amazing sex and you’re cuddling with your partner, when you start to feel cramps or pain you haven’t felt before. It takes the mood right out from under you and you find yourself on Google desperately wondering what it could be.
One common thing we all forget is a huge factor in our lives and will always come into play? Water. Stay hydrated during the day so when night comes, you’re not left feeling sick or having body aches. Staying hydrated fuels your muscles and relieves a lot of tension in your body, and it can prevent a lot of the issues listed below.
We chatted with doctors and health experts to bring you a list of the common causes of feeling sore after sex. Of course, consult with your doctor about any pains going on in your body, but don’t let yourself panic!
1. Your pelvic floor needs a workout.
While your my mind may jump to some scary conclusions, let’s be rational for a second. Sometimes if you’re sore after intercourse, it’s just plain ol’ muscle cramps. If you have a weak pelvic floor, this could leave you with some discomfort during and after sex.
You can exercise these muscles by tightening and then releasing 10-15 times.
2. You’re putting too much strain on your back.
If your back is causing problems after sex, it may be time to reconsider some positions in bed and maybe pay a little more attention to core and upper body workouts at the gym. According to Floyd N. Keller Jr., the National Director of the Pan American Sports Federation, back pain can be caused by a number of different positions during sex:
“Keep in mind some positions like the woman on top can put stress on your lower back. Although you may feel you are not expending too much energy in this position, depending on the weight of your mate, you can be pushed deeper into the mattress and your lower back muscles will try to compensate trying to lift your hips up to balance you out.
Now, depending on how adventurous you and your partner are with positions, having sex while standing and carrying your partner (picture piggyback ride but the passenger is in the front) can also put a heavy demand on your lower back. Both these positions will limit you to primarily hip movements involving the lower back, whereas some positions allow for more of your body to be included in on the motion (think missionary or doggie),” Keller said in an interview.
Keller advises to strengthen your core and lower abdominal muscles to help combat pain in these areas.
3. You may be dry down there.
According to Samantha Morrison, a health and wellness expert at Glacier Wellness, she suggests women be more aware of vaginal dryness.
“While it is most commonly associated with aging women due to decreased estrogen production, vaginal dryness can happen to anyone suffering from dehydration. Besides for causing flaky skin, itchiness, and infections, vaginal dryness can severely hamper any sexual pleasure and lead to post-coital bleeding. Fortunately, a dry vagina can easily be solved by increasing foreplay or by incorporating sexual lubricants,” Morrison advises.
4. But it could also be an indication of something serious.
Multiple Sclerosis is an immune disorder in which the protective covering of your nerves gets eaten away. Morrison explains, “Because sexual arousal begins in the central nervous system (CNS), multiple sclerosis can play a major role in one’s sex life. In addition to altering mood and energy levels, MS often causes impaired sexual sensitivity or painful intercourse. In fact, studies show that nearly 7 out of 10 women with multiple sclerosis experience vaginal dryness.”
5. It may all be in your head.
Dr. Deepali Raina, an online gynecologist for icliniq.com, weighed in on the symptom of pain during sex.
“Pain after sexual intercourse may happen in conditions like pelvic inflammatory disease, severe endometriosis, or vaginismus. Some women may have a septated vagina which may lead to pain. Prolapse of the uterus or urinary bladder may also give rise to pain or vague discomfort after intercourse,” she says.
But she also advises that while all of these could be viable options as to why you’re hurting, it could just be down right psychological. According to her, “Too much of physical labor leading to excessive sweating during sex may cause muscle pains due to dehydration. Women may experience pain in hip or knee joint due to prolonged flexion at these joints in various sex positions.”
6. Things got a little too intense.
Lindsay van Clief, a certified sex educator, says that sometimes we don’t always realize how intense things can get in the moment.
“Our bodies’ pain tolerance is increased during sex by endorphins which are released from the physical activity and excitement you are experiencing. This is the biochemical excuse for being ‘swept away in the moment’. You may over stretch or over exert yourselfand not realize 100 percent the effects of your body. It might not be until after or even the next day that you understand how it affected the body.”
7. You’re dehydrated.
van Clief also can’t say enough about the importance of water and the affect it has on your muscles. Her point? Drink more water!
“One of the leading causes of muscle aches is dehydration. Make sure you are hydrated before and after sex to help your body take care of itself. Particularly if you have been out drinking and dancing, you need water to support all the sweat, and fluids that leave the body during sex (as well as keeping your body normally hydrated),” she warns.
Shelby Slaughter’s favorite things include: Her dog, tacos, avoiding the gym, and everything “How To Get Away With Murder” and “This Is Us.” You can usually find her at a party near the food or obsessively Googling anything relating to Taylor Swift.
6 Sex Positions Worth Trying When You Have Arthritis
Let’s just get straight to the point: Sex is great! It’s good fun and good for you — unless it hurts. And people with arthritis are all too aware of how quickly sex can go from “wow” to “whoa” when you’re coping with chronic pain or pain brought on by certain movements. I mean, nothing says sexy like “I think you’re breaking my pelvis.”
But that doesn’t mean you should avoid sex. In fact, sex is one of the best activities you can do for arthritis, says Laura Deitsch, a licensed clinical professional counselor and sexologist with Vibrant.
Sex is gentle, low-impact exercise. The endorphins released by a good orgasm can even reduce pain and inflammation, Deitsch explains. The trick is finding sex positions that maximize pleasure while avoiding your particular pain spots.
These tips for a hotter sex life with arthritis can help too.
“Arthritis patients live with chronic pain that isn’t alleviated by time, stretching, or simple healing,” she says. “So in order to keep lovemaking happy with an arthritic body, we have to get creative.
Finding the ideal position will be very individual, but these six are worth giving a shot. Keep an open mind and read on:
Face down, legs together
Have the receiving partner lay down on their stomach on the bed while the giving partner enters from behind. If the receiving partner has hip, hand, and/or knee problems, laying on the stomach will provide a lot of relief, Deitsch says. Plus, squeezing the legs together can help increase and intensify an orgasm in women. (There’s a reason so many ladies self-pleasure in this position.) Avoid this position if you have neck issues, she cautions.
The receiving partner lays face down with a wedge or regular pillow to support their hips and lift their butt up in the air. The giving partner enters from behind. Entering from behind, as opposed to face-to-face, requires less stretching of the hips, legs, and pelvis for the receiving partner, Deitsch says. This can help the bottom partner if they have sore hips or their back prevents them from lying flat; if the top partner is the one in pain, this move doesn’t put as much pressure on their knees or low back.
Standing up, facing a wall
Standing up takes the pressure off the receiving partner — literally, Deitsch says. Have the receiving partner stand facing a wall, bracing themselves with their hands or forearms, while the giving partner enters from behind. This allows the giving partner to offer additional support if necessary and the standing position requires less stretching of the pelvic area and less stress on both people’s shoulders, she adds. If height presents a problem, try having the shorter partner stand on a sturdy box.
Straddling sitting up or laying down
Having one partner straddle the other during sex offers several advantages for people with arthritis, she says. You can have the giver or the receiver in either position. For the person laying down, this takes pressure off knees, ankles, and feet while allowing for the hips to be supported with pillows. If back pain makes lying flat too difficult, the person on the bottom can sit up with their back propped up. For the person doing the straddling, this takes pressure off the hands, elbows, wrists, and shoulders, while still allowing for intimate eye contact. This also allows the person on top to control the speed and depth of penetration.
“Scissoring sideways can be helpful for people who are experiencing hip or back issues or who find thrusting painful,” Deitsch says. While it may take some maneuvering at first — you just need to get into a position where you can grind your genitals on the other person in some way — eventually you should be able to relax into it. “This position allows people to adjust themselves and not have as great of a thrusting impact which can reduce pain,” she explains.
Pull out the toy box
Sometimes there simply is no position that is perfectly comfortable for both partners, but that doesn’t mean you both can’t have a mutually satisfying experience or that one needs to suffer for the other, she says. Enter: adult toys.
“As joints stiffen in the hand, vibrators can act as a tool for fingers that aren’t as mobile or nimble,” Deitsch explains. She recommends the Palm Power specifically for arthritis patients, thanks to its wide array of attachments, or the Mimic for those looking for a more natural experience. As an added bonus, some studies have found that vibration can reduce inflammation and pain in joints, she adds. Win/win.
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Some 53 million adults in the U.S. suffer from arthritis, according to the CDC, and while it’s an oft-talked about condition, there’s one not-so-pleasant aspect of it that’s harder to open up about: Living with debilitating joint pain and fatigue can make sex feel like an unpleasant chore.
(The 21-day plan in Love Your Age is the life-changing reset every 40+ woman needs!)
The good news is that you’re not doomed to lead a sexless life forever. In fact, many people who suffer from arthritis find some pain relief in regular low-impact physical activity—and sex definitely counts, says integrative physician Andrea Pennington, MD, author of The Orgasm Prescription for Women: 21 Days to Heightened Pleasure, Deeper Intimacy, and Orgasmic Bliss.
The key to maximizing pleasure and alleviating pain is to plan ahead a little bit. (Prevention Premium’s Dr. Ian Kerner, PHD, talks about the benefits of scheduling sex.) If, like many arthritis sufferers, you find that your pain is worse in the mornings, Pennington recommends making time for sex in the afternoon or evening, after you’ve had a chance to walk around and be active. “This helps your joints to be more limber so when it’s time to be intimate, you’ll be less stiff,” she says. “I recommend staying active with as much daily walking as you can tolerate.”
Pennington also recommends regular meditation for all her patients with arthritis. “It’s been shown to decrease pain as well as mental distress, so it’s an excellent addition to an overall healthy lifestyle that can also have a positive impact on your sex life,” she says.
A third—and way more fun—way to lessen joint pain when you and your partner do decide to get busy is to prolong foreplay with a warm bath or a gentle massage. In addition to relaxing your joints and melting away stress, it can go a long way toward putting you in the mood.
And finally, being strategic about the sex positions you choose will help too. Doggy-style and standing-up sex might put a lot of pressure on your joints, but there are plenty of others left to try out. Pennington says these five are the best for relieving joint pain while bringing you and your partner closer together.
Hip Pain and Sex: Care Instructions
How can you care for yourself at home?
- Learn which sexual positions may be good or bad for your hips. For example, some hip problems cause pain when you bend forward. Others cause problems when you lift your hips or arch your back.
- Try positions you’ve never considered before. You may need to use a firmer surface than your mattress, such as a soft rug on the floor or even a sturdy chair. Oral sex might be easier than intercourse.
- Go slow. Sex is like exercise—warming up and stretching first are important. Many people use yoga to gently stretch their muscles. When you’re ready to have sex, keep your movements slow and gentle.
- Take a hot shower to help relax your muscles. Or have your partner give you a massage.
- Increase the time you and your partner spend in touching and caressing each other before sex (foreplay).
- If it hurts, stop. That may seem obvious, but when things get passionate, it can be hard to stay in control. Try to keep it slow so that you can stop right away if your hips start to hurt.
8 Sex Positions For Truly Inflexible People
Inflexible people have sex, too. We can’t all be bent into pretzels and simultaneously orgasm our faces off. For most of us, this is not the reality.
When I say inflexible, I’m not being cute here. I’m not just casually dropping this word to mean non-yogis or those unqualified to be Cirque du Soleil acrobats. What I mean by inflexible is having to go to yoga twice a week just to touch your shins. THAT level of immobility.
You shouldn’t be left by the wayside just because you can’t stand on one leg or put your feet next to your ears during sex.
Sometimes you want to do even the simplest of suggested positions on one of these lists, only to find your leg does not move in that direction, or your knees are too pained to stay in that kind of isometric hold for such a prolonged duration.
It’s not fair! We want to get off too, you know.
You shouldn’t be left by the wayside just because you can’t stand on one leg or put your feet next to your ears during sex. It feels like every sex position guide forgets those of us who can’t outwardly rotate our hips or do a backbend (or any bending, TBH).
In light of this fact and because stiff joints don’t deter horniness, here are eight sex positions for truly inflexible people.
1. Modified Open-Legged Spoon
This take on the classic spoon makes clit access easier, all while staying true to its lazy-girl roots. This is the position we’re going to call upon when we’re sexually active geriatrics so, take heed.
Have your partner lie on his or her side, and lie on your back, perpendicular to his or her body. Your partner should be able to enter you from below easily.
If you can’t open your knees for a full open-legged spoon, this position is for you. Instead of rotating your hips in a butterfly spread (because you literally can’t), drape your knees over your partner’s side. You get to lie back, legs just slightly elevated, knees comfortably bent.
2. Downward Dog
Did someone say, “You don’t have to move during this sex position?” Sign me up.
When you’re inflexible, a sex position that allows you to do as little as possible is the best case scenario. Also, lazy sex positions are the best, objectively speaking. During downward dog, you get to just chill.
Lie on your stomach and have your partner enter from behind. Seriously, just lie there with your legs together, flat on the bed, and enjoy your life. This position allows for pinpointed G-spot stimulation while you put in zero effort.
No strained muscles for you — only copious orgasms.
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A position with such an exotic name sounds pretty intimidating. Luckily, those of us with a lack of natural mobility still get the luxury of an exciting name.
To pull off lotus, have your partner sit on the bed. Climb on top and straddle them, face-to-face. Lotus is just another way of saying, “Sitting on your partner’s lap with a penis or dildo inside your body.”
You can set the pace, rocking back and forth, grinding your clitoris to reach orgasm.
4. Elevated Doggy-Style
The biggest issue an inflexible person has with doggy style is the pressure it puts on your knees. For me, this even happens when I’m on the bed. If you’re trying to get down and dirty on the floor, on a couch, on some grass, etc., it’s a whole other hellish story.
To combat achy knees, try a slight modification to the classic doggy. Stick a pillow under each of your knees. The added layer of comfort makes a world of difference. If you have sensitive wrists, put another pillow underneath your hands.
Voila! You can finally have sex comfortably.
5. David Copperfield
You know what is the best when you’re not bendy? Receiving some good, old-fashioned oral sex. Get to it.
6. Sit To Stand
Having sex standing up is both difficult, dangerous, and annoying. No one has an orgasm during standing up sex, probably. Instead, try sit to stand. Lie down on the bed, with your butt at the edge. Have your partner enter you while standing next to the bed. Wrap your legs around your partner (or whatever feels comfortable).
No one will break their hip or dislocate a shoulder. Instead, everyone gets to come. You can even bring in a finger vibe for extra stimulation.
7. Lifted Missionary
Lifted missionary is an excellent position in the event both you and your partner are lacking in the flexibility department.
This position allows for coital alignment technique: Your clitoris is better aligned with your partner’s pubic bone which allows for much-needed stimulation. Yes, that’s right. You CAN orgasm in missionary.
Lay me down for I am slain.
8. Standing Doggy-Style
As if you could ever get enough doggy style, this variation takes all the best aspects of sit to stand and downward dog, smashing them together to create one fantastic, uber-easy position.
Bend over the bed, feet on the floor, stomach to the mattress. Your top half should be relaxed and flat. If flat isn’t working for you, you can rest up on your elbows
Have your partner enter you from behind. You can easily reach through your legs for some ball sack or clitoral action, assuming your arm CAN do that.
In your case, maybe not. Either way, this position requires very little movement on your part which makes it an obvious winner.
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Sometimes, if you are suffering from chronic or acute joint or muscular pain, sex can be unpleasant, difficult, or even impossible. The pain of getting into the right position, thrusting, and moving in a natural rhythm with your partner increases existing discomfort. For people suffering from these conditions, sex might not seem worth it.
To us, that’s unacceptable.
When pain outweighs the pleasure of sex, couples can lose intimacy and become frustrated with themselves or their partners, which can lead to other relationship struggles. It’s a real problem; a pulled back from lifting something wrong in the yard can have rippling effects throughout a relationship.
Pain is bad enough. Pain that inhibits sex is a multiplying disaster. That’s why we’re so happy to offer these tips and alternative positions to reduce discomfort.
None of these will cure pain, or even lower it in day-to-day life. For that you need your doctor. But these are ways you can manage pain, or work around it, so that you and your partner can have the healthy sex life that you deserve.
There are occasions where your doctor tells you not to have sex, or that excessive physical action will be bad and exacerbate your chronic or acute pain. None of these tips are meant to circumvent that. If they don’t work, or they are painful, don’t do them. These are just ideas that you can practice if pain makes sex difficult.
These tips are just for joint, back, or arthritis pain. They are not recommendations for people suffering from dyspareunia, pelvic pain, vaginal pain, penile pain, or pain caused by STDs. If facing any of those, learn more and see your doctor.
Readers with specific disabilities may find some of these joint and muscle pain tips to be helpful, but for more disability-specific advice, please check out our page on sex toys and positions for people with disabilities.
Want to have a little bit of good pain during sex? Learn more about BDSM.
Remember: Sex Isn’t Only About Penetration
There is something weird about how there is “sex,” but then also “oral sex,” “non-penetrative sex,” “manual sex,” etc… As if sex can only be one thing, and everything else is a variation in a minor key, or somehow lesser. That isn’t true.
Sex can be what you and your partner want to do together, and it doesn’t have to fit into a narrow category. If you are having a lot of trouble moving, making thrusting penetrative sex too difficult, that doesn’t mean you have to forsake intimacy.
Other options include:
Initial Tips to Reduce Pain
There are ways to reduce pain before you have sex, or to prepare your body for action before intercourse. You won’t always have the luxury of planning these in advance, but if you do, they can help make sex less painful and more pleasurable.
- Take a warm bath. This will relax your muscles, leaving you looser and less tense. Less rigidity puts less pressure on your joints.
- Stretch out beforehand. Stretching is always a good idea when you have pain, especially before having sex, which often puts you in some unusual positions.
- Gather more pillows. These can be used under your back or butt to alter the way you’re lying. This can be very good for your back and knees, depending on the position.
- Mediation also relaxes your mind and body both.
- Plan in advance the positions you are going to do, and talk about it with your partner. Because in the heat of the moment, your rational brain isn’t always working, and you may think: I can totally do this reverse doggie-style double screwdriver! We’re not saying you have to have a script, but have in the back of your mind which positions you’ll be wanting to do—or wanting to avoid.
So which positions are the best for you? Well, it depends on what kind of pain you have. Let’s break it down.
Sexual Positions for Different Types of Chronic and Acute Pain
In a wide variety of positions, positioning toys can ease stress on joints by adjusting leverage or moving weight around. These toys can be helpful for many positions, including those we’re going to discuss below. Feel free to use them as you see fit. These are guides, not rules.
Best Positioning Sex Toys For Reducing Discomfort
With anchor pads that allow you to be restrained in any position on the bed, The Sportsheet can help alleviate pain from trying to maintain a position unassisted.
Linking your legs together, the G-Spot Link not only allows for deeper penetration, but also reduces the stress of holding your legs in place, and allows your partner to easily manipulate your legs.
Doggie Style Strap
Your arms use The Doggie Style Strap to aid in thrusting, reducing the stress placed on hips or other joints while still allowing for increased penetration in a variety of positions.
A Spreader Bar keeps your legs locked apart, reducing the strain of maintaining that position while letting your partner reposition your legs easily.
If joint pain makes thrusting difficult, wearing a Thigh Strap-On allows your partner to ride the dildo strapped to your thigh, so you can still experience face-to-face penetration without the pain.
Door Jam Cuffs
If you enjoy standing sex but want to take some of the weight off your joints, Door Jam Cuffs can shift some of that burden to your arms instead, and also aid in stability.
Super Sex Sling
For sex on your back, the Super Sex Sling provides a padded neck strap and cuffs you can hook your feet into, reducing the strain of holding your legs in position.
Suction Handle Bar
Attaching to most smooth surfaces, the Suction Handle Bar can help provide stability in a number of positions and locations.
Suction Foot Rest
As with the Handle Bar, the Suction Foot Rest will attach to most smooth surfaces, giving you a leg up to increase stability or ease of entry.
Sex Positions for Back Pain
At any given moment, 31 million Americans are suffering back pain. 80% will have back pain at some point or other in their lives. Should that eliminate sex for every one of these people? Of course not. Try these positions.
For more information on sex for those with bad backs, read our Best Sex Positions (Or Toys) For Back Pain or Injury.
Sex Positions for Knee Pain
After backs, knees are the most common form of pain, with over 100 million Americans reporting knee pain at some point in their lives. It may be an injury, arthritis, or you may have just wanged it on the edge of the bed. Whatever the cause, it doesn’t have to end or postpone your sex life.
Sex Positions for Hip Pain
Hip pain and damage can get gradually worse throughout life, and hip replacements are getting more common. Between 2000 and 2010, the number of hip replacements for Americans over 45 more than doubled, and as the procedure gets more advanced, it becomes more common.
It isn’t the end of anything, and people with hip replacements lead long active lives. But pain or replacement may require some sexual modifications and different positions.
For more information on sex for those with hip pain, read our 6 Tips for Enjoyable (and Safe!) Sex After Hip Replacement Surgery.
Sex Positions for Arthritis/Osteoarthritis
Here’s a bit of good news: it turns out that sex can actually help relieve arthritis! But that doesn’t mean it is always easy to do so. Arthritis, which can affect every joint, makes it more difficult to move, to thrust, or to grip, all of which can be vital for sex.
But, if you want to use sex to get better, or just have sex because, well, it is awesome, arthritis doesn’t have to stop you.
Since arthritis can impact your back, legs, knees, or hips (as well as arms and other joints, though those may not apply as much to sexual positioning tips), any of the above positions that correlate with your particular pain should work. Try what works for you.
For more information on sex for those with arthritis, read our Positions and Toys that Let You Have Exciting Sex Regardless of Your Arthritis post.
Make Sex Pleasurable For Both Of You
Our guiding advice is: do what works. Don’t think that you have to have sex the same way, and don’t think that the above positions are the only ones you can do. Experiment. Play around with angles and toys. Modify any positions you want.
After all, no one’s pain is exactly like anyone else’s… and no one’s sex life is exactly like anyone else’s—nor should it be! You and your partner have your own intimacy, your own secrets, your own private games and pleasures, your own favored positions. These might change to different degrees because of pain, but the intimacy and love behind them don’t have to.
Expand your ideas of sex. Change up your routines. Change your ideas. Pain isn’t the end of sex. It’s a call for more innovation. We’re glad to help.
When poet William Cowper said, “Variety’s the very spice of life, that gives it all its flavor,” he may very well have been talking about the bedroom.
A little (or a lot) of variety can make sex more fun and pleasurable, but when a physical condition makes certain positions challenging or painful, finding safe, creative alternatives is important.
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As you explore different positions, keep in mind that sex should never be painful, says Megan Fleming, Ph.D., a sex and relationships therapist in New York City.
“Too often, I hear of partners who grin and bear it because they believe their partner is close to climax,” she says. “This is a bad idea, because you will be reinforcing negative sensations and feelings about sex.”
Knowing they’ve caused you pain or discomfort can also be a turnoff for your partner as well, she adds.
To make sure you and your partner get the most out of your time in the bedroom (or whichever room you choose!), here are some experts tips on different positions to try:
Positions for an Aching Back
Back pain is the No. 2 reason for doctor visits, according to the American Chiropractic Association. But that doesn’t mean it has to keep you from satisfying sex. If you’re the one with back pain, avoid positions that put pressure on the spine, such as missionary position with you on the bottom.
“The partner who doesn’t have back pain should be taking the active role most physical exertion,” says Fleming.
Read More: 15 Exercises Every Woman Should Do to Improve Her Sex Life
Lie on your sides in a spooning position, she suggests. Either one of you can take the front role, or you can switch off, stimulating each other where it counts with a toy, your hands or your genitals. You can also flip into a “69” position on your sides so you can both give and receive pleasure at the same time.
Bad Knee? Take a Seat
Knee pain is another notoriously common ailment that can really put a damper on your sex life. If you have a bad knee, avoid positions that put pressure on your knees, such as “doggy style” or you on top.
For men with knee pain, Fleming says, a favorite is sitting on a chair and having their partner on their lap, facing forward or away from them. For women with knee pain, lying on their stomach or on their backs in missionary style is a good way to avoid knee strain — and everyone can benefit from the spooning position!
Hips Don’t Lie
“Different versions of missionary are fabulous for someone with a bad hip,” said Kait Scalisi, M.P.H., a sex and relationship educator in New York City. “It’s easy to make sure the hips are supported and aligned.”
Read More: Top 9 Foods for Men’s Sexual Health
Her recommended variation is the coital alignment technique, because it also provides the clitoral stimulation that many women need in order to orgasm.
“The person on the bottom lies with their legs straight and the back, hips and knees supported with pillows as needed,” she explains.
“The person on top lies with their legs open on either side of the other person’s. They support their weight evenly on their forearms, elbows, thighs and upper knees, again using a pillow wherever needed. Then the person on top slides their body upwards so your pelvises align.” Then, rather than thrusting forward and back, rock up and down.
For a Pain in the Neck
If you’re experiencing neck pain from a chronic condition or something as simple as sleeping awkwardly, avoid positions like being on the bottom in missionary. “Being on top is a great option here if you can easily hold your head up,” says Scalisi.
Read More: 13 Exercises Every Man Should Do to Improve His Sex Life
Spooning is another great option, she says, because you can use pillows to support your neck, head and shoulders. It’s also more challenging to move quickly in this position, so there may be less jostling. If you’re not in the mood to lie fully down, go for doggy style.
“The person on bottom can support their chest and neck with pillows,” says Scalisi. “And rather than have their partner thrust — again you want to avoid that jostling which could tweak the neck in a not-fun way — they can push back on to them and/or rotate their hips around them.”
Woman on Top
In her practice, Heather Jeffcoat, D.P.T., a Los Angeles physical therapist and author of “Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve,” sees cases of vaginismus and interstitial cystitis — conditions that make sex painful for many women.
Vaginismus causes involuntary muscle spasms around the vagina, while interstitial cystitis means recurring pain or discomfort in the bladder and surrounding pelvic area.
Read More: Signs You Definitely Need to See Your Gynecologist
With these and all sexual-pain disorders, Jeffcoat recommends avoiding the missionary position. Instead, start with the woman who is experiencing pelvic pain on top. This allows her to control the speed and depth of penetration.
“Many women are also more comfortable in a side-lying position with rear vaginal entry,” Jeffcoat adds.
Positions for Pregnant Moms
While it’s wise to check with your doctor, most women can continue having sex throughout their pregnancy. Amniotic fluid in the womb and the mucus plug, which seals your cervix and staves off infections, protect the baby.
Read More: 9 Foods for Better Sex for Women
“The only position to avoid when pregnant is missionary after 20 weeks, because a woman’s enlarged uterus puts pressure on her aorta,” says Fleming, “which could compromise blood flow to the placenta.”
If missionary is your favorite, adapt it by wedging a pillow under your left hip, she says, which helps shift the baby off the aorta. Otherwise, stick to positions like doggy style and spooning.
Sometimes Size Does Matter…
When you’re well-endowed in the penis department, ample foreplay is extremely important for your partner’s comfort, says Fleming. You may even want to add some external lubricant for easier penetration.
Go for positions in which your partner can control pacing and depth of penetration. And while there’s no need to completely avoid certain positions in this situation, make sure to use plenty of lubrication for anal sex and anything from behind.
… But Not All the Time
The answer to the ongoing debate, “Does size matter?” is … not really. How you maneuver your manhood is what counts.
So, if you’re on the smaller side, guys, then it’s all about the angles. “Positions and angles really matter,” says Fleming. “A woman’s G-spot is around three inches inside of her anterior vaginal wall.”
Read More: 9 Ways to Ensure Your Relationship Is Built to Last
If you want to reach the G-spot with deeper penetration, try doggy style. This also allows your partner to squeeze her legs together around you for more sensation.
Avoid positions in which her legs are fully open — without the ability to squeeze them — and positions that don’t allow you or your partner to use hands or a toy to stimulate her clitoris.
Positions for a Small Vagina
A particularly small or tight vaginal opening is usually a symptom of treatable muscular spasms known as vaginismus — or, in rare cases, other medical conditions.
That said, if you’re able to have sex, Fleming suggests positions in which you can control pacing and depth of penetration. You on top after plenty of foreplay or 69 may be good picks. Limit positions in which you have less control, such as you on the bottom.
Positions for Larger Body Size
Much like penis size, overall body size is a common source of sexual insecurity. But regardless of shape and size, everyone deserves (and can have) a gratifying sex life.
Focus on relaxation, sensation and what you find attractive about your partner, rather than personal insecurities, says Fleming. This will help you stay present and enjoy sexy play, instead of becoming more of a distracted observer.
Read More: 9 Ways Your Relationship Can Be Toxic to Your Health
Because endurance and stamina can be an issue for people with excess weight, Fleming recommends positions that require less energy, such as spooning and doggy style. If you’re the heavier one, avoid positions that place much of your weight on your partner — such as you on top without bracing yourself up on your arms and knees.
Too Tall or Too Short?
A hefty height disparity between you and your partner shouldn’t mean a pleasure shortage.
Missionary is a good option for working around height differences, according to Scalisi, because it puts the person on top in charge of alignment. “Some version of doggy style is also fabulous,” she says. “One partner can kneel or lie on a bed while the other stands, or you can stand on a stool and lean against the wall or bend over a couch, etc.”
In addition to experimenting with various positions, timing is an important thing to consider: “Most people with pain have windows where they have more energy and less discomfort,” says Fleming.
Mornings may be a bad time for sex if you have arthritis, for example, while a night of rest may make morning sex ideal if you’re experiencing back pain.
If you take daily pain medications, plan sexy play during windows of maximum relief. Warming up your muscles with foreplay, light stretching or a warm bath or shower before sex can also help minimize pain and strain.
Read More: 10 Foods to Fire Up Your Love Life
No matter what your condition, don’t be afraid to use props like pillows and rolled-up towels. “I like to think of it as props in yoga,” says Scalisi. “They help you get into the positions more deeply and more aligned so you can fully reap all their benefits!”
Lastly, think beyond penetration. Whether you’re dealing with pain, discomfort or size differences, keep in mind that sex isn’t merely about penetration: Your hands, mouths and toys can go a long way to enhance pleasure and intimacy for both you and your partner.
What Do YOU Think?
Have you ever abstained from sex because of a physical condition? Have any other creative positions that we left out? Any other advice for people whose conditions limit their action in the bedroom? Leave a comment below and let us know!
Yesterday, you thought your morning romp was of the hurts-so-good variety. But today, it just plain hurts. What gives?
Changes in partner, position, and products—as well as those related to aging—can lead to some post-coital soreness, says Isa Herrera, a physical therapist in New York City who specializes in integrative pelvic floor therapies for women.
But it’s still important to figure out the cause—and find a solution STAT. Because, as Herrera says, “you should never give up on sex.” Amen.
Here’s how to determine what may be ailing you, and how to fix it or prevent it next time.
1. You skipped the foreplay (or lube).
Most people know that vaginal dryness can make for uncomfortable intercourse, but it’s worth repeating since it remains the **most common** cause of post-sex discomfort, says Alyssa Dweck, MD, an assistant clinical professor of gynecology at the Icahn School of Medicine at Mount Sinai in New York City. Usually, dryness simply means you were a wee bit impatient.
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What to do about it: Sufficient arousal (extend that foreplay!) can help prevent the pain. You’ll have more moisture down there, and your vagina becomes more elastic as your excitement grows. Also, don’t be afraid to use lube.
2. Your session was especially long or frisky.
Common sense alert: “Of course you’re going to be sore if you’re very vigorous,” says Leah Millheiser, MD, director of the female sexual medicine program in Stanford University School of Medicine’s department of obstetrics and gynecology. Especially if you’re not well-lubed, those passionate sex sessions can cause little tears in your vaginal tissue, which—hello!—is delicate.
What to do about it: Rest up. Dweck recommends taking a warm bath with unscented Epsom salts and, if necessary, using a hydrocortisone cream around the vaginal opening for relief. Next time, be sure to pause for lube when you need to. “Listen to your body and know when you need to take a break,” says Dr. Millheiser.
3. Your birth control is to blame.
Low-dose combination birth control pills (like Yasmin, Levora, Estrostep and Ortho-Tri-Cyclen-Lo) are implicated in a lot of sore vagina cases. “This is related to the suppression of your own natural estrogen and testosterone, and replacing that with the levels in birth control, which are lower,” says Dr. Millheiser. This can make some women’s vaginal tissue thinner and drier—almost like they’re post-menopausal—making them more vulnerable to irritation and pain.
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What to do about it: Short-term, Dr. Dweck suggests natural personal lubricants, like Restore by Good Clean Love. Long-term, talk to your doc about changing your birth control prescription.
4. Your pelvic floor muscles are tight.
Go-getter, active young women are often tight—and not just in their hamstrings. They’re also tight in their pelvic floor muscles, Herrera finds. “If they’re running, doing SoulCycle, and they’re sitting in poor posture at work… the muscles can’t let go during sexual activity,” she says. Cue pain. There’s a good chance this applies to you if you have other issues, like feeling like you have to go to the bathroom all the time or you can’t fully relieve yourself, she says.
What to do about it: Pelvic floor physical therapists can guide you through various exercises—often as straightforward as deep breathing—that can help you relax your pelvic floor muscles. Think of them like reverse kegels. In the meantime, try switching up your sexual position so you’re more in control. It’s possible your partner could be hitting a trigger point, or essentially a knot in the wall of the vagina.
5. Your skin is reacting to products.
If your pain occurs only after using certain hygiene products (like scented cleansers), condoms, or spermicides (such as nonoxynol-9), it’s pretty safe to say your soreness is related to product-induced skin irritation, Dr. Dweck says. Certain condoms (especially if you’re allergic to latex), a new shower soap, or underwear washed with a scented dryer sheet can trigger reactions in some women, too.
What to do about it: Ditch the irritating products (duh!) and search for the most natural, scent-free alternatives you can. Dr. Millheiser even advises against lubes advertising a
“tingling” sensation, which to some women can feel more like burning (hard pass).
6. You have a medical condition.
Bacterial vaginosis, yeast infections, chlamydia, gonorrhea, herpes—all are infections that can make sex (and its aftermath) uncomfortable, Dr. Millheiser says. So, if you have any sort of unusual discharge or lesion down there, take your concern to the pros. Same goes for an ache that’s deep in your pelvis, which could signify a cyst, a fibroid, or endometriosis, Dr. Dweck says.
What to do about it: See your gyno. Infections are totally treatable, and cysts and fibroids can be removed (if necessary). Plus, conditions like endometriosis can be effectively managed—if they’re diagnosed correctly. “In general, pain lasting longer than 24 hours with after-sex bleeding, unusual discharge, or odor calls for a gyno visit,” Dr. Dweck says.
Whatever the cause of your pain, you don’t need to settle for feeling sore after sex. There are tons of tools and resources at your disposal, so you owe it to yourself (and your sex life) to take the time and find one that works.
Additional reporting by Alyssa Dweck, MD.
Back and Hip Problems That Can Make Sex Hurt
How physical therapy can help
Like other musculoskeletal conditions, pelvic-area orthopedic problems usually respond beautifully to physical therapy. At Raquel Perlis Physical Therapy, we take an integrated approach, combining any of the following techniques to rehabilitate your pelvis and relieve pain during sex. Some will be familiar if you’ve had physical therapy in the past.
Core stabilization exercises to support and strengthen your abdominal muscles and back. People often do these exercises incorrectly, straining their pelvic floor and back. Learning proper technique is vital.
Exercises to strengthen your hips and legs.
Exercises to relax, release, and stretch your back, hips, and legs.
Hands-on techniques such as massage, myofascial release, soft-tissue mobilization, and scar mobilization.
Muscle-energy techniques to gently improve joint alignment.
Muscle reeducation to improve your posture, balance, movement, and body mechanics.
Hot and cold packs.
Cold laser (not recommended for pregnant women).
Ultrasound (not recommended for pregnant women).
Relaxation and breathing techniques.
After a course of physical therapy, most women feel significantly better and can start to enjoy pain-free, pleasurable intercourse.
Pelvic Congestion Syndrome
High pressure and stretching of veins in the pelvis may result in pelvic pain, tenderness, or dyspareunia (pain with intercourse). The pain can be either a dull, aching pain or a sharp, deep pain. This pain often is worse just before menstrual period, with prolonged standing, or with intercourse. Once other pelvic organ pathology such as cysts or abnormal growth of the uterus or ovaries or infection have been ruled out, the syndrome commonly is labeled Pelvic Congestion Syndrome.
Some patients with Pelvic Congestion Syndrome (PCS) have an underlying correctable problem. Some have pelvic (iliac) vein obstruction and others have pelvic varicose veins due to venous blood running in the wrong direction from the upper abdomen toward the pelvis. Ovarian vein blood flow usually goes from the ovary toward the left renal (kidney) vein or toward the inferior vena cava, the large vein in the abdomen carrying blood back to the heart. If the one-way valves in the ovarian vein have failed, blood will flow in a reverse direction (reflux) toward the pelvis. Ovarian vein reflux can cause very high pressures to develop in the veins of the pelvis, sometimes causing pelvic pain, dyspareunia, and varicose veins in the deep pelvis.
A similar process in the male causes reflux of blood down a testicular vein into the scrotum. The high venous pressures in the scrotum result in progressive development of varicose veins in the scrotum and the spermatic cord which connects the testicle to the rest of the body. These scrotal varicose veins are called a varicocele. Some varicoceles cause pain, especially with lifting; others reduce the sperm count and may be responsible for male infertility. Treatment of the varicocele by sealing the testicular vein usually resolves the pain or infertility problem.