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Blog Banner: Painful sex, leakage and that constant ‘gotta go’ feeling… Is it all just normal when you’re a woman?

Painful sex, leakage and that constant ‘gotta go’ feeling… Is it all just normal when you’re a woman?

Separating fact from fiction when it comes to women’s pelvic and sexual health.


By Cindy Land, RN, BCB-PMD
February 22, 2018

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Millions of women experience pelvic or other sexual health issues at some point during their lives. But there is no need to suffer in silence. The conditions are treatable and there are resources readily available to help.

Here are 5 common myths I’ve heard that keep women from seeking medical help for pelvic and sexual health problems – and the actual facts that I hope put these myths to rest.

Myth #1: Pelvic health issues like bladder leakage and painful intercourse are to be expected as a woman – especially if you’ve been through childbirth.

Fact: Pelvic health problems are not something that you just have to accept because you are a woman, have had children or have reached a certain age.

I want you to know that at any stage of life:

  • It’s not normal for sex, a pelvic exam or putting in a tampon to be painful, or to have vaginal dryness.
  • It’s not normal to have to go to the bathroom every 30 minutes. And on the flip side, it’s not normal to hold it through an entire 8-hour shift. (What is normal is using the bathroom every 2 to 3 hours when you’re awake, and using it no more than once in the middle of the night.)
  • It’s not normal to feel like you have to pee all the time, or to lose control of your bladder when you’re coughing, laughing, sneezing or walking.
  • It’s not normal to be unable to empty your bladder fully.

These issues have lots of different underlying causes. In fact, there are often multiple factors. And these causes are rarely just age- or gender-related. Some vaginal deliveries can cause pelvic floor problems. But it’s key to know that if a woman does have a weaker pelvic floor muscle or decrease in sex drive after having a baby, it doesn’t mean it will never come back. It’s also important to know that vaginal deliveries are not the only potential cause of pelvic floor issues. Women who have never had children or who have delivered via cesarean section can be affected, too.

Myth #2: No one knows what I’m going through and it’s too embarrassing to talk about.

Fact: One out of every four women has some kind of pelvic or sexual health issue in her life. Still, many feel isolated and are shy to talk about it.

The best thing women can do is to be open and honest about these things with their friends. Many women don’t know treatment is an option. Or, they don’t know the difference it can make to their quality of life. So if you experience a pelvic or sexual health issue and talk about it, it can really help someone else. Creating a culture where women are helping women is really important, especially in an area like this that can be embarrassing to discuss.

Talking with your partner is equally important. It can be uncomfortable, yes. But not talking can create a divide between the two of you. And that can increase your feelings of isolation even more.

Having open dialogue will also dispel myths that your partner might assume. Take the case of dealing with vaginal dryness, for instance. This can be an underlying reason for painful sex. Dry, sandpaper-like vaginal tissue is not conducive to enjoyable sex. And because of that, a woman who is dealing with it may very well decrease her sexual activity. Vaginal dryness is commonly caused by a loss of estrogen associated with menopause or with breastfeeding. A partner, however, might incorrectly assume it to be a sign of a lack of interest. That’s why it’s so important to communicate! Most partners want to know if intercourse is causing pain. They are usually very willing to take the steps to help create enjoyable sex!

Myth #3: Bladder problems just happen as you age. You can’t reverse it.

Fact: Pelvic and bladder issues affect women of all ages. I have treated women as young as 20, as old as 90 and every age in between.

As you age, your body does change. But that doesn’t mean that it can’t be fixed or that there might not be a simple solution.

There are many distinct issues that could be affecting someone with pelvic pain or bladder problems. And there are numerous reasons for these issues, too. A person’s issue could be linked to when, what and how much liquid they’re drinking. It could be linked to stress, depression or anxiety. It could be linked to other medical conditions like irritable bowel syndrome (IBS) or constipation. And there are a host of other possibilities.

This complexity is why getting a thorough pelvic exam and assessment is so important. An exam can identify the information that’s needed to correctly and effectively treat pelvic pain and bladder issues. There are a variety of treatment options to address each unique issue and its underlying cause or causes. Some treatment options work better for some individuals – and other options work better for others.

If you are experiencing pelvic or sexual health issues, talk to your primary care doctor.

Your doctor can refer you to a specialist for a pelvic exam and assessment. Within the HealthPartners organization, there are specialists at:

Myth #4: Surgery is the only option for pelvic and sexual health issues.

Fact: The days of, “Let’s just do surgery or prescribe pills,” have passed. Exercises and other lifestyle changes can clear up many issues. So, pelvic physical therapy is now the starting point for treatment. Options may include:

  • Bladder retraining
  • Managing fluids and making other behavior changes
  • Vaginal tissue care
  • Reeducating the pelvic muscle on how to relax and contract

Often, education can make us aware of habits we did not even know we had. For someone waking up more than once during the night to go to the bathroom, avoiding caffeine, carbonated drinks and alcohol could help. The feeling of needing to pee all the time can be reduced by using the bathroom at regular, normal intervals. Vaginal moisturizers and using lubrication during sex can drastically reduce pain for women experiencing vaginal dryness (perhaps while breastfeeding or after menopause). All of this, combined with pelvic muscle exercises, can effectively resolve a patient’s symptoms without medicine or surgery.

Myth #5: Kegels don’t help at all.

Fact: Kegels are very effective in reducing or resolving urinary leakage. That is, they are when done correctly. Many women need help identifying the right muscle to do Kegels (pelvic floor exercises). And 50 percent of women perform them incorrectly. If you are not able to locate the right muscles and correctly contract and relax them, the exercises won’t help. And if you get into the habit of doing the exercises improperly, it can even make things worse. As with any exercise, proper technique is key.

About Cindy Land, RN, BCB-PMD

Cindy Land is a pelvic health specialty nurse and the pelvic health program coordinator at Lakeview Hospital. She works closely with a team of OB-GYNs, urologists and physical therapists at Stillwater Medical Group to provide noninvasive therapy and treatments to women who have bladder or pelvic issues. Cindy is board certified in Pelvic Muscle Disorders and has more than 10 years of experience in the urology field. She also has extensive training in pelvic health and in bladder function testing called Urodynamics. Cindy has a passion for women’s health and is proud to help give women the tools they need for healthy bladder and pelvic muscles. In her spare time, Cindy loves to spend time outside with her husband, 6 kids and dogs.

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