Really satisfying sex is all about communication: yes, between partners, but also all up and down the tingling, zinging xylophone that is your central nervous system (CNS). The better the communication, the better the sex.

During sex, your body is talking to your brain, delivering updates, prompting greater blood flow and lubrication to the areas that need it, preparing your parts to accommodate intercourse.


the spasms of pelvic floor muscles are the heart of the Big O


A lot of information comes from the pelvic floor muscles – those muscles that hold the bladder, vagina, uterus, and bowels in place. Healthy pelvic muscles = good communication = stronger, longer orgasms. I asked our PTs Meagan and Bri to walk us through it.

What role do the pelvic muscles play in a woman’s orgasm?

“The pelvic floor muscles are intricately tied in with the sexual organs,” Meagan says. “Blood flow and tissue health contribute to the amount of sensation and overall neurological input going to a woman’s central nervous system.”

The spasms of pelvic floor muscles are the heart of the Big O, so naturally, the healthier those muscles are, the better they communicate with your CNS, and the more pleasurable climax can be.



What causes weak communication from the pelvic muscles?

According to Bri, the clients they see with this issue tend to fall into two categories: low tone and high tone.

Low-tone pelvic floor muscles are a bit … flabby. Women with this issue may have weak or no orgasms and may also have incontinence or pelvic organ prolapse. Low-tone muscles aren’t able to communicate well with the woman’s CNS, says Meagan. “If there isn’t enough oomph behind the pelvic muscles, they’re just whispering to the nervous system, which might not be enough to get her to orgasm.”

Then there’s high-tone pelvic floor muscles. Women with this issue often have trouble with intercourse because their pelvic muscles are in constant spasm or are too tight to allow penetration. And when sex hurts, orgasms aren’t likely to happen.

What causes high- or low-tone pelvic muscles?

Several things can affect tone: Vaginal delivery of a baby can cause lower tone, Bri says, especially if the birth involved cuts or tears in the perineum. Extra body weight can weaken pelvic muscles. Athletes often have high tone issues, particularly if their sport involves pressure on the perineum area, as with cyclists or equestrians. Oh, yeah, and those crunches. It is possible to over-exercise the pelvic floor muscles, so ease up on the crunches. I mean seriously, which would you rather have: a six pack? or great sex?



How To Get Better Orgasms?

As Bri says, start with the usual lifestyle stuff: eat right. Sleep. Exercise. Practice good hydration and urination. Do your kegels and do them right. If you have pain during sex, try some lubrication and see if that takes care of the problem. Be smart and consistent about these, and you may find you can get your O on without any professional help.

If you do need help having better sex, there are lots of ways a physical therapist can help you. If the vagina is too tight for comfort, a series of dilators can use the body’s natural elasticity to widen it. Vibration applied to the area stimulates blood vessels and helps bring healthy blood and oxygen to where it’s needed. Education to learn to do kegels correctly, including when to stop.

One great way have good sex? Have sex. It’s one of life’s more pleasant “use it or lose it” rules – sex promotes blood flow, stretching and hydration of tissue, and muscle contractions. “It’s sport-specific training!” says Meagan.

Most of all, don’t be afraid to bring up the topic with your doctor. We know – this just isn’t easy, but you’re entitled to have a happy, healthy sex life, and sometimes that takes a little outside help.

“When women first come to me, they stand at my door, scowling, saying, ‘OK, PT for my hoohah, what are you going to do to me?’” Meagan says, “We really want people – men and women – to be educated on what physical therapy can do for them. Because here’s the good news: you have so much more control than you think you do. We’ll give you some tools, some strategies to heal and avoid problems, but mostly what we’re going to give you is information.”

“Too many people assume what’s happening to them is normal,” says Bri. “I hear, ‘My mom had painful sex, my grandma had painful sex, it’s just genetic.’ Well, no, no, it isn’t. Your pelvic floor is your pelvic floor. We want to educate people on what’s normal and healthy, and if they’re outside that range, what they can do about it. Because there’s a lot we can do.”

If you’ve worked with a PT or taken other steps to improve your sex life, how about sharing what worked (or didn’t!) with the Gennev community? Shoot us an email (we may share your ideas but NOT your name, we promise) or catch us on Facebook, Twitter, or Instagram.  



Shannon Perry

June 7, 2017
Director of Programming & Media

Medically Reviewed By

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