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High Tone Pelvic Floor:

A Podcast with Darshana

By Kimberly Castelo

Sex should not be painful. 

Repeat that a few times with me.

Sex should not be painful. 

Sex should not be painful. 

Sex should not be painful. 

But unfortunately, for a lot of people with vulvas, sex is painful.

One of the reasons for this pain is due to something called High Tone Pelvic Floor. This occurs when the pelvic floor muscle around the vagina and vulva tenses and gets tight during penetration. This tightness physically stops penetration from occurring comfortably. 

Many of my clients tell me that penetration feels like hitting a wall, which can be incredibly uncomfortable and painful for them. 

But what is causing this? And what can you do to fix this? 

One of the most common causes of this tightening in one’s pelvic region is pressure and stress. 

That’s why understanding how your body holds stress and pressure is important: 

  • Where do you hold stress in your body? 
  • Where do you experience the physical effects of being put under pressure? 

One couple I was seeing who was experiencing High Tone Pelvic Floor gave me wildly different responses. 

When I asked the penis-owning partner where they held stress and pressure in their body, they answered that they felt tightness and tension in their neck and shoulders. 

When I asked the vagina-owning partner, they said that they held stress and pressure in the lower part of their body, specifically the vaginal area. 

So it would make sense that under feelings of stress, pressure, and anxiety, the vagina owner would experience a physical wall of tense muscles in their pelvic floor, resulting in pain during penetrative intercourse. 

Unfortunately, this becomes a cycle where the vagina owner experiences pain during penetration and then becomes anxious about the pain leading up to penetration, causing even more pain. 

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Why would someone who experiences pain during penetration want to participate in sexual intercourse that is associated with such pain?

They expect pain, they experience pain -- and it reinforces that painful message: Sex = pain.  

But repeat with me again - sex should not be painful. 

There are many reasons behind High Tone Pelvic Floor, and these reasons can be explored and navigated individually and/or with partners. It’s important to figure out why these muscles are tightening and what you can do to relax these muscles and enjoy sex more thoroughly and pleasurably. 

High Tone Pelvic Floor doesn’t have to be forever, and whether it’s fear, shame, anxiety, or something else, it is possible to work through this and get the sexual experience and fulfillment you deserve.

To learn more about High Tone Pelvic Floor (Vaginismus) and different ways to approach and navigate this, check out my interview with Darshana here.

If you’re wanting to heal and have pain free sex, then check out a course my colleague Mia Fine and I created called Healing From Painful Sex: A Roadmap to the Treatment of Vaginismus. You can also connect with a sex therapist at Healing Moments Counseling in Seattle to work through High Tone Pelvic Floor.

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About Kimberly Castelo, LMFT-S, CST-S, CIIP

Kimberly (she/her) is a Licensed Marriage and Family Therapist, an AASECT Certified Sex Therapist, Certified Emotionally Focused Couples Therapist. She is the founder and owner of Healing Moments Counseling, a practice that focuses on sex therapy, attachment, social justice, and all types of relationship constellations. 

Kimberly is a Washington State Supervisor, an AAMFT Supervisor, an AASECT Certified Sex Therapist Supervisor and an EFT Supervisor. Kimberly also provides sex supervision through the Modern Sex Therapy Institute where folx train to be sexual educators and therapists. Kim additionally serves on the MSAA Health Advisory Counsel.

Kimberly is a national speaker, speaking on topics of faith, sexuality, grief, coping with Multiple Sclerosis, high tone pelvic floor, menopause and more! She is a gifted teacher and emphasizes the freedom that comes from education!

Work with Kim