Decreased Sensation with Intercourse

Decreased sensation during intercourse can be a deeply frustrating and distressing experience for many people. Whether you're dealing with it intermittently or as a consistent issue, the lack of sensation or reduced pleasure during sexual activity can impact your self-esteem, relationships, and overall well-being. Fortunately, it’s important to know that you are not alone, and there are effective solutions for understanding and managing this issue.

Decreased sensation, sometimes referred to as hypoesthesia, can manifest in various ways. For some individuals, it may mean a general decrease in genital sensitivity, while others may experience a complete loss of feeling. The causes of decreased sensation during sex are often complex, involving both physical and emotional factors. However, the good news is that many of these issues can be addressed and treated effectively with the help of pelvic physiotherapy and other interventions.

In this post, we will dive into some of the most common causes of decreased sensation, explore the role of pelvic floor health, and provide you with tips for improving sensation and sexual health.

Common Causes of Decreased Sensation

1. Pelvic Floor Dysfunction

The pelvic floor muscles are integral to sexual function. These muscles support the bladder, bowel, and reproductive organs and also play a significant role in sexual response. When the pelvic floor is either too tight or too weak, it can lead to diminished sensation during sex.

• Overactive pelvic floor muscles (tightness) can restrict blood flow and reduce the responsiveness of the genital region, making it difficult to feel the same level of pleasure during intercourse.
• Weak pelvic floor muscles can lead to reduced muscle tone and coordination, which affects sexual arousal and sensation. This can occur due to childbirth, aging, or lack of proper pelvic floor exercise.

Regular pelvic floor rehabilitation through exercises such as Kegels (strengthening) or relaxation techniques (for tight pelvic floor muscles) can help restore normal pelvic floor function and improve sexual sensation.

2. Nerve Damage or Compression

Another common cause of reduced sensation during intercourse is nerve damage or nerve compression. The nerves responsible for genital sensation include the pudendal nerve, pelvic nerves, and the vagus nerve. Damage or compression of these nerves can occur during childbirth, pelvic surgery, or as a result of nerve entrapment.

• Childbirth is a known risk factor for nerve damage, especially if an episiotomy was performed or if there was significant perineal trauma during delivery. This can lead to reduced sensitivity in the genital area.
• Pelvic surgeries such as hysterectomy, prostatectomy, or hernia surgery may also impact the nerves, leading to decreased sensation or even pain during intercourse.

If you suspect nerve-related issues, seeking help from a pelvic physiotherapist who specializes in nerve mobilization techniques can be invaluable. These techniques focus on reducing nerve compression and improving nerve function.

3. Hormonal Changes

Hormonal changes have a profound impact on sexual sensation and arousal, particularly in individuals who are going through significant transitions such as menopause, postpartum, or andropause (male menopause).

• Estrogen depletion in women during menopause can cause vaginal dryness, which can lead to discomfort and reduced sensation during intercourse. It can also cause thinning of vaginal tissue, making it more sensitive and prone to irritation.
• Testosterone levels, which are important for libido and sexual function in both men and women, naturally decrease with age and may contribute to a reduction in sexual desire and sensation.

Hormonal treatments, including vaginal estrogen creams, hormone replacement therapy (HRT), or testosterone therapy (for men) can be helpful, but it's crucial to discuss any changes with a healthcare provider to determine the best approach.

4. Psychological and Emotional Factors

The mind and body are intricately linked when it comes to sexual sensation. Psychological factors such as stress, anxiety, depression, and trauma can have a significant impact on sexual response and the ability to feel pleasure during sex. These factors can lead to muscle tension, emotional blockages, and a diminished sense of sexual enjoyment.

• Performance anxiety can be especially challenging, leading to a lack of relaxation and difficulty achieving or maintaining an erection (in men) or experiencing sufficient arousal (in women).
• History of sexual trauma can cause emotional and psychological barriers that make it hard to enjoy intimacy and may lead to reduced genital sensation.

To address these factors, many individuals benefit from talk therapy or sensate focus exercises. Pelvic physiotherapists often work alongside psychotherapists to help individuals address both the physical and emotional aspects of decreased sensation.

5. Medical Conditions

Certain health conditions can contribute to decreased sensation during intercourse. For instance, diabetes, multiple sclerosis, chronic pain, fibromyalgia, and other neurological conditions can affect nerve function, circulation, and sexual response.

Additionally, chronic inflammation or autoimmune diseases can lead to changes in the pelvic area that affect sensation. For example, vulvodynia (vulvar pain) or vaginal atrophy can cause discomfort and a reduction in sensitivity.

Managing underlying medical conditions with the help of your doctor can improve sexual health. Pelvic physiotherapists can also assist with specific exercises to target the pelvic floor and other muscles involved in sexual response.

How Pelvic Physiotherapy Can Help

Pelvic physiotherapy plays a crucial role in addressing many of the causes of decreased sensation during intercourse. The aim is to restore balance to the pelvic region by addressing muscle function, nerve mobility, and emotional well-being. Here’s how pelvic physiotherapy can help:

1. Pelvic Floor Rehabilitation

Whether you have a tight pelvic floor or a weak pelvic floor, pelvic physiotherapists can design a treatment plan that addresses your specific needs. Relaxation exercises help release tightness in the pelvic floor, while strengthening exercises can improve muscle tone and coordination. This can result in improved blood flow and muscle responsiveness, enhancing sensation.

2. Nerve Mobilization Techniques

If nerve compression or nerve damage is contributing to decreased sensation, nerve mobilization techniques may be used to improve nerve function. These techniques can help reduce tension and promote better nerve communication, which may result in improved genital sensation.

3. Breathing and Relaxation Techniques

Breathing exercises and relaxation techniques are essential for reducing stress and anxiety, which are often major contributors to decreased sexual sensation. Techniques such as diaphragmatic breathing help activate the parasympathetic nervous system, allowing individuals to relax and fully experience sexual pleasure.

4. Education and Sensate Focus Exercises

In addition to physical treatments, pelvic physiotherapists often educate their clients about healthy sexual practices and introduce sensate focus exercises. These exercises help individuals reconnect with their bodies and remove performance pressure, ultimately improving sexual satisfaction and sensation.

5. Collaboration with Other Healthcare Providers

Pelvic physiotherapists work alongside other healthcare providers, including gynecologists, urologists, psychologists, and sexual health specialists, to create a comprehensive treatment plan. This collaborative approach can lead to better outcomes and more holistic care.

Conclusion

Decreased sensation during intercourse is a common issue that can be caused by a variety of physical, emotional, and hormonal factors. Understanding the root cause is the first step toward finding an effective treatment. Pelvic physiotherapy can play a pivotal role in restoring pelvic floor function, improving nerve mobility, and addressing emotional barriers that impact sexual health.

If you're struggling with decreased sensation, consulting with a pelvic physiotherapist is an excellent first step. Together, you can work toward improving your sexual health and regaining the pleasure you deserve.