Lear about the muscles often causing sexual pain during intercouse. Ideal muscles are both strong and flexible. Their fibres can contract to provide support, and they can also release and lengthen. Balance between strength and mobility can be developed through targeted exercises and mindful use of the body. For some people, learning to relax and move the muscles is an important part of reducing sexual pain.

This website is a danish website for Danes who speak english. Remember always check with a doctor.

Imagine your pelvis as freely suspended. Around it are muscles like elastic bands that keep the pelvis stable and balanced. If one or more of these “elastic bands” are tense, the pelvis can be pulled out of balance – which may trigger pain during sex.

When pain appears, the body often reacts by tightening the muscles even more to protect the area. Over time, this can create a vicious circle: pain during sex leads to tension, and tension leads to more pain during sex and imbalance. The purpose of a stretching and movement programme is to make the body strong and flexible – and perhaps most importantly, to help you sense the state of your muscles.

The exercises should invite the muscles to contract and to let go, with full attention to the body’s signals. When you work with both tight and less active muscles, regular and gentle practice matters.

Mapping muscles that can contribute to pain during sex

Pain during sex can be linked to tension, reduced mobility, or lack of coordination in specific muscles around the pelvis. It is rarely only one muscle that is involved.

Below are the muscles that often play a role when pain during sex occurs during or after intercourse.

The psoas consists of several muscles and runs from the spine to the thigh bone

Iliopsoas (hip flexors)

The iliopsoas consists of two muscles that lie deep inside the body along the lower back. They run from the spine, through the pelvis, and attach to the thigh bone. These muscles are central for movement and stability in the hip – and for the connection between the upper body and the legs.

The iliopsoas is active when you bend at the hip, stand up, walk, and arch the lower back. If the muscle is tense or overactive, it can cause pain in the groin, the lower back, and the front and inner thigh. In some people, tension in the iliopsoas can be linked to sexual pain such as deep vaginal pain, pain with penetration, or soreness after sex.

This muscle can be difficult to work with on your own, and many people benefit from guidance from a physiotherapist. Start by learning about the muscle, and you may also search YouTube for gentle and trustworthy exercises.

Obturator internus

The obturator internus is a deep muscle in the pelvis. It helps rotate the leg outward and stabilises the hip, especially when you stand, walk, or move from sitting to standing.

If the muscle is tense, pain may be felt at the pubic bone, deep in the pelvis, or during movements such as spreading the legs, rotating the hip, sitting down, or standing up. Tension in the obturator internus can also contribute to pain during sex closer to penetration, especially when the legs are apart.

The pelvic floor muscles

The pelvic floor muscles stretch from the tailbone to the pubic bone and form the base of the pelvis. They support the bladder, bowel, and uterus and play an important role in continence, body stability, and sexual function.

Tension in the pelvic floor can cause pain around the tailbone, a stiff lower back, and narrowing in the vagina. Overactivity in the pelvic floor is a common factor in pain during sex during and after intercourse. (Read the article about the pelvic floor muscles.)

Bulbospongiosus (outer ring muscle at the vaginal opening)

The bulbospongiosus is a more superficial muscle located around the vaginal opening. It is closely linked to sensation, touch, and reflexive muscle tension.

If this muscle is tense or hypersensitive, it can cause stinging, burning, or sharp pain with touch and penetration – often already at the entrance to the vagina. This muscle and the pelvic floor are the primary muscles that cause pain during sex.

How to use what you know about the muscles

Put on your detective hat. Approach your body with curiosity. Notice when sexual pain occurs:

• where in the body you experience pain during sex (external, mid-vaginal, deep)
• when during intercourse the pain occurs (mostly at the beginning, more afterwards)
• whether specific positions or movements make pain during sex worse or better

These observations can help you choose which muscle groups it makes sense to work with in order to reduce that sexual pain occurs. There will often be several relevant exercises for each area – choose the ones that feel most accessible and right for your body.

The following are general exercises. Before you begin, talk to your doctor about any precautions needed to take care of your individual needs. If you have weak knees or hips, avoid exercises that strain them.

“Let go” breathing – Breath & relaxation (nervous system first)

Purpose: To calm the nervous system and reduce muscle tension.

• Stand, lie on your back with knees bent, or sit upright on a chair.
• Place one hand low on the abdomen or over the vaginal opening, with fingers pointing towards the anus – or sit heavily and grounded on the chair.
• Inhale slowly through the nose and notice the movement under your hand or against the surface you are resting on.
• Exhale gently through the mouth and think: “let go.”
• Repeat for 2–5 minutes at a calm pace.

Use this breathing as the starting point for all exercises. “Let go” breathing can help relax the pelvic floor and create calm in the nervous system. Read more: Breathing You can also use this breathing if you feel sexual pain occure or during a gynaecological examination.

Gentle warm-up

Purpose: To wake up the body, increase circulation, and release unnecessary tension.

Choose the option that suits you best:

1. Place an object on the floor in front of you – for example a book or a sock. Bend your knees calmly, lean forward and pick up the object with both hands. Slowly come back up while exhaling and thinking “let go.” Repeat 8–15 times at a pace that feels comfortable.
2. Draw circles with the hips. Move them both clockwise and counterclockwise. Start with small circles and let them gradually become larger. Notice if certain directions feel stiffer – without pushing yourself.
3. Shake it out. Feel the rhythm of the body and shake the body free of tension.

Working with the psoas muscles

Purpose: To allow the psoas muscles to both work and let go through calm, dynamic movement.

The exercises should feel light and controlled – not like strong stretching. The psoas often responds better to movement, variation, and a sense of safety than to direct stretching. If an exercise creates more tension or discomfort, choose an easier version.

Supine heel slide

• Lie on your back with knees bent and feet on the floor.
• Slowly slide one heel forward so the leg lengthens slightly.
• Slide the leg calmly back again.
• Breathe freely and think “let go” on the exhale.
• Repeat 6–10 times and switch legs.

This exercise works dynamically with the psoas without pressure and is often more effective than a direct hip flexor stretch. When you slide the heel forward, keep the movement small and controlled. For most people, this means the foot slides about 5–10 cm forward. You should feel a light sense of movement or stretch in the hip – not a strong stretch. If you feel tension, pain, or a need to brace, the movement is too big.

Supine pelvic tilt (small movement)

• Lie on your back with knees bent.
• Gently tilt the pelvis so the lower back alternately releases from the floor and returns towards it.
• Keep the movement small, slow, and fluid.
• Use “let go” breathing.
• Repeat 8–12 times.

This exercise influences the psoas through its connection to the lower back. The aim is to allow a deeper release without stretching.

Standing wall lean with weight shifting

• Stand with your back lightly leaning against a wall.
• Step a small step forward with one leg.
• Slowly shift your weight forward and back between the legs.
• Let the pelvis feel heavy and relaxed – without holding or bracing.
• Repeat 6–10 calm shifts and switch legs.

Here, the psoas is trained indirectly through balance and weight transfer, which often regulates better than stretching.

Working with obturator internus

Purpose: To allow obturator internus to let go and regain mobility through calm, controlled movement in the hip joint. These exercises work with rotation and support – not pressure or deep stretches.

Supine knee fall-out (controlled rotation)

• Lie on your back with knees bent and feet on the floor.
• Slowly let one knee fall out to the side so the thigh gently rotates in the hip socket.
• Keep the movement small and controlled.
• Bring the knee calmly back to upright.
• Use “let go” on the exhale.
• Repeat 6–10 times and switch legs.

This works obturator internus quite directly, without triggering protective tension.

Seated femur rotation

• Sit near the edge of a chair with both feet on the floor (about hip-width apart), upper body supported forward on a table with elbows on the table.
• Let one knee move slowly side to side so the thigh bone rotates gently in the hip joint while the pelvis stays still.
• The movement should be soft and rhythmic – not big. Think “hip joint,” not “knee.” Work with one leg at a time.
• Breathe calmly and think “let go” on the exhale.
• Continue for 1–2 minutes.

This exercise influences obturator internus in a functional way – similar to how it is used in everyday movement.

Standing, wall-supported femur rotation

• Stand with one side lightly supported against a wall or a chair.
• Lift the outer leg slightly off the floor.
• Move the leg very slightly inward and outward so the thigh bone rotates gently in the hip socket.
• Imagine the movement deep inside the hip.
• Keep it small and controlled – the focus is lightness, not strength.
• Repeat 5–8 times and switch sides.

This works obturator internus through calm rotation and support, which is often more effective than stretching.

Relaxation and contact with the pelvic floor

Purpose: To invite the pelvic floor muscles to let go through positions, breathing and attention – not through pressure or strong stretching.

You do not need to do all of the exercises. Choose one or two that feel safe and accessible for your body.
If you have knee or hip problems, choose supine or supported positions.

Supine relaxation with leg support

• Lie on your back with knees bent and let the lower legs rest on a chair or be supported up against a wall.
• Let the lower back rest heavy into the surface.
• Option: place one ankle over the opposite knee.
• Breathe calmly and think “let go” on the exhale.
• If it feels good, let the knee move slightly away from the body – without pressure.

Supine butterfly (supported)

• Lie on your back with your legs up against a wall.
• Bring the soles of the feet together and let the knees fall out to the sides.
• Support the legs with the wall and/or pillows.
• Take 3–5 calm “let go” breaths.

Supine knees-to-chest (gentle version)

• Lie on your back with knees bent.
• Bring the knees up towards the chest and let them fall slightly out to the sides.
• Hold gently around the knees or lower legs.
• Breathe calmly and imagine the distance between the sitting bones widening on the exhale.
• Bring the legs together again before placing the feet back on the floor.

Kneeling positions (only if it feels safe)

• Kneel with a comfortable distance between the knees and rest your elbows on the floor.
• Let the abdomen and pelvis hang heavy.
• Breathe calmly and notice how the pelvic floor may release on the exhale.
  Skip this if it strains your knees, hips, or lower back.

Relaxation and gentle activation – teaching the muscle to let go

The exercises above help you relax the pelvic floor.
When pelvic floor muscles have been tense for a long time, it can also help to practise very light contraction and release. This can help the nervous system re-learn the difference between activity and rest.

The purpose is not to strengthen the muscle, but to reprogramme how it is used – so the pelvic floor learns to release its grip again.

Exercise: A small air kiss

Gentle contact – activate and rest

• Lie on your back or sit with good support.
• Take a few calm breaths. Remember: this should feel almost too easy – if you are unsure, you are probably already doing too much.
• Make a few small, gentle air kisses with your mouth and notice how the lips activate lightly and then release again.
• Transfer that sensation to the pelvic floor.
• Imagine making a very small, gentle “air kiss” with the pelvic floor.
• Activate the pelvic floor very lightly – as if you gather the muscle fibres a little (about 10%) – and hold for 1–2 seconds.
• Release on the exhale and think “let go.”
• Notice how the area opens and rests.
• Stay in relaxation for 3–4 calm breaths before repeating.

Repeat 3–5 times. If you notice increased tension, discomfort, or pain, skip the exercise and return to pure relaxation.

Combine activation and relaxation

knibnu.dk is a free programme with exercises that combine pelvic floor exercises, breathing and body movement.

In your case, relaxation is the main focus. Use the exercises to practise the difference between light activation and letting go again – not to hold tension over time.

Choose exercises that feel calm and help the muscle release, and skip those that increase tension or discomfort.

Bulbospongiosus – outer ring muscle at the vaginal opening

The bulbospongiosus is a superficial muscle around the vaginal opening and is closely linked to touch and reflexive tension. Tension in this muscle can cause stinging or pain with touch and early penetration.

There are no specific stretch exercises for bulbospongiosus.
Exercises that support pelvic floor relaxation and gentle activation will usually also affect bulbospongiosus.

When the pelvic floor and nervous system settle, the muscle around the vaginal opening has a better chance to release. The exercise “a small air kiss” works especially gently with the area around the vaginal entrance and may play a part in sexual pain that happens early with touch or penetration.

Next steps could be:

Read: Myofascial trigger points in the pelvis
Read: When pelvic floor muscles interfere with sex