The Pelvic Floor: Sexual Dysfunction & Pilates

If there's one thing people still shy away from, it's talking about sex. More specifically, any trouble they may be having enjoying or performing intercourse. An estimated 43% of women, and 25% of men suffer from some type of sexual dysfunction, so if you're experiencing it, you are definitely not alone. The causes vary, but Pilates has been shown to help if it's connected to a pelvic floor issue.

Common symptoms of sexual dysfunction are:

  • Women: painful sex, pressure, low back pain during intercourse, inability to reach orgasm

  • Men: erectile dysfunction, inability to reach orgasm

Unlike our previous posts (The Pelvic Floor: A SeriesPregnancy, the Fourth Trimester, & Beyond, 3 Exercises to Alleviate Low Back Pain) which dealt with addressing a weakened pelvic floor and supporting muscles, sexual dysfunction can be caused by a tight and overworked pelvic floor.

How does this happen?

The pelvic floor is not relaxing because doing so causes pain. This may be the result of trying to alleviate accompanying pain in the back or abdomen that is temporarily relieved by contracting the pelvic floor. It becomes a habit- a way of momentarily dealing with chronic pain in a different area of the body.

It's actually quite easy to apply Pilates principles in order to begin to alleviate sexual dysfunction. By connecting the mind and body through breathing, visualization, and targeted exercises, Pilates can provide a lot of benefit and potentially help you avoid medical intervention*.

Pilates breath work is one of the easiest ways to begin to work the pelvic floor out of a constant state of contraction. This is done by inhaling through the nose and exhaling out through mouth. Deep breathing is the goal, so you should see your ribs and low belly lift and lower. The inhale opens up space within the body, allowing the muscles to relax and soften. The exhale allows awareness of initiation of the muscle before “over-muscling” causing tightness and stiffness. 

To practice this, lie down on your back with knees bent, lay hands on the middle and low belly and relax. Breathe into your lowest hand, feeling the expansion. Exhale and feel the hand lower. Repeat 3-4 rounds. Try to isolate the breathing to that part of the body until you can completely relax and initiate from that part of the body.

Visualize the air entering the body through the nose and traveling to the lowest reaches of the belly. Imagine it is filling all the spaces beyond the ribs and lungs. See the air fill and recede as you begin your exhale. Visualize the air leaving the body through the mouth. Repeat this process and direct the air into and out of different spaces in the body.

If you are still having trouble connecting to or isolating the different parts of the low belly and ribcage, try laying a heavy book onto the lower belly and inhale without it popping up. This means you will be breathing into the back of the body (low back). Upon exhaling, feel the book lower, as though it’s sinking into the body, all the way to the back.

Here’s a great exercise to practice initiating the pelvic floor while stretching and relaxing the low back:


Stand with legs together, acting as though you have magnets at your ankles, knees, and inner thighs. Take a breath and lift arms overhead, in line with your ears.

Roll and articulate down until fingers touch the floor, or use a low stool or chair if you’re having trouble reaching the floor.

Make sure hips are over the feet, not leaning back, and knees are not bent. Keeping eyes on your navel, imagine you have a seat belt across the front of your hip bones and lift the low belly away from the seat belt as you lower down.

Keep the low belly engaged as you round up slightly, then round back down. Repeat 8-10 times, ending by fully articulating the spine back up, one vertebrae at a time until you come back to a standing position.

*If you suffer from a medical condition, always seek the advice of a medical professional prior to engaging in any physical activity. This article is not intended to replace the recommendations of a qualified medical professional.* 

Jennifer Mapalad