Constipation and Intercourse

Women's Health Physical Therapy

Constipation and intercourse, how are the two related, you ask?

Well, the pelvic floor or levator ani has a valuable role including support to our pelvic organs, a sphincteric function, and helping during intercourse. A muscle within the pelvic floor called the puborectalis, slings around the rectum and forms a kink called the anorectal angle.  This angle contributes to fecal continence. It is the coordination of the rectum sensing fullness, increases in intra rectal pressure, the relaxation of the puborectalis, and the anal sphincters relaxing which allows for successful defecation.

When everything works together our pelvic floor remains happy and healthy. When things don’t coordinate well in the pelvic floor, often discomfort and constipation can be the result. When we voluntarily delay or ignore our urge to have a bowel movement, it creates tension within the puborectalis, and can also teach the pelvic floor inappropriate coordination–or a bad habit of not relaxing when the rectum senses stool. This habit can cause the pelvic floor muscles to shorten and/or develop painful areas referred to as trigger points. Another thing that can happen when the urge to poop is ignored frequently, is the possible enlargement of the rectum in addition to back pain. The rectum isn’t made to do this and it can become stretched out and floppy and may even lead to nerve damage.  Worse, it can delay the ability to know it’s time to poop allowing more stool to be present before you get the urge to have a bowel movement and this can lead to constipation.

So, how does delaying having a bowel movement when the urge hits lead to pain with intercourse? Well, unhappy, or tense pelvic floor muscles can make it difficult for penetration to occur as well as cause pain deep inside the vagina during intercourse.  Also, if the muscles of the pelvic floor aren’t working properly it can make achieving orgasm challenging to even impossible!  When things are not working well in this area it makes it harder to get increased blood flow into the pelvic floor and this is a big part of what ensures climax with orgasm.

This is a very simplified explanation of how over time, repeated delaying the urge to have a bowel movement can cause constipation and create or contribute to pain with intercourse. So, the best thing to do when you get the urge to have a bowel movement is to suck it up and go right then–whether it is at work, at the mall, or in the comfort of your home. Take this seriously and go, your vagina and sexual partner may thank you later.

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