A Physical Therapists Perspective On Sexual Communication and Sexual Function
As a pelvic floor therapist, a common reason women and men seek out treatment is due to sexual concerns, such as painful intercourse, erectile dysfunction, and diminished orgasm ability. A pelvic floor therapist’s job is to assess the muscles and nerves in the pelvis and the surrounding areas to determine if they are contributing to your symptoms. However, it is important to remember that there are many factors that can contribute to sexual concerns in this area. This is why your physical therapist (PT) may ask questions regarding other health concerns, such as heart conditions, medications, hormones, and your relationship with your partner(s). This can help your PT determine if there are other factors that could be helpful to address your concerns in addition to the types of treatment you would receive in your sessions. One important area that a pelvic floor therapist may ask about is the communication between you and your partner(s), including communication regarding sex, to determine if this is an area that requires more attention with an appropriate provider, such as a sex therapist.
Couples with sexual concerns have more sexual communication issues than couples without sexual concerns. It is possible that experiencing issues with sex can create issues with communication but its also possible that couples who have difficulty with communication, either sex related, or non-sex related, may increase the likelihood of sex concerns developing.
Sexual communication includes discussion on sexual preferences, desire to engage in certain sexual activities, sex values, past experiences, quality of communications, and frequency of communications. A large review of the available research, called a meta-analysis, was performed to determine the impact of sexual communication on different aspects of sexual function.
Sexual satisfaction is very important since it allows partners to express their likes and dislikes with the intent to increase the likes and reduce the dislikes. This is incredibly important since partners can demonstrate differences regarding their sexual preferences and preferences can change over time. This communication allows for greater emotional intimacy which further increases sexual satisfaction.
Sexual desire is “the motivation to engage in or be receptive to a sexual event, whether partnered or alone”. Other descriptions of desire can include libido, drive, interest. Communication protects against the loss of desire in long-term relationships. It is also one of the most important ways women address desire discrepancies.
Sexual arousal requires physiological and mental changes in response to external or internal stimuli. Communication is extremely important to assist with problem-solving, especially for couples where one or more partners are experiencing arousal or erectile dysfunction. In fact, feeling desired, accepted, appreciated by a partner, and acceptance of sexual history has a particularly large impact on women’s arousal. Unfortunately, communication when a partner is experiencing erectile concerns is typically poor or non-existent.
Women who are unable to achieve orgasm typically reported more difficulty with sexual communication with their partners and increased discomfort when discussing sexual concerns as compared with women who did not have orgasm concerns. There has also been a significant correlation with premature ejaculation and poor sexual communication.
Overall, a meta-analysis was performed regarding the impact of sexual function on various sexual functions. It found that sexual communication has been shown to be positively associated with sexual desire, sexual arousal, orgasm, and overall sexual function for both men and women. Sexual communication is positively associated with male erectile function and female lubrication. Additionally, sexual communication resulted in less pain for women. Communication demonstrated a particularly strong role with women’s sexual desire. A possible explanation for this is women may be more likely to experience responsive versus spontaneous desire, which would depend on better communication.
Unfortunately, more research is needed to explore the full impact of sexual communication and sexual function. This is especially true for same-sex or mixed orientation couples as there is minimal research. One thing is for sure, communication, especially regarding sex, can be helpful for a multitude of sexual aspects including pain, lubrication, and libido and will likely be an important aspect to addressing your pelvic concerns.
Written by Jordan Schmidt, PT, DPT
References
Mallory, A. B., Stanton, A. M., & Handy, A. B. (2019). Couples' Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis. Journal of sex research, 56(7), 882–898. https://doi.org/10.1080/00224499.2019.1568375
