Yet for many people, pain during or after sex is something they silently endure for months or even years. Some assume it’s “normal,” others feel embarrassed to talk about it, and many don’t realise that help is available.

The truth is, painful sex is common, but it is not normal. Most importantly, it’s treatable.

What is Sexual Pain?

Pain associated with penetrative sexual intercourse is known as dyspareunia. It can occur:

• Before penetration
• During penetration
• With deep penetration
• During certain positions
• After intercourse
• Following orgasm

The pain may be described as burning, stinging, sharp, aching, cramping or a deep pelvic pain.

What Causes Painful Sex?

There isn’t one single cause, which is why a thorough assessment is so important.

Some common contributors include:

• Overactive or tight pelvic floor muscles
• Endometriosis or adenomyosis
• Pelvic pain conditions
• Vaginismus
• Vulvodynia
• Childbirth-related changes
• Scar tissue following surgery or birth
• Hormonal changes (including menopause and breastfeeding)
• Vaginal dryness
• Previous infections
• Stress, anxiety or fear of pain

Often, more than one factor is contributing.

The Role of the Pelvic Floor

Your pelvic floor muscles sit at the base of your pelvis and support your bladder, bowel and reproductive organs.

Just like muscles anywhere else in the body, they can become tight, tense, overworked or painful.

When these muscles don’t relax properly, penetration can become uncomfortable or even impossible. They may also refer pain into the pelvis, hips, lower back or abdomen.

Many people assume they need to “strengthen” their pelvic floor, but in cases of sexual pain, the focus is often the opposite—helping the muscles learn to relax, lengthen and coordinate effectively.

How Can a Pelvic Health Physiotherapist Help?

Pelvic Health Physiotherapists are specially trained to assess and treat the musculoskeletal contributors to sexual pain.

Treatment is always individualised and may include:

• Education about your pain and why it’s occurring
• Pelvic floor relaxation and down-training
• Breathing and nervous system regulation strategies
• Manual therapy to reduce muscle tension
• Scar tissue management
• Graded exposure using vaginal dilators where appropriate
• Self-release tools such as a vibrating pelvic wand (promotes blood flow, helps muscles relax and helps desensitise tissues)
• Advice regarding lubricants and vaginal moisturisers
• Movement and exercise prescription (such as pelvic opening stretches)
• Pain management strategies
• Collaboration with your GP, gynaecologist, psychologist or other members of your healthcare team when needed

Your treatment plan is tailored to your symptoms, goals and comfort level. You remain in control throughout every assessment and treatment session.

You Don’t Have to Just Live With It

Painful sex can impact confidence, relationships, intimacy and quality of life—but it doesn’t have to become your normal.

With the right assessment and treatment, many people experience significant improvements in pain, pelvic floor function and confidence.

If you’ve been avoiding intimacy because of pain, or you’ve thought that it’s “just something you have to put up with,” know that there are evidence-based treatment options available.

Take the First Step

You deserve to enjoy intimacy without fear or pain.

If you’re experiencing pain with sex, we’d love to help. Book an appointment with one of our Pelvic Health Physiotherapists to begin understanding the cause of your symptoms and work together towards comfortable, confident intimacy once again.

Maybe you’ve found yourself rushing to the bathroom, crossing your legs, or planning every outing around where the nearest toilet is.

If this sounds familiar, you’re not alone.

Urge urinary incontinence (UUI) affects millions of people, but despite how common it is, it’s not something to simply accept as your normal. With the right assessment and treatment, many people see significant improvements in their symptoms.

What is Urge Urinary Incontinence?

Urge urinary incontinence is the involuntary leakage of urine associated with a sudden, strong urge to urinate that is difficult to delay.

Unlike stress urinary incontinence, which occurs with coughing, sneezing or exercise, urge incontinence is caused by an overwhelming bladder urge that often comes with little warning.

Many people describe it as:

• “I barely get any warning.”
• “The closer I get to the toilet, the worse it gets.”
• “As soon as I put the key in the front door, I start leaking.”
• “Running water makes me desperate.”
• “I have to know where every toilet is.”

These are all classic signs of urge urinary incontinence.

Why Does It Happen?

Your bladder and brain are constantly communicating.

Normally, as your bladder slowly fills, it sends gentle messages to your brain letting you know it’s filling. Your brain then decides whether it’s an appropriate time to empty.

With urge urinary incontinence, this communication becomes disrupted. The bladder begins sending strong “empty now!” signals even when it isn’t full, creating a sudden, difficult-to-control urge.

There are many reasons this can happen, including:

• Overactive bladder
• Pelvic floor dysfunction
• Constipation or bowel dysfunction
• Recurrent urinary tract infections
• Menopause and reduced oestrogen levels
• Pregnancy and childbirth
• Neurological conditions
• Bladder irritation (including caffeine or some artificial sweeteners)
• Concentrated urine (not drinking enough fluid)
• Pelvic surgery or pelvic radiation

Often, several factors are contributing at once.

The Pelvic Floor Plays a Bigger Role Than You Think

Your pelvic floor muscles do much more than help prevent leakage.

When urgency strikes, these muscles help send calming signals back to the bladder, allowing you to delay the urge until it’s appropriate to empty.

If the pelvic floor muscles are weak, poorly coordinated or overly tense, this calming response may not work as effectively.

That’s why pelvic floor assessment is such an important part of managing urgency and urge incontinence.

How Can a Pelvic Health Physiotherapist Help?

The first step is understanding why your urgency is occurring.

A Pelvic Health Physiotherapist will complete a comprehensive assessment to identify the factors contributing to your symptoms before developing an individualised treatment plan.

Management may include:

Bladder Retraining

One of the most effective treatments for urge urinary incontinence is bladder retraining.

This involves gradually teaching the bladder to tolerate larger volumes of urine and reducing the frequency of urgent toilet trips.

Over time, this helps reset the bladder-brain communication and improves bladder control.

Urge Suppression Strategies

When urgency strikes, the instinct is often to run to the toilet.

Ironically, rushing usually makes the urge worse.

Instead, we teach strategies to calm the bladder, including:

• Stopping and standing still
• Pelvic floor contractions (“quick squeezes”)
• Slow diaphragmatic breathing
• Calming the nervous system
• Toe curls, calf raises, squeezing your buttocks together tightly – these reflexes activate the nerve that contracts the bladder
• Walking slowly to the toilet once the urge settles

These techniques help reduce the intensity of the urge and give you back control.

Pelvic Floor Muscle Training

Depending on your assessment findings, treatment may include improving pelvic floor strength, endurance, coordination or relaxation.

Not everyone needs stronger muscles—sometimes they simply need muscles that work at the right time.

Lifestyle Advice

Small changes can make a big difference.

We may discuss:

• Fluid intake and timing
• Caffeine intake
• Bladder irritants
• Managing constipation
• Healthy bladder habits
• Reducing “just in case” wees

Education

Understanding what’s happening inside your body is often one of the most empowering parts of treatment.

Once you know why urgency occurs, it becomes much easier to manage with confidence.

You Don’t Need to Plan Your Life Around Toilets

Many people with urge urinary incontinence:

• Avoid long car trips
• Skip exercise classes
• Decline social invitations
• Wake multiple times overnight
• Wear pads “just in case”

These symptoms can have a huge impact on quality of life—but they don’t have to.

The good news is that conservative treatment, including pelvic health physiotherapy, is recommended as a first-line treatment for urge urinary incontinence and overactive bladder.

Take the First Step

If you’re constantly rushing to the toilet, leaking on the way, or planning your day around bathroom access, it’s time to know that help is available.

You don’t have to let your bladder call the shots.

Book an appointment with one of our Pelvic Health Physiotherapists to receive a thorough assessment and personalised treatment plan. Together, we’ll help you regain confidence, improve bladder control, and get back to living life without constantly worrying about the nearest toilet.

What is therapeutic ultrasound?

The ultrasound head or transducer, produces high frequency mechanical sound waves that travel through tissue. As these waves interact with cells and extracellular structures that make up soft tissue, they can produce thermal and non-thermal mechanical effects. These effects can influence cell signalling, membrane permeability and local tissue behaviour.

A gel is used on the skin to help the ultrasound energy pass efficiently from the treatment head into the tissues beneath the skin. The gel also reduces friction and skin irritation during treatment

Caesarean scar management

Once the incision is appropriately healed, therapeutic ultrasound may be incorporated alongside scar mobilisation and other soft tissue techniques, to help address scar sensitivity, reduced tissue mobility and discomfort.

The aim is not simply to “break down” scar tissue, but to improve comfort and tissue mobility as part of a broader, individualised rehabilitation program. Evidence for scar- specific ultrasound remains limited, so treatment should be guided by clinical assessment rather than used routinely for every scar.

Instruction from our women’s health physiotherapist will include:

• Soft tissue mobilisation of the scar and surrounding area
• Effective deep abdominal core activation training with graded exercise

Encouraging a postnatal woman to “get to know and love” her tummy again, is an important part of our women’s health physiotherapy.

Breast engorgement & lactation-related breast symptoms

Therapeutic ultrasound has been used by physiotherapists for breast symptoms, such as engorgement, tenderness and ductal narrowing/blocked areas. Small studies suggest that a multimodal physiotherapy approach can reduce symptoms. However, there is a recent randomised controlled trial that found ultrasound itself was not superior to sham ultrasound. This highlights an important point – ultrasound is best considered an adjunct, rather than a stand-alone treatment.

What about mastitis?

It is important to distinguish inflammatory breast symptoms from bacterial mastitis and breast abscess. Current mastitis guidance emphasises reducing inflammation and avoiding overly aggressive breast massage or excessive milk removal. Therapeutic ultrasound should only be considered following appropriate clinical assessment and within an evidence-informed treatment plan.

Our women’s health physios have worked in this area for many years, and understand the importance of clinical effectiveness being demonstrated in their treatment of mastitis and lactation-related breast symptoms.

Women’s health physiotherapy is about more than the scar or breast!

We look at the whole postnatal picture. This may include pain, loss of functional movement (neck, back, wrists, hips), abdominal wall function, pelvic floor health, breastfeeding challenges, scar mobility and your confidence in returning to everyday activities and feeling strong as a mum.

If you are experiencing a painful/tight caesarean scar or persistent breast symptoms after birth, our women’s health physiotherapist can assess whether therapeutic ultrasound is appropriate for you – and, importantly, what other treatment strategies may be more beneficial.

Our well trained, caring physios are only a phone call away.

Opening your bowels should not feel like a full body workout, where you are holding your breath, straining, pushing so hard or rocking back and forth. You may even be spending what seems like forever on the toilet to just open your bowels. It is not normal to feel exhausted, sweaty, or like you’ve completed a gym session after opening your bowels. Or you may leave the toilet and feel you have not emptied your bowels completely.

An important point is you are not alone, as many people live with defecation dysfunction. This is a condition that affects the body’s ability to effectively empty their bowels.

The good news?  There is help available and one of the most effective tools is Rectal Balloon Training (RBT). This training can be provided from a Pelvic Health Physiotherapist, who has a special interest in defecation dysfunction.

What is Defecation Dysfunction?

Defecation dysfunction refers to difficulty emptying the bowels, even when stool is present in the rectum and the urge to go exists.

Common symptoms include:

• Excessive straining
• A sensation of incomplete emptying
• Feeling blocked or obstructed
• Needing multiple attempts to empty
• Spending a long time on the toilet
• Needing to use your fingers to assist evacuation
• Reduced or absent urge to open your bowels
• Chronic constipation

For many people, the problem isn’t simply the stool itself, but rather how the muscles, nerves and rectum are working together.

The Role of Your Pelvic Floor in Bowel Function

Your pelvic floor muscles form a supportive sling at the base of your pelvis and play an important role in bowel control and emptying.

When everything is working well, the pelvic floor muscles relax and lengthen when you sit on the toilet. This relaxation allows the anal canal to open so stool can pass comfortably and efficiently.

However, sometimes these muscles don’t get the correct memo. So instead of relaxing, the muscles may tighten, brace or contract during attempts to empty the bowels. This is known as dyssynergic defecation or a defecation disorder.

Over time, this can lead to:

• Ongoing constipation
• Excessive straining
• Haemorrhoids
• Pelvic floor tension
• Pelvic organ prolapse
• Worsening bowel symptoms

Is it Just a Muscle Issue?

Your rectum also plays a crucial role.

The rectum acts as a storage reservoir and contains stretch receptors that help detect when stool is present. These receptors signal to the brain that’s its time to open your bowels.

Sometimes, particularly in people with longstanding constipation, the rectum can become stretched over time. As the rectum enlarges, it becomes less sensitive and requires larger volumes of stool before the urge to empty is triggered.

As a result, people may experience:

• Reduced bowel urges
• Missing the body’s signals to go
• Infrequent bowel motions
• Significant stool accumulation

This is where Rectal Balloon Training (RBT) can be particularly helpful.

What is Rectal Balloon Training?

Rectal Balloon Training (RBT) is a specialised assessment and treatment technique used by Pelvic Health Physiotherapists to improve bowel emptying and rectal sensation.

A small balloon attached to a catheter is gently inserted into the rectum and gradually inflated with air. This allows us to assess:

• Rectal sensation
• Awareness of bowel filling
• The urge to defecate
• Pelvic floor coordination during emptying

Depending on the test findings, your Pelvic Health Physiotherapist can use the balloon as a treatment tool to retrain the bowel-brain connection. For some people, the goal is improving awareness of rectal filling and restoring normal bowel urges. For others, the focus is learning how to relax the pelvic floor and coordinate effective bowel emptying,

Think of RBT as physiotherapy to train your bowel reflexes.

How can a Pelvic Health Physiotherapist Help You?

At Physiotherapy for Women, we take a comprehensive approach to bowel dysfunction. We firstly listen to your story and your symptoms. By working together with open discussion, we set a treatment plan, including achievable goals.

Treatment may include:

• Education about bowel function and anatomy
• Optimising toilet posture
• Breathing and pressure management strategies
• Pelvic floor muscle relaxation training
• Defecation training
• Rectal Balloon Training
• Stool consistency optimisation
• Fibre and fluid education
• Strategies to improve bowel urges
• Management of pelvic floor tension and pain

Our goal is simple: to help bowel motions feel effortless again.

You Should Not Have to Fight Your Bowels

Opening your bowels shouldn’t feel like a full-body workout!

If you are straining, pushing, spending excessive time on the toilet, or feel like you’re never completely empty, your body must be telling you that something isn’t functioning as efficiently as it could be.

The good news is that there are evidence-based treatments available to help you. Pelvic Health Physiotherapists are uniquely trained to assess and manage your bowel opening problems. If you are struggling with constipation, incomplete emptying, or bowel dysfunction, we’d love to help you.

Contact our clinic today to book an appointment with one of our Pelvic Health Physiotherapists. Congratulations for taking the first step towards better bowel health.

Passionate about women’s health, and particularly about educating and empowering women to put themselves higher on their priority list, Amilia is committed to proactive care and to promoting and delivering high quality physiotherapy services for women.

Amilia graduated with a Bachelor of Physiotherapy from the University of South Australia in 2012. Since then she has followed her passion for women’s health working in private practice in Adelaide.

Prior to completing her Physiotherapy degree, Amilia completed a Bachelor of Science at Flinders University, majoring in microbiology. It was during this degree that her son arrived, and following his birth Amilia encountered a women’s health physiotherapist, who inspired her to take up the profession.

A daughter was to follow, and soon after completing her first degree Amilia took up the huge challenge of studying Physiotherapy full time, whilst helping to run her husband’s electrical business.

Completing her Physiotherapy studies whilst caring for two small children, Amilia can empathize with so many women out there who have huge demands to meet in life, both physically and emotionally.

The recent addition of baby three, has meant Amilia’s life has not slowed down and its more important than ever to keep on top of her health and wellbeing.  Amilia feels strongly about helping her clients to realise this in their own lives, and working with them to achieve it.

Amilia is extremely keen to extend her knowledgewhenever there is an opportunity and is frequently attending professional development courses; she is trained in Dry Needling, Clinical Pilates, Continence and Women’s Health and is always looking to add more to her repertoire.

Chrissy graduated with a Masters of Physiotherapy from Flinders University in 2016 and started working in musculoskeletal physiotherapy where she developed a passion for working with women of all stages of life.

Chrissy has experience in private practice, in-patient orthopaedics and sports physiotherapy. Her love for Physiotherapy began when she was exposed to injuries whilst playing soccer. This fostered her interest in the prevention, management and treatment of injuries.

She has a passion for healthcare and is intrigued by the complexities of the human body. Employing a goal-specific and patient-centered approach is her treating philosophy. She aims to improve the quality of life and functional ability of her clients through education, exercise and hands-on therapy.

Chrissy has an interest in women’s health, empowering women to prioritize their health through the different stages of life – as well as additional training in Clinical Pilates, Dry Needling and Headache Treatment.

Outside of work, Chrissy enjoys Reformer Pilates, beach walks and socialising with family and friends.

Helping women to maintain an active lifestyle throughout their various life stages, and feel empowered about their health, are key motivators in Louise’s practice.

Graduating from King’s College London in 2008, Louise has worked in London and Adelaide across a variety of settings and clinical areas. She utilises this experience to cater for clients with a variety of musculoskeletal conditions and rehabilitation needs to get them back to doing what is important to them and feeling confident in their bodies.

Pregnancy and postnatal recovery are particular areas of interest. With young children, Louise is aware of the challenges that can be faced during these times and the benefits that can be gained from taking a holistic approach to care during these times of change in a women’s life.

Continuing to develop her knowledge and remaining current in her practice are of high importance to Louise; she undertakes regular training and professional development opportunities and has additional training in areas such as Clinical Pilates, continence and women’s health and occupational health.

Outside of work, Louise enjoys keeping active-playing netball, running and doing Pilates, in addition to getting outside with her young family and making the most of the warm Australian weather! Good food, a good book and catching up with friends are also also key at helping Louise keep life balanced.

In 2008, on obtaining her Bachelor of Physiotherapy in India, Sangeeta embarked on a diverse professional journey. She has accumulated physiotherapy experience across a range of healthcare settings, including hospitals, community environments, and private practice in India, Singapore, and Australia. Complementing her practical experience, she pursued further education, achieving a Graduate Certificate in Musculoskeletal Physiotherapy from the University of South Australia in 2011.

In her journey as a musculoskeletal physio, Sangeeta soon realised the need for specific physiotherapy care across the broad spectrum of women’s health. Becoming a mother herself made her aware of the importance of pelvic health. This personal journey inspired her to take action. Sangeeta completed a Graduate Certificate program in Pelvic Floor Physiotherapy in 2022 at the University of Melbourne.

Sangeeta pelvic health skills include pregnancy and postnatal weakness, pelvic organ prolapse, urgency, urge & stress incontinence, pre & post pelvic surgery, pelvic pain, painful sex, bladder & bowel weakness.

Sangeeta continues with regular professional development to ensure she is up to date with all the recent evidence in the area of pelvic health research.

Sangeeta’s strength lies in her ability to listen to her patient’s narratives.  She ensures they feel valued, understood and empowered as they navigate their individual therapeutic journey to better health.

Outside of her work, Sangeeta enjoys spending time with her family, taking care of her two little girls, and embracing the joys and challenges of motherhood. She also plays badminton, a sport that not only keeps her active but also offers a chance to connect with friends over friendly matches.

Sophie graduated with a Bachelor of Physiotherapy from the University of South Australia in 2019. Growing up with a love of sport, she initially saw herself pursuing a career in sports physiotherapy. However, during her early years working in private practice, she began treating pregnant and postpartum women — and quickly discovered a passion for pelvic health that would shape her career.

Sophie went on to complete her Master of Physiotherapy (Pelvic Health) at the University ofMelbourne, graduating with First Class Honours in 2025. She has also achieved APA Titling as a Women’s, Men’s & Pelvic Health Physiotherapist — recognition of advanced clinical expertise and leadership within the field of pelvic health.

In addition, Sophie holds qualifications in neuromuscular dry needling and Clinical Pilates, allowing her to integrate hands-on treatment with targeted rehabilitation strategies.

As part of her Master’s degree, Sophie conducted original research into pelvic pain and endometriosis in Adelaide — a condition she is deeply passionate about improving awareness and care for. A significant milestone was achieved through this research, with Sophie advocating for meaningful improvements in pelvic pain management within South Australia.

Sophie is committed to ongoing education and evidence-based practice, ensuring her patients receive the highest standard of care.

Sophie is passionate about supporting individuals across all stages of life to regain confidence, control and comfort in their bodies. Whether guiding women through pregnancy, supporting postpartum recovery or helping individuals navigate complex pelvic health conditions, she strives to create a safe, respectful and empowering environment for you to share your story (free of judgement!).

Her ethos extends beyond symptom relief. Sophie believes in educating, empowering and collaborating with each patient to achieve meaningful, long-lasting outcomes. She recognises that no two presentations are the same, and there is no “one-size-fits-all” approach. Together, you will develop an individualised management plan aligned with your goals — so you can return to doing what you love.

And yes — she is especially passionate about helping women with the fundamental three P’s of everyday life: pee, poo and pleasure.

Sophie grew up in Tanunda in the Barossa Valley, where community, connection and a love of wine were part of daily life. Growing up in a close-knit country town instilled in her the importance of kindness, support and genuine care for those around her — values she carries into her clinical work every day.

Known for her bubbly, warm and motivating personality, Sophie brings positive energy into every session. Outside the clinic, she rarely sits still — she loves keeping active, listening to music, and sharing plenty of laughs with friends and family.

Rebecca established the Physiotherapy for Women practice in 2000. Having a special interest in the life stages of women from a health point of view, Rebecca developed a unique physiotherapy clinic, providing a combination of musculoskeletal, pelvic health and exercise therapy.

Over her many years of physiotherapy practice, Rebecca has learnt the importance of firstly listening to a client’s presenting story, along with understanding their goals – what do they actually want! This approach guides the assessment and treatment pathway, based on open communication with the client and clinically informed practice. This philosophy has enabled Rebecca to treat diverse presentations of pain, weakness and dysfunction in a woman’s body, regardless of age.

Handing on these skills to her excellent physiotherapy team within Physiotherapy for Women, was always seen as important and continues to occur. Encouraging team mentoring and continuing professional development, has enabled Rebecca to retire from clinical hands-on physiotherapy at the end of 2025, but still remain actively involved in running the business.

As Managing Director, Rebecca strives in supporting the happy physiotherapists and front desk team. The business aims for every woman coming in to the Lockley’s practice to receive excellent physiotherapy services, where open communication is first and foremost. This is vital in assisting each client to understand what is involved in their individual health journey. There will of course be times when that pathway is not always straight forward and multi-disciplinary health measures may be necessary.

Rebecca enjoys life away from work, respecting the need to find that balance between living and loving life to it’s fullest. Maintaining physical strength and agility through the aging process, has given Rebecca the chance to be active with her grandchildren and to experience the many sides that nature has to offer when gardening, bushwalking and kayaking.