Pelvic Pain & Sexual Dysfunction Treatment in Las Vegas
Pain with sex. Pain when you sit. Pain that no one has been able to explain. You're not imagining it — and you don't have to keep living with it.
Pelvic pain is one of the most undertreated and misunderstood categories of pain in physical therapy.
It rarely shows up on imaging. It doesn't always have a clear structural cause. And because it involves intimate parts of the body, many patients take years to seek help — or are told repeatedly by providers that everything looks normal.
If everything looks normal but nothing feels normal, there's a reason. The pelvic floor muscles, connective tissue, and nerves in the region are extraordinarily capable of generating pain that doesn't appear on an MRI. Finding and treating that source is exactly what we do.
What we treat in this category
Dyspareunia (painful intercourse) Pain during or after sex — at the point of entry, deeper in the pelvis, or both. Often caused by pelvic floor muscle tension, scar tissue, or nerve sensitivity. Frequently under-addressed because patients don't know it's treatable, or feel embarrassed raising it with a provider.
Vaginismus Involuntary contraction of the vaginal muscles that makes penetration painful or impossible. Highly treatable with a combination of manual therapy, neuromuscular retraining, and a graduated dilator program — at a pace that's entirely set by the patient.
Vulvodynia and vulvar vestibulodynia Chronic vulvar pain or burning — sometimes constant, sometimes provoked by touch or penetration. The underlying driver is often pelvic floor tension combined with peripheral nerve sensitization, and both respond to treatment.
Coccydynia (tailbone pain) Pain at the base of the spine, often worsened by sitting, standing up, or using the bathroom. The coccyx is directly connected to the pelvic floor, and tension in those muscles is a primary source of coccyx pain.
Post-surgical pelvic pain Scar tissue from hysterectomy, endometriosis excision, C-section, or other pelvic surgeries can adhere to surrounding structures and generate pain that outlasts the healing process. Manual therapy mobilizes scar tissue and restores mobility to the affected area.
Clitoral or genital pain Pain in the clitoris, labia, penis, or scrotum in the absence of infection or structural pathology is frequently driven by pelvic floor trigger points or pudendal nerve irritation — both addressable with PT.
Bladder-related pelvic pain Bladder pain syndrome and IC/PBS often overlap with pelvic floor dysfunction.
The pelvic floor can be too tight — not just too weak
For pelvic pain and painful sex The pelvic floor muscles often develop tension and trigger points in response to tissue changes, hormonal shifts, and avoidance behaviors. Manual therapy — including internal myofascial release — addresses that tension directly. We may also work with a dilator program to progressively restore comfort and function.
For bladder symptoms Urgency, frequency, and leakage in menopause are often a pelvic floor coordination issue on top of a tissue change issue. We work on muscle function, bladder habits, and the neurological urgency response.
For prolapse Pelvic organ prolapse is common in menopause. PT doesn't reverse it structurally, but it significantly reduces symptoms, improves support, and — critically — helps you stay active without worsening it.
For overall strength and resilience Menopause accelerates muscle loss, bone density decline, and joint laxity. Pelvic PT that integrates strength training is particularly powerful at this life stage — which is why we often coordinate care with our women's strength training program.
What treatment looks like
Treatment for pelvic pain is always built from the evaluation findings — never applied from a standard template. Depending on what we find, your treatment may include:
Internal and external myofascial release of the pelvic floor and surrounding muscles
Scar tissue mobilization
Dry needling for trigger point release
Nerve mobilization along the pudendal and surrounding nerve pathways
Graduated dilator program (for penetration-related symptoms)
Movement and posture retraining
Breathing and pressure management strategies
A note on internal assessment
An internal pelvic floor exam is often the most clinically useful thing we can do for pelvic pain — it allows us to directly assess the muscles and tissue that are generating symptoms. We understand this can feel daunting, especially if previous pelvic exams have been painful or uncomfortable.
Here's how we approach it: we explain everything before we do anything. The exam is always consent-based, always at your pace, and always stoppable. External assessment provides meaningful information on its own, and we'll always start there. Nothing happens that you haven't agreed to.
Many patients find that the internal exam gives them more clarity about their pain than anything else they've experienced — because for the first time, someone is actually examining the structure that hurts.
Your first visit
Your first visit is a conversation and an evaluation. We want to understand your full history — when symptoms started, what makes them better or worse, what you've already tried, and what you want your life to look like without this pain.
Then we assess. Slowly, thoroughly, and always with your comfort as the frame.
You don't have to keep living with this.