Pelvic pain is a hidden problem – it can’t be seen, its hard to diagnose and women often suffer many years before finding help. Sexual, vulval, pelvic and bladder pain is very distressing both physically and emotionally. Sexual pain can be due to a number of conditions including vaginismus, vulvodynia, endometriosus, painful bladder syndrome or coccydynia. In most of these conditions the pelvic floor muscles are tight or overactive and painful. The pelvic floor muscles are at the base of your peklvis, attaching from the pubic bone in front to the tail bone at the back . These muscles play a role in sexual function and support and control your bladder and bowel. If you have difficulty relaxing your pelvic floor muscles sex can be painful. The pelvic floor muscles may spasm involuntarily in response to or anticipation of pain or penetration leading to an overactive pelvic floor. This may happen with endometriosus, after pelvic surgery, an infection, nerve damage or injury. High stress levels, psychological factors (mood / relationship issues ore past abuse) and overuse of core muscles can also all contribute to an overactive pelvic floor. 1 in 5 women experience pelvic or sexual pain. There is evidence to support physiotherapy in reducing pain through treatment of the pelvic floor muscle tension and overactivity.