Painful Sex after Coccygectomy for Tailbone Pain?

After coccygectomy (surgical removal of the tailbone) as a treatment for tailbone pain (coccyx pain), should patients worry about whether sex will be painful?
  • I don’t know any published research on this one way or the other, but for patients I have treated after they have had coccygectomy, I don’t recall many  that have reported problems with sex after the surgery.
  • It’s possible, though, that people are embarrassed to mention it or I am not asking in a way that gets the best info..
  • In general, people in pain may have less interest in sex or may fear that the physical nature of sex may worsen their pain, especially pain in the pelvic area, which includes the tailbone (coccyx).
  • So, anything that helps to decrease someone’s pain (whether the treatment is medications, injections, or surgery) may subsequently helped to improve their interest in sex and their ability to comfortably engage in sex.
Body position during sex: how much pressure on the tailbone?
  • The specific position that the person is in during sex may also be important.
  • In general, positions that put direct pressure (such as your body weight, or another person’s body weight) onto the tailbone are more likely to be painful.
  • So, a person laying on their back would be more likely to have tailbone pain if they are slightly reclined, as compared with someone laying flat.  (While laying flat, most of the body weight is on to the sacrum, rather than the coccyx).
  • People with tailbone pain may need to work together with their partners to find the positions that are least likely to cause worsening of the tailbone pain. Examples include figuring out who should be ‘on top’.
Vaginal versus anal sex
  • Also, it is important to distinguish between vaginal intercourse versus anal intercourse.
  • My guess is that anal sex would potentially be much more problematic for people with tailbone pain, whether they had surgery for the coccyx or not. But again I don’t have actual research/surveys to support that, just my expectation based on the anatomy there.
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