Warming up your muscles with foreplay, light stretching or a warm bath or shower before sex can also help minimize pain and strain. Size doesn't matter; it's the motion in the ocean that counts. Your hands, mouths and toys can go a long way to enhance pleasure and intimacy for both you and your partner. Vaginismus causes involuntary muscle spasms around the vagina, while interstitial cystitis means recurring pain or discomfort in the bladder and surrounding pelvic area. A Self-Treatment Guide to the Sex Life You Deserve," sees cases of vaginismus and interstitial cystitis — conditions that make sex painful for many women. Missionary is a good option for working around height differences, according to Scalisi, because it puts the person on top in charge of alignment. If you're the one with back pain, avoid positions that put pressure on the spine, such as missionary position with you on the bottom. Sometimes Size Does Matter How you maneuver your manhood is what counts. But regardless of shape and size, everyone deserves and can have a gratifying sex life. Any other advice for people whose conditions limit their action in the bedroom? Props are your friend. Video of the Day A little or a lot of variety can make sex more fun and pleasurable, but when a physical condition makes certain positions challenging or painful, finding safe, creative alternatives is important. Instead, start with the woman who is experiencing pelvic pain on top. Find the best sex position that works for you and your lover! For women with knee pain, lying on their stomach or on their backs in missionary style is a good way to avoid knee strain — and everyone can benefit from the spooning position!