Dyspareunia: Understanding and Managing Painful Sex

Dyspareunia is a medical term for painful sexual intercourse. It is characterized by persistent or recurrent pelvic pain that occurs before, during, or after intercourse. This condition affects both men and women, and can significantly impact your quality of life, relationships, and emotional well-being.

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Pain associated with dyspareunia can include sharp, burning, throbbing, or cramping sensations in the genital or pelvic region. The pain may be localized to a specific area or may be more generalized throughout the pelvis.

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Dyspareunia can stem from physical factors such as pelvic floor muscle dysfunction, infections, endometriosis, vaginal dryness, and scars from surgery or childbirth. It can also stem from emotional factors like stress, anxiety, and a history of sexual trauma.

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How Does Physical Therapy Help Dyspareunia?

Pelvic floor physical therapy (PFPT) is a specialized area of physical therapy that focuses on the assessment and treatment of the pelvic floor muscles, which play a crucial role in sexual function, bladder and bowel control, and pelvic stability by assisting with force transfer through the pelvis. These muscles also play a role in the function of the low back, hips, and torso. A 2021 review article in the journal Sexual Medicine Reviews explained the relationship between overactive pelvic floor muscles and sexual dysfunction.

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A pelvic floor physical therapist can help individuals with dyspareunia by:

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• Assessing the pelvic floor muscles. This includes evaluating muscle strength, flexibility, coordination, and any areas of pain or tension.

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• Providing manual therapy. This may involve hands-on techniques to decrease muscle tension, improve tissue flexibility, and reduce pain.

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• Teaching relaxation techniques. Learning to decrease tension in the pelvic floor muscles can be crucial in reducing pain during intercourse.

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• Developing a personalized exercise program. This may include stretches to improve flexibility and exercises to strengthen weak muscles.

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• Educating about pain management strategies. This may involve guidance on pain-relieving modalities, lifestyle modifications, and stress management techniques.

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Research suggests that pelvic floor physical therapy is an effective treatment option for dyspareunia. It is a non-invasive, low-risk approach to helping you avoid or reduce the need for medication and surgery. If you are experiencing painful sexual intercourse, seeking help from a pelvic floor physical therapist can be an important step toward improving your quality of life and restoring your sexual well-being.

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If you live in the Denver area, contact me at Activcore DTC to schedule an appointment.

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REFERENCES:

Adamian L, Urits I, Orhurhu V, et al. A comprehensive review of the diagnosis, treatment, and management of urologic chronic pelvic pain syndrome. Curr Pain Headache Rep. 2020;24(27):1-11.

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Bradley MH, Rawlins A, Brinker CA. Physical therapy treatment of pelvic pain. Phys Med Rehabil Clin N Am. 2017;28(4):589-601.

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Padoa, A., et al. “The Overactive Pelvic Floor (OPF) and Sexual Dysfunction” Part 1: Pathophysiology of OPF and its Impact on the Sexual Response. Sexual Medicine Reviews. 2021; 9(1):64–75.

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Padoa, A., et al. The Overactive Pelvic Floor (OPF) and Sexual Dysfunction. Part 2: Evaluation and Treatment of Sexual Dysfunction in OPF Patients. Sexual Medicine Reviews. 2021;9(1):76–92.

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Tracey A. Pelvic floor physical therapy and its merit in the treatment of female urogenital pain. Curr Pain Headache Rep. 2022;26(10):775-782.

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Vincent K, Evans E. An update on the management of chronic pelvic pain in women. Anaesthesia. 2021;76(Suppl 4):96-107.

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‍Disclaimer:  The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.