Pain with Sex
Painful sex (also known as dyspareunia) is distressing. It can negatively impact your mental health and intimate relationships. Women’s Health Physiotherapy is an effective treatment option for managing the physical causes of your pain.
Causes of pain with sex
Tight pelvic floor muscles
Your pelvic floor muscles wrap around the entrance to your vagina. If these muscles are too tight then they can constrict the entrance to your vagina and cause pain when trying to achieve penetration.
Atrophy & Inflammation
Thinning, drying and inflammation of the vaginal walls can occur when oestrogen levels are low in the body. Low oestrogen levels often occur in menopause and the postpartum period; and can also be due to chemotherapy, radiation and certain medications. Inflammation can also be caused by vulval skin conditions and diseases.
Vaginal dryness
Vaginal dryness can cause friction, irritation and pain during intercourse. Vaginal dryness is another symptom caused by low oestrogen levels and can also be naturally occurring in women with normal oestrogen levels. It can also be caused by vulval & vaginal skin conditions and diseases.
Psychosocial factors
Our thoughts and emotions are deeply connected with our sexual experiences. Depression, anxiety, stress, relationship issues with your intimate partner, a history of sexual abuse and negative previous sexual experiences can all contribute to pain with intercourse.
Physiotherapy Management of Painful Sex (Dyspareunia)
manual therapy to release tight pelvic floor muscles
prescription of pelvic floor relaxation exercises
dilator therapy (dilators are tube-shaped medical devices that come in progressively bigger sizes, they are inserted into the vagina to slowly stretch the tissues and help you learn to relax your pelvic floor muscles during penetration)
advice about the best personal lubricants and vaginal moisturisers for your condition
education about alternate positioning to decrease pain during intercourse
referral to GP for topical oestrogen where indicated
referral to psychologist where required
