Dyspaerunia

Dyspareunia is the medical term for painful intercourse. Both men and women can experience it. Unfortunately, many people suffer in silence – because of embarrassment, shame or simply not knowing that there are effective treatments available. Let’s bring this important topic into the spotlight.

What is Dyspareunia?

Dyspareunia is when a person experiences ongoing pain in the genital area or within the pelvis during sexual activity. Colloquially, this is often referred to as “painful intercourse.” There are two types of dyspareunia:

• Superficial dyspareunia: When pain is felt at or close to the entrance of the vagina with penetration.

• Deep dyspareunia: Occurs with deep penetration and is felt in the deep vaginal tissues, cervix, or lower abdomen. It may feel worse in certain positions.

In addition to physical pain, many people suffer a great deal emotionally. It can be distressing for both the person experiencing the pain and their partner – and put stress on a relationship. Some people may even shy away from any form of intimacy (kissing, touching) because of worries that this may lead to intercourse.

Who Is At Risk of Dyspareunia?

It may be surprising to learn that both men and women may experience pelvic pain and dyspareunia. Men may experience pain with erection, ejaculation, or following ejaculation. Learn more here

Anyone can experience painful intercourse, but there are certain factors that increase the risk. These include:

• Endometriosis or adenomyosis

• Interstitial cystitis

• varian cysts or fibroids

• Presence of scar tissue in the pelvis and lower abdomen from previous surgeries or trauma

• Pelvic organ prolapse

• Vaginismus (pelvic muscle spasms)

• Infections

• Vaginal dryness

• Stress or emotional trauma

  It is also quite common for women to experience painful intercourse after having a baby, which is called postpartum dyspareunia. In fact, it has been reported that 62% of women experience dyspareunia in the first 3 months after delivery. Learn more about postpartum dyspareunia

What Is The Role of The Pelvic Floor in Dyspareunia?

The pelvic floor is a group of muscles, ligaments, and connective tissue that are located at the bottom of the pelvic bones. The pelvic floor is our body’s foundational core, providing:

• Support to the pelvic organs

• Stability for the low back and hip joints

• Support for the bowel and bladder

• The framework for sexual sensation and arousal (when functioning properly)

When working optimally, the pelvic floor muscles are able to dynamically relax and contract. When they are not working properly (called “dysfunction”), the pelvic floor muscles lack the flexibility and elasticity needed to allow for comfortable and pain-free penetration. This can be because they have too high or too low muscle tension (muscles are unable to relax and contract) or are weak. Or, a person may not be able to properly control their pelvic muscles for a variety of reasons.

How Can Pelvic Health Physiotherapy Help Me?

If you struggle with dyspareunia, it’s common to feel uncomfortable to bring it up with anyone, including a healthcare provider. Know that you’re not alone and there is help available. Speaking to a Pelvic Health Physiotherapist , who sees and treats people with this issue all the time, is a good place to start.

A Pelvic Health Physiotherapist works closely with you to understand your type of pain, and identify possible source(s) of it. This is done through a thorough examination in which they will assess your muscle tone by gently pressing on your pelvic floor muscles. Your therapist will provide feedback and teach you how to connect to the areas of tension.

They will then implement evidence-based strategies to help you better relax your pelvic floor muscles. This can include things like deep diaphragmatic breathing and pelvic floor awareness exercises. Certain stretches and yoga poses can also be helpful. To address muscle tension more directly, manual therapy and the use of vaginal dilators can help improve flexibility.

How Do We Approach Treatment For Dyspareunia?

We understand that you may be feeling a lot of emotions – shame, embarrassment, helplessness, and more. We are here to offer you a safe, non-judgmental space for sharing how you feel. Together, we will create a step-by-step, evidence-based plan to help you get where you want to be: pain-free, pleasurable intimacy. Through expertise, compassion and professionalism, we will help you release any shame or embarrassment you may feel, and (re)gain control and confidence.

Our approach is holistic and outcome-driven, using a combination of education and clinical care to put you on a positive course to restoring your pelvic health and wellness. Treatment plans are customized to your needs and goals.

Book an appointment to learn more about how we can help.

What Other Treatments Are Available?

We highly recommend including multiple approaches in your journey to pain-free intimacy. Our team at Proactive Pelvic Health Centre will also incorporate some or all of the options below into our treatment plans based on your needs.

Lubricant/moisturizers. Vaginal dryness can often factor into painful intercourse. Lubricants add moisture and lessen the friction during penetration. We recommend using a basic water-based option to start. If you’re finding that it dries out quickly, a silicone-based option may give you better results. If no matter how much lubricant you apply, you are still having pain related to vaginal dryness or irritation, the next step would be to try a vaginal moisturizer.

Scar tissue mobilizations. If your Pelvic Health Physiotherapist determines you have scar tissue that may restrict your pelvic mobility, connective tissue techniques may be used. The goal is to slowly “desensitize” the tissues and increase their flexibility.

Sex therapy. Sex therapy can help people address emotional factors than may be contributing to their pain, as well as the impact it’s having on their relationship. Couples often attend sessions together.

Devices: The OhNut is a wearable device that allows for control of the depth of vaginal penetration. It is placed at the base of the penis to create a buffer, which prevents penetration to deeper painful areas. The size of the buffer can be controlled as there are 4 detachable rings. They are comfortable to wear and provide a sensation similar to vaginal penetration. A Pelvic Health Physiotherapist can help you integrate it into your treatment plan.