By Dr. Allison Feldt, PT, DPT
2 min read
Painful Sex is known as Dysparunia a condition characterized as pain before, during or after penetrative sex.
Pain with sexual intercourse is a common and multifactorial condition which can often be attributed to a combination of musculoskeletal and psychological components. Possible causes of dyspareunia include injury to the pelvic floor during childbirth, endometriosis, pelvic inflammatory disease, infection, overactivity in the pelvic floor musculature, stress and painful bladder syndrome. Psychosocial factors such as depression, physical or sexual abuse, and anxiety also are possible causes of dyspareunia.
Women may report pain (burning, stinging, sharp) with initial penetration or feeling as though their partner is hitting a wall with deeper thrusting or certain deeper penetrating positions. Pain and soreness can persist after intercourse as well.
Because this condition can be caused by a combination of factors, treatment should address all relevant elements. Pelvic floor rehabilitation is an important part of this treatment approach. PF muscles typically become overactive and weak with this condition. Overactive muscle without the ability to relax can become painful to the touch causing muscle spasms which can also be painful. Pelvic PT can help address the overactivity of the muscles by incorporating relaxation techniques, stretching, as well as manually releasing the muscles to decrease the tension. Patient’s receive a lot of education about the anatomy and function of their pelvic floor as well as how to properly activate, relax and lengthen their pelvic floor muscles. The goal of physical therapy is often to decrease the tension in the musculature and improve the patient’s ability to control these muscles.
Pro Tips:
● If pain is present with insertion in the vagina. Pause will initial insertion so that you have a moment to perform relaxation techniques such as diaphragmatic breathing. Once the pain begins to fade continue with insertion but go slow and repeat this process as necessary.
● Opt for positions that you are able to relax your butt muscles, inner thigh, and abdomen. You can prop your legs on the pillow so you can really relax during sex.
● Some people report that sex on all fours is more comfortable.
References:
Ghaderi F, Bastani P, Hajebrahimi S, Jafarabadi MA, Berghmans B. Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. Int Urogynecol J. 2019;30(11):1849-1855. doi:10.1007/s00192-019-04019-3
About the author
Allison is a pelvic floor physical therapist and the founder of Body Motion PT in Edmonds. A mom who knows the aftermath of pregnancy and birth firsthand, she's on a mission to help women restore their core and pelvic floor at every stage of life.
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