20 Jun Dyspareunia or Sexual Pain
Dyspareunia is the term used for pain experienced with, during, or after sexual intercourse. It can occur before penetration, on penetration, during penetrative intercourse or be an ongoing pain afterwards. It can be felt deep inside the pelvis, or closer to the entrance of the vagina, near the clitoris, or in the vulva. It may be felt as a sharp, dull, throbbing, cutting, stabbing, rubbing, or an achey pain.
There are many reasons why people experience dyspareunia. These reasons may include
- decreased arousal response and lubrication (particularly common postnatally, or during menopause)
- a ‘tight’ pelvic floor, or uncoordinated pelvic floor (involuntary spasm or tightening of the pelvic floor)
- history of pain in the region, or near the region (severe period pain, low back pain, pelvic pain)
- history of trauma (psychological or physical)
- history of UTIs or thrush
- psychological factors can contribute, including anxiety and depression
A multidisciplinary team including GP, gynaecologist, psychologist, sex therapist – can all help to address factors that are contributing to dyspareunia.
Physiotherapy plays an important role, and can help reduce dyspareunia with:
- assessment and management of tight or painful muscles, helping to normalize pelvic floor muscle tone and function
- education and advice regarding pelvic floor muscles, anatomy and function
- advice and improving understanding regarding positioning choices, arousal response, and lubrication
- consideration of broader lifestyle factors that may be contributing
- neuromodulation such as ‘e-stim’ or use of TENs
Many clients feel worried to seek help for this condition. Some people aren’t even aware that the pain they experience is not normal. Many think they just have to ‘put up with it’, and aren’t aware that it can be improved.
It is important to remember that dyspareunia is extremely common among all age groups, and there is help available. There is nothing to be embarrassed about, and seeking help is the first step!