Painful sex, also known as dyspareunia, or the inability to have sex due to pain, can be life altering and very challenging to deal with. Some people may experience pain with insertion while others experience pain with deeper penetration. Pelvic floor physical therapy can be extremely helpful in relieving these symptoms and help you to get back to your life.
– Pain with insertion (can also apply to insertion of tampon, finger, etc.)
– Pain with deep penetration
– Unable to have pelvic exam due to pain
– Inability to wear tampons or menstrual cups
There can be many different causes for painful sex. Non hormonal related causes include pelvic floor muscle spasms, nerve pain at the opening (vestibule) of the vagina or of the vulva, painful bladder syndrome, scar tissue due to surgery, endometriosis, or childbirth, or trauma including physical and/or mental.
Hormonal causes of painful sex may include low estrogen (either due to peri or post menopause), your period stopping for another health-related reason, or breast feeding.
Your physical therapist will perform a thorough evaluation to assess your symptoms. Being the evaluation may be both internal and external, you and your therapist will work together to ensure your comfort throughout the entire process. Your therapist will assess not only the pelvic floor musculature but will evaluate the low back, hips, and movement patterns to achieve a more comprehensive insight into what is going on. If your therapist feels you may need further examination or testing, she will refer you to an MD.
After determining the cause of the problem, the therapist will then be able to address the issue more effectively. Treatment for dyspareunia, or painful sex, includes both manual and therapeutic exercises to help stretch and release the pelvic floor musculature. Manual techniques may involve gentle muscle releases and dilator work, if appropriate. Your therapist may choose to teach you how to perform the manual releases on yourself at home between sessions. Exercises will focus on relaxation of the pelvic floor muscles. During treatment, your comfort is of utmost importance and treatment will be tailored to meet your tolerance and goals.