Let’s Talk About Sex

For many women, sex is far from enjoyable or pleasurable. In fact, sex can be painful for many women.  So painful for some, that it is not at all possible.  Dyspareunia is the term we use for painful sex. Pain may be experienced before, during or following sexual intercourse. Dyspareunia may be deep (felt deep inside the vagina), or superficial (felt at the introitus or entry to the vagina).  It can affect women of all ages. The important point is, sex should not be painful, and there are treatment options out there (that don’t include “just have a glass of wine and try to relax”).

Often there are multiple factors that are contributing to why a woman experiences pain with sexual intercourse (or any form of arousal, touch, or penetration). These may include various physical and psychological factors such as; lubrication, infection (UTI, thrush), surgery, endometriosis, physical or emotional trauma, stress, anxiety, relationships, personal beliefs and more.  Some of these factors may affect the function of the pelvic floor muscles and nerves which may be one of the reasons why a woman is experiencing dyspareunia. 

Pelvic floor muscles lay in the base of the pelvis and surround the vaginal and anal openings. They play a huge role in sexual function. Sometimes, these muscles, and the nerves in the area, are not functioning optimally. This may result in pain sensations being experienced in anticipation of, during, or following sexual activity. One of the reasons this occurs is due to involuntary contraction or persistent spasm of the pelvic floor muscles when they should be relatively relaxed during sexual activity.  We call this spasm/involuntary contraction of the pelvic floor muscles, vaginismus. 

Pelvic floor physiotherapy can often assist women experiencing pain with sex (dyspareunia), particularly those experiencing vaginismus. It will vary depending on each individual, but frequently we work on techniques that help to relax the pelvic floor muscles. Some techniques we use are rather passive (breathing exercises, stretches), and some techniques are more physical or involve manual therapy to the pelvic floor muscles, devices such as dilators and biofeedback tools.  We also work with you on your overall pelvic health including bladder and bowel function and pain education and management.

Treatment for dyspareunia is never the same for any two women, and often input from multiple health professionals is required to achieve holistic care and optimal outcomes. Other health professionals that can assist include psychologists, sexologists, GPs and other specialists.

If you experience pain with sexual intercourse, and you haven’t had a pelvic floor physiotherapy assessment, we recommend you do. Further information can be found at the links below, or give us a call.

This is intended as general information only. It is not to be interpreted as professional advice. Please consult a health professional before attempting any form of treatment. We use the terms women/woman/her/she, however, we treat anyone who identifies as a woman or has female genitalia and is supportive of all LGBTQ and non-binary people.  If you are male and in need of assistance, we know of some wonderful physios around town and can point you in the right direction.