Dyspareunia and Physiotherapy

Dyspareunia is genital pain experienced just before, during or after sexual intercourse. Some women have always experienced pain with intercourse from their very first attempt. Other women begin to feel pain with intercourse after an injury or infection or cyclically with menstruation. Sometimes the pain increases over time. When pain occurs, the woman may be distracted from feeling pleasure and excitement. Learn how physiotherapy can help in treating dyspareunia and restore a healthy and pain-free sexual experience. Find out more about dyspareunia and its physiotherapy treatment options.

Causes

• vaginal dryness from menopause, childbirth, breastfeeding, medications
• skin disorders that cause ulcers, cracks, itching, or burning
• infections, such as yeast or urinary tract infections

•  spontaneous tightening of the muscles of the vaginal wall 
• endometriosis
• pelvic inflammatory disease
• uterine fibroids
• irritable bowel syndrome
• radiation and chemotherapy

Some factors also affect a person’s ability to become aroused can also cause dyspareunia. These factors include:

• stress, which can result in tightened muscles of the pelvic floor
• fear, guilt, or shame related to sex
• self-image or body issues
• medications such as birth control pills
• relationship problems
• cancer, arthritis, diabetes, and thyroid disease
• history of sexual abuse

Symptoms

• Pain while inserting a tampon or during penis penetration
• Pain with particular partners.
• Deep pain during thrusting
• Burning pain or aching pain.
• Throbbing pain, lasting hours after intercourse.

Physiotherapy Treatment  

Education: by helping to describe the role of the pelvic floor musculature in the pain cycle and provide techniques that can be used in the home environment

Manual therapy to mobilise muscle and soft tissue, normalize overactive muscles, improve circulation and desensitize areas

Desensitization therapy: learning vaginal relaxation techniques, such as Kegel exercises, that can decrease pain

Sex therapy: learning how to re-establish intimacy and improve communication with your partner

Water-based lubricants rather than petroleum jelly or other oil-based lubricants are preferable. Oil-based lubricants tend to dry the vagina.

Psychological therapies, such as cognitive-behavioral therapy and mindfulness-based cognitive therapy 

Pelvic muscle relaxation exercises, sometimes with biofeedback can help women with tight pelvic muscles learn to consciously relax them.