Painful Sex

Painful sex can happen at any stage of life for women, but it happens more often during a women’s childbearing years in approximately ⅓ of the population. It is often misdiagnosed by 5-7 providers before a woman receives the help she needs. She can often have pain in this region without any sexual activity. This pain can be present all the time or come and go.  It can burn, itch, be red or raw in the region. 

Why Diagnosis It? 

Once you understand what area the pain is being generated from and when it occurs, you can more accurately treat it.  

Three of the Most Common Diagnosis: 

  1. Vaginismus: Uncontrollable muscle spasms of the pelvic floor that prevents penetration. Pain with intercourse. 
  2. Vulvodynia: Pain with contact or without contact in the external genital region called the vulva. This includes the mons pubis, labia layers, clitoris, opening of vagina and urethra, the vestibule and all the glands. 
  3. Vestibulodynia:  Pain that occurs at the entrance of the vagina and can be felt with or without contact to the area.  Glands that produce lubrication for sexual activity are located there. The skin may be red or raw looking and they may have atrophic tissue there. Hormones, infections, stress, hypersensitivity, tight pelvic floor muscles often play a role in this. 

Can Painful Sex Be Treated: 

All of these diagnoses can be treated. It usually involves a multi-disciplinary approach between your Family Physician, OB/GYN, Urogenital MD and specialized Pelvic Health Physical Therapist. 

The Most Common Components With Painful Sex: 

  1. Pelvic floor muscles that are too tight and short. These muscles then have pain and poor blood flow in and out of the region. Therefore, Improving the flexibility and the movement patterns of the floor muscles themselves  greatly improves these conditions. 
  2. Hormonal changes at different stages of life. Postpartum, breastfeeding, peri-menopause, menopause, oral contraceptives. 
  3. Use of Medications- oral contraceptives, acne meds, antibiotics, yeast infection meds. 
  4. Systemic Disease- Autoimmune diseases, interstitial cystitis,urinary tract infections, etc 

Pelvic Floor Physical Therapists  play a significant role in treating painful sex due to their understanding of the pelvic floor muscles and their nerve function. Our specialized Physical Therapists also know how to assist blood flow patterns, thereby decreasing painful swelling and bloating in the region.