Painful sex

Dyspareunia (painful sex) is pain that is persistent and recurring before, during, or after sexual
intercourse and it can happen to anyone at any age.

What Causes Dyspareunia?

There are a number of different causes that may lead to dyspareunia some include:

  •  Injury to the pelvic floor from things like childbirth, post-surgical conditions, pelvic inflammatory disease, endometriosis, scar adhesions.
  • Musculoskeletal dysfunction, where the pelvic floor muscles become overactive
    and don’t fully relax, they may also contract when they should be relaxing.
  • Psychosocial factors: stress, depression, anxiety, sexual or physical abuse.

How Can Physiotherapy Help?

The goal of physiotherapy in treating dyspareunia is to:

  • Reduce vaginal pain by reducing the overactive pelvic floor musculature.
  • Improve patient awareness and ability to control these muscles.
  • Improve the ability of the vaginal tissues to stretch.
  • Teach appropriate techniques for penetration.

What are the physiotherapy interventions to treat dyspareunia?

  • 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.
  •  Exercise: with the focus of relaxation through the pelvic floor.
  • Biofeedback and Electrical stimulation: assists in reducing overactive muscles.
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