Happy Monday my friend! In honor of February and Valentine’s Day we are going to be talking about a variety of pelvic floor dysfunction’s that can cause painful intercourse, otherwise known as dyspareunia. This is unfortunately common in our society, and it should be a direct referral to a pelvic floor physical therapist. However our medical world is really slacking on making the appropriate recommendations for these people. I am hopeful that this blog will educate you on why this can happen, and hopefully give you a direction on where you can go to get a solution!
Painful intercourse can happen for a variety of reasons: an up-regulated nervous system, hypertonic musculature, and inflamed tissues. Let’s go to some of the most common dysfunctions that’ll tell her physical therapist can treat!
By definition dyspareunia means pain with attempted vaginal penetration. That is why this word is used interchangeably with the description of painful intercourse. In regards to dyspareunia there are two different types and the first type is known as superficial dyspareunia, and the second is known as deep dyspareunia. The superficial refers to pain with initial entry into the vaginal wall. The deep dyspareunia refers to pain with either mid to deepest layer of the vaginal canal.
In simpler terms, you can think of it as pain with the initial attempt at penetration. Then the deep version is where there is pain with either half or full completion of penetration.
Are you asking yourself, why would this happen? Typically the source is traced back to overactive pelvic floor musculature, and potentially increased skin/tissue sensitivity. The person suffering from this may also have a high stress level, up-regulated nervous system and experience anxiety.
Vaginismus is a pelvic floor disorder that is defined as “inability to penetrate vagina due to pain”. There is often superficial muscle tension associated with it, and there is high correlation of psychological problems, such as fear, surrounding intercourse or any type of penetration. Women who suffer from vaginismus are often the same type as listed above with a higher stress level, increased anxiety, upregulated nervous system, and may have a difficult time relaxing.
Vaginismus is best treated not only buy a pelvic floor physical therapist but along side a mental health therapist as well.
Vulvadynia is defined as a chronic pain or discomfort around the opening of your vagina (vulva) for which there’s no identifiable cause and which lasts at least three months. This can be a really frustrating diagnosis because of the “no identifiable cause” part of that definition. Either way it is pain associated with the vulva and dyspareunia can also be present with it. It also has a high correlation with chronic stress, pelvic floor muscle overactivity and hypertonicity. It is treated by pelvic floor physical therapy, education/pain management, and occasionally pharmaceuticals.
All three of the above listed pelvic floor dysfunctions can lead to painful intercourse. That can be an extremely hard obstacle to deal with! Unfortunately getting in to see your doctor, or Ob/GYN often takes time and that time is so precious in the rehabilitation world. The sooner you can seek help to begin treatment, the faster you can heal!
Pain science is very complicated, and honestly it’s too much to try and explain within a blog. I think the one concept to take away is that “acute pain” is described as pain when it first occurs or “with initial injury”. That acute pain can become chronic after 3-6 months (depending on who you ask) and after that the pain cycle becomes much more complicated in rehabilitation and in healing.
Please don’t wait to talk to a medical professional! Go to Belle’s Contact page and fill out the form and submit your questions to me today!