A big word for a big problem.
Pain with sex (or dyspareunia) is more common than you may think. A lot of women suffer in silence because it can be embarrassing to mention to doctors and sometimes when it is mentioned, it is dismissed as being “all in their head” or even “normal”.
There can be many different causes of dyspareunia, and I hope to outline just a few below.
If you are looking for further information regarding dyspareunia causes and treatment options, please visit Jean Hailes helpful information page.
Women can experience a lack of lubrication after childbirth, when breastfeeding, post-menopausally and when having particular hormonal treatments (eg medications post-breast cancer, contraception medication).
Lack of lubrication causes dryness, a feeling of friction, burning and sometimes stinging with intercourse.
Simple remedies to alleviate this issue can range from – using vegetable oil or silicon-based lubricants, vaginal moisturisers, vaginal estrogen supplementation and ensuring adequate foreplay.
Vaginismus is an overactivity or spasm in the superficial pelvic floor muscles. Some women have always had it or it can start after trauma, infection, surgery or emotional problems.
The tight pelvic floor muscles hinder penile penetration and can cause severe pain at the entrance and inside the vagina with intercourse.
Treatment often includes: physiotherapy, deep tissue release, dialators and relaxation exercises.
Vulvodynia is pain experienced on the outside of the vagina, on the vulva. It can be spontaneous, burning, sharp pain but most often occurs when provoked by sex or tampon insertion.
It is often accompanied by vaginismus (see above).
Treatment is similar to that for vaginismus, but often these women also require medications to help calm their pain levels down.
Pain experienced in the lower abdomen or deep inside the vagina during sex can have multiple causes. These may include: deep pelvic floor muscle tension, endometriosis, constipation, pelvic inflammatory disease, prolapse, fibroids or adhesions from pelvic or abdominal surgery.
Treatment is obviously variable and may include: antibiotics for infection, surgery to treat prolapse, hysterectomy, surgery to remove endometriosis adhesions, restoration of normal bowel function and visceral manipulation to help loosen adhesions.
Other causes of dyspareunia can include episiotomy scar pain, radiation-scarred tissue, sexually transmitted infections, imperforate or intact hymen, abscesses, vaginal infections (thrush, bacterial vaginosis) and skin conditions (Lichen sclerosus/planus, eczema).
The majority of these conditions are often treated by a gynaecologist or GP. Episiotomy scar pain and radiated tissue often responds well to physiotherapy advice and input.
If you suffer from dyspareunia, you may benefit from a physiotherapy assessment!
So come and book in with Rachel, our women’s health and continence expert!