One of the very best parts of the human experience is the ability to feel pleasure. For some, this can be more complicated, difficult, or seemingly impossible. It’s an unfortunate truth that many people, particularly women, live with the idea that some women just don’t enjoy sex and that this is normal. This is untrue. Sex should be pleasurable for both partners and penetrative sex should not be painful. While it can be difficult or uncomfortable to talk about, the topic of sex should not just be left for the bedroom. Below I will go into further detail on this condition using pieces from Dr. Jess’s upcoming book, Postpartum is Forever.
Dyspareunia, or painful intercourse, can be caused by a myriad of different reasons, ranging from psychological concerns to structural problems. Many women experience painful intercourse at some point in their lives whether it be due to hormonal shifts, emotional reasons, vaginal dryness, etc. Oftentimes, pelvic floor dysfunction plays a role in this condition. In fact, a whopping 84% of us experience painful intercourse following childbirth?! This isn’t surprising considering what our abdominal and pelvic floor muscles go through during a C-section or vaginal delivery. We need time to heal. At least 6-8+ weeks to be exact. But after our scars have healed and we are “cleared” for sex by our OBGYN or midwife, oftentimes, our bodies are still not ready for sex. The big takeaway: you are not “damaged” if intercourse is still painful after your 6-week check-up. It will get better, but you need to act! The most important thing you can do for your health and for your family is to be your own advocate.
Symptoms
Symptoms of dyspareunia are:
- Throbbing pain that lasts for hours after intercourse
- Burning or aching pain
- Deep pain during thrusting
- Pain with penetration, even with putting in a tampon
- Pain only at penetration
Physical Causes
Although the problem can affect both men and women, it is more common in women. Women with dyspareunia have pain in the labia, clitoris, and vagina. If the pain is acute and occurs because of deep penetration, it can be because of a medical treatment or medical condition, such as:
- Hysterectomy and other pelvic surgery
- Some cancer treatments
- Vaginal dryness
- Atrophic vaginitis, which is a common condition in postmenopausal women that causes thinning of the vaginal lining
- Side effects of drugs, such as tamoxifen and antihistamines
- Allergic reaction to douches, spermicides, and clothing
- Endometriosis, which is a painful condition that causes the tissue of the uterine lining to migrate and grow abnormally inside the pelvis
- Valvular vestibulitis, inflammation of the area that surrounds the vaginal opening
- Skin diseases affecting the vaginal area, for example, lichen sclerosus and lichen planus
- Sexually transmitted diseases, vaginal yeast infection, and urinary tract infections
- Trauma that often stems from a history of sexual trauma or abuse
- Cystitis or inflammation of the bladder wall because of a bladder infection
- Fibroids or non-cancerous tumors growing on the wall of the uterus
- Irritable bowel syndrome (IBS), which is a disorder of the gastrointestinal tract
- Ovarian cysts, which are cysts resulting from a buildup of fluid inside the ovary
- Pelvic inflammatory disease (PID)–PID is an inflammation of the female reproductive organs because of an infection
- Uterine prolapse or a condition in which the pelvic organs extend into the vagina
Psychological Causes
- Depression, fear, and anxiety contribute to vaginal dryness and can inhibit sexual arousal (Meana, 2009)
- In addition to this, stress can also trigger tightening of the pelvic floor muscles that results in pain
- Psychological trauma
Diagnosis
Dyspareunia can be diagnosed based on the presenting symptoms. Your medical and sexual history along with a physical examination will help the doctor determine the cause of pain during intercourse. A common presenting complaint of dyspareunia is pain on touching the genitals, early and deeper penetration. The doctor will assess the symptoms and ask questions about the exact location, length, and time of the pain.
What Now?
So, what can be done? Check the list of side effects on your medication bottles. Talk to your primary care physician about alternative medication options. Find a mental health counselor in your area. Find a pelvic floor physical therapist who can help you find the root cause of your painful intercourse. This isn’t something you have to live with forever. This doesn’t have to be a taboo topic to discuss. There are healthcare professionals, like myself, who can help you on your healing journey towards great sex, something you deserve to have! Reach out to us by giving us a call at 401-602-7006 or emailing us at info@aranciapt.com to book a free consultation!
Tags: health and wellness, healthy tips, Arancia Physical Therapy, Natural pain relief, physical therapy, health, wellness, physical therapist
