By: Jane O’Brien
Dyspareunia is defined as pain before, during or after intercourse. Reviews in literature indicate that a prevalence of as many as 50 percent of women experience pelvic pain and painful intercourse. Despite the prevalence, this problem is commonly overlooked and untreated. If left untreated, pelvic pain can deter one from engaging in sexual activity.
There are many reasons for dyspareunia including musculoskeletal dysfunction, endometriosis, pelvic inflammatory disease, post-operative scarring and adhesions. People experiencing dyspareunia from musculoskeletal dysfunctions may be presented with associated joint mobility issues, muscle pain, tension and weakness of the pelvic floor muscles. To effectively treat dyspareunia, intervention must consider the underlying condition responsible for the pain and the secondary muscle reactions that may become a continued source of pain.
Patients with a musculoskeletal dysfunction as the cause of their dyspareunia may be referred to physical therapy for treatment.
Interventions may include manual therapies such as trigger point release, joint and soft tissue mobilization, patient education, biofeedback, vaginal dilators, modalities and exercise. Studies have shown that Physical therapy treatment for short, painful and weak pelvic floor muscles can be highly effective.
The pelvis is lined with muscles which move the hips, support the pelvic organs, help with elimination and create sexual pleasure. These muscles are attached to the fascia (connective tissues) of the hip. This links the function of the pelvic floor muscles directly to the hips. If the pelvis is not level, the pelvic muscles will either be stretched (too long) or be in tension (too short). Power is equal to force times distance. If the lengths of the muscles are altered, the muscle force needs to change to maintain power and proper muscle function.
An orgasm is defined as sexual climax and is characterized by intense physical pleasure accompanied by quick cycles of muscle contraction in the lower pelvic muscles which surround the primary sexual organs. Tension in the pelvic floor muscles can cause weakened contractions of the pelvic floor muscles. In other words, pelvic floor tension can lead to decreased orgasm potential! Seek help from a Women’s Health PT to improve your quality of life and recapture your sex life.
Receiving treatment from a Women’s Health Physical Therapist who is trained in Pelvic Floor Disorders can alleviate pelvic muscle tension, pelvic pain and benefit your sex life. It is not uncommon for a Women’s Health practitioner to work with a patient to alleviate pelvic pain and find that a by-product of the treatments is improved orgasms.
Intercourse promotes health and vitality, creates pleasure, and provides a means for reproduction. When one person’s pleasure and desire for lovemaking increases, both partners benefit. Disorders in the pelvic region are common, but not the norm for the body.
- Abrams P, et al. The Standardization of terminology of lower urinary tract function: report from the standardization sub-committee of the international continence society. Neurourol Urodyn 2002: 21:167-178.
- Messelink B, Benson T, Bergam B, Bo K, et al, Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the International Continence Society, Neurourol Urodyn 2005: 24: 374-380.
- Wurn L and Wurn B. Increasing Orgasm and Decreasing Dyspareunia by a Manual Physical Therapy Technique. Med Gen Med, 2004; 6(4): 47.
- Fisher K. Management of Dyspareunia and Associated Levator Ani Muscle Activity. Phys Ther 2007: 87(7): 935-941.