24 May Pain with intimacy
by Annette Beauchamp
“Ouch, my vagina hurts.” When good sex is bad.
Some women experience pain during sex. Pain is a barrier to intimacy and sexual pleasure. This may occur even when you have found a loving and supportive partner. Intimacy is one of the basic building blocks of a good relationship.
Pain with sex is called dyspareunia (DIS-PAR-YOON-EE-A)
I wish I could tell you, I see fewer women than I do with dyspareunia. However, I can tell you that the sooner you seek therapy, the sooner you can achieve greater intimacy and comfortable sex. Therapy requires some effort from you, but the results are very rewarding. Do you also experience pain with tampons, cycling or when wearing pants with thick seams?
Signs + Symptoms
The external tissues of the vulva can appear dry and very red or very pale. Other symptoms include burning, itching and a tearing feeling. This condition can begin suddenly or appear gradually.
Causes are complicated, and may include a number of factors, some of which are:
- Pelvic muscle over-activity: In plain language, this is muscle tightness. It is more complex to a physio. A muscle should be able to contract and relax easily. The pelvic floor muscles relax when you empty your bladder and bowel. It lengthens to deliver a baby. Sex involves contracting and relaxing your pelvic muscles. For some people, relaxing the pelvic floor muscle is not a natural skill. It has to be learned.
- Poor Lubrication is a result of pain. And, it may happen if you anticipate pain. It is also associated with lack of arousal. Comfortable foreplay leads to increased blood supply to the entire pelvic floor and lubrication. This may be lacking in an intimate relationship.
- Nerve Irritation: Vulvodynia or Vestibulodynia. Women describe this pain as burning, stinging, sharp, throbbing or itching. The irritation involves the local pelvic nerves.
- Hormonal Changes – Reduced Oestrogen status: This occurs post-natally, during and beyond menopause, and following removal of ovaries or chemo-therapy for breast and ovarian cancer. The symptoms may abate with application of oestrogen or lubrication, but require close medical management.
- Infections: vulval, urinary, vaginal or bowel, internal pelvic and abdominal
- Pelvic conditions: including endometriosis and adenomyosis.
- Surgical procedures of the pelvis.
- Other skin conditions: dermatitis, eczema, psoriasis, and lichen conditions. These require expert management by a medical skin specialist.
- Social and Emotional Issues: Generalised stress and anxiety reduce your ability to relax and may effect pelvic muscles. Difficulties with partners and relationships can contribute to this. As can a memory of past negative sexual experiences.
- The wrong diagnosis: Sometimes, women and their doctors misdiagnose dyspareunia as chronic thrush or bacterial vaginosis. If you think, your treatments have not fixed your problem to date, return to your GP to discuss the possibility of dyspareunia.
- You may not have a trigger that you can identify.
Since there are many factors involved in dyspareunia, it is worthwhile having a discussion with someone who is an expert in this area.
Help is available
Seek Help. If you ignore this, it will not go away.
Please see SHE Physio Pilates if you have pain with intimacy. You will learn how to manage your condition, how to reduce the tension and pain in your pelvis.
Enjoy your life. Enjoy your body.
Please make an appointment with SHE.
SHE Physio Pilates: personal care for personal health.
Call on 0408 465 312
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