Painful intercourse is a troubling condition that can cause physical and psychological distress. It affects confidence and self image and can lead to strained relationships. It is estimated that almost 8-23 % of women globally, experience pain with sex. Painful intercourse can be coined with term pelvic pain or dyspareunia in medical terms.
Pain with sex has had an interesting rather derogatory history in terms of understanding and treatment. The word "dyspareunia" comes from greek,dys-"bad" and pareunos"bedfellow", meaning "badly mated". It was previously considered a psychological disorder and only in 2005 it was put under the pain category. For ages women have been blamed for his condition by partners and medical professionals! I have had patients tell me about their experience with medical professionals and have heard phrases like-" its all in your head", " have a glass of wine", " you need to just relax", "don't be so uptight". These phrases are not only insulting, but it also is invalidating the pain and feelings that a person is going through. There are some organizations like IPPS, ISSHW and others working hard to change this and also understand the reasons why this happens. Pelvic health professionals esp pelvic physical therapist are bring awareness not only among patients but also among other medical doctors like obgyn, urologists and others are advocating for pelvic pain patients.
So why do people experience pain with sex?
There can be numerous reasons as to why this happens. It can be after episiotomy during child birth, it can be after a surgery, it can due to UTI, it can be due to chronic conditions like Interstitial cystitis or endometriosis, lichens sclerosis, or can be due to any past unpleasant or negative experiences among many other. But, pain with intercourse can be present even without any precipitating factors. It can also originate from pelvic floor dysfunction, which in fact is the most common reason.
What can you do about it?
According to the data and guidelines, pelvic floor physical therapy is the first line of treatment and the most beneficial one with none to minimal side effects when performed by a skilled pelvic PT. Like I said above, there can be numerous reasons for pain and hence resorting to Dr. Google is not advisable and you should always consult a medical/healthcare professional. Sometimes, when you’ve had pain for a long time it starts to feel like the pain is all in your mind! Pain is mediated by the nervous system, which includes the body and the brain. The pain is not all in your body, but it is not all in your head either! For a treatment to be effective, the treatment needs to treat the body and the mind. So including other medical professionals like urologist, physiatrists, gyn, psychotherapist who understand and treat pelvic pain is advisable.
I have written in a concise form, essentially what would be considered my first session with a patient in the report below. If you need tips to help the pain immediately, you can download this tips report here.
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