Have you been experiencing pain during or even after sex? This is known as dyspareunia. Dyspareunia is more common in women but still can affect men. For women, the pain can be centered around the vagina, clitoris or labia. The good news is that dyspareunia is very treatable in most cases. Some of the most common types of causes are:

  1. Vaginal Dryness
  2. Side Effects of Drugs (antihistamines and tamoxifen)
  3. Inflammation of the vulvar vestibulitis
  4. Certain Skin Diseases
  5. UTI’s (Urinary tract infections) and STD’s (sexually transmitted diseases)
  6. Psychological trauma relating to past sexual abuse

Spotting the Symptoms

Symptoms of dyspareunia can include:

  1. Pain at the entrance of the vagina
  2. During sex when deep penetration is involved
  3. Vaginismus (extreme tightening of the vaginal muscles during intercourse)

It’s important to note that there is a primary and secondary dyspareunia. The primary would be for those who have always experienced pain with sex. This may also be known if you have had trouble using tampons. The secondary is when you begin to experience pain during sex when you have not in the past. Often this can be related to childbirth, pregnancy, breastfeeding, and menopause as changes in hormones occur (among other things).

What Are My Options

Due to the nature of dyspareunia, treatment will vary from person to person as there are many reasons linked with painful sex. Below we list a few options that might be considered depending on your reason:

  • For vaginal dryness, you can stimulate the clitoris more beforehand or use over the counter lubrication to ease penetration.
  • Sitz baths (sitting in a warm tub of water) are great to painful inflammation
  • Sometimes dyspareunia appears to last months or years that appears to have no physical cause. This could be caused by stress and anxiety or muscle tightness. Pelvic floor physiotherapy has a role and may be used in conjunction with psychological services
  • Antifungal medication will be given for those with vaginal yeast infections.
  • For those with UTIs and STDs, antibiotics will be prescribed.
  • Vulvar Vestibulitis can be treated with topical estrogen cream, low-dose pain medications, and pelvic floor therapy.

When to Seek Help

The first time you have sex can be uncomfortable but you should never be experiencing pain. If pain occurs before, during, or after sex, this would be a good time to make an appointment with your doctor. It’s always a good idea to seek help earlier than later. Living with the anticipation of having painful sex can create stress and anxiety (and definitely make things worse!). It can lead to you avoiding having sex with your partner.

The Role of Physiotherapy

 Physiotherapy can assist in decreasing muscle tone by using a combination of manual therapy, breathing techniques, stretching/strengthening program and/or muscle stim/biofeedback. As mentioned before the treatment varies from individual to individual.


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