Dyspareunia (pain during sexual intercourse)

Dyspareunia is the term used to describe pain during sexual activity. This includes pain during arousal, orgasm, intercourse and following intercourse.

Causes

  • There are many causes of dyspareunia consisting of physical, hormonal and emotional factors.

  • Some causes include pelvic floor muscle tightness, following surgery or child birth, decreased estrogen levels whilst breastfeeding, history of trauma or negative sexual experiences, following infections such as UTI or thrush as well as sensitive skin.

Signs & Symptoms

  • Pain or discomfort during arousal, orgasm, intercourse and following intercourse.

  • The pain may be at the entrance of the vagina or deep near the cervix.

Differential Diagnosis

  • Urinary tract infection

  • Pelvic inflammatory disease

  • Vaginal infections

PROmotion Assessment 

  • Management consists of treating the original cause of the pain as well as pelvic floor muscle relaxation exercises and stretches, vaginal dilator therapy, breathing and nervous system relaxation exercises.

  • Learning about the female sexual process and response is important as well as addressing general lifestyle factors.

  • Strategies to care for your vulva are taught if women also have vulval pain.

How to Manage

  • Management consists of treating the original cause of the pain as well as pelvic floor muscle relaxation exercises and stretches, vaginal dilator therapy, breathing and nervous system relaxation exercises.

  • Learning about the female sexual process and response is important as well as addressing general lifestyle factors.

  • Strategies to care for your vulva are taught if women also have vulval pain.

References

Vandyken C, Hilton S. Physical Therapy in the Treatment of Central Pain Mechanisms for Female Sexual Pain. Sexual Medicine Reviews. 2016;  DOI:10.1016/j.sxmr.2016.06.004.