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Painful Intercourse (Dyspareunia) - Symptoms and Causes

Posted on Jan 06 2021
Posted by: Dr. Sudini Borkar (PT)

According to the American College of Obstetrics and Gynecology, almost 75% of women suffer from pain or discomfort during intercourse at some point. The experience of pain is different for every woman, some it goes unnoticed and some it’s persistent.

Sex isn’t supposed to be painful

Most of the time the women feel that pain during sex or other discomforts are “Normal”, which is not so. Sex isn’t supposed to hurt. It is a pleasurable experience.

According to the World Health Organization, A “healthy Sexual health is a state of Physical, Mental and Social wellbeing in relation to sexuality”. A healthy Physical body of the couple, mutual consent of two minds and soul along with a healthy relationship and connection with your partner is the key to a healthy sexual health.

The various difficulties associated with female sexual health are:
1. The Decreased Desire or wish/ enjoy participating in a sexual act. This is usually more prominent in elderly women than in younger reproductive women.
2. The Inability to maintain or sustain sexual excitement. Women usually say that they have a strong wish for sex but once they are at that moment, they get bored soon or want to get done with it.
3. Some complain, about not being able to sustain or delay in getting an orgasm.
4. The most common is the Pain during the Sex. Highly reported complain and women silently suffer from this problem. They consider it normal. Well, my brave ladies, it’s not right for a woman to always be in pain.

What could be the cause of this:
1. Vaginal dryness is reported by most sexually active women between the age group of 25 to 50 years which could be due to the imbalance in the estrogen hormone, famously known as the “Female hormone”. In young women, it could be due to her lifestyle while post-menopausal and menopausal women complain due to decrease in the female hormone because of the physiological aging. It can occur in women who have suffered from Vaginal fungal infection (Recurrent). Adequate foreplay before the partner penetrates helps to increase the function of the Bartholin’s gland which produces lubrication. Dryness not only makes it painful but also throws off the vagina’s balance of good bacteria making it easily prone to infection.
2. Anxiety or Fear of pain or Previous history of sexual abuse leaves a deep mark on the women’s mind which can lead to the poor connection with the partner during the act.
3. Interpersonal relationship also plays a prime role in sexual health. Loving your partner at both emotional and physical levels is important to connect and have healthy sexual health. So, my dearies, avoid sex if you have had a long day of arguments and quarrel.
4. A very important and mostly ignored is the Pelvic floor muscle health. The pelvic floor is the muscle through which the vagina, the urethra, and the anus open. The decreased tone or tightness of the muscles reduces the opening of the vaginal canal. Now imagine, you trying to enter a small door that is half your dimension. It’s difficult, right? It’s the same when the erectile penis enters a narrow vaginal opening. Sometimes, looseness of these muscles can lead to vaginal laxity and you don’t feel anything at the time of penetration.
5. Sometimes you or your partner’s musculoskeletal health might be a concern. Constant body aches, easy fatigue, and long-term alignment can give rise to unhealthy sexual health not letting you participate actively.
6. Dearies are you clean down there!!! Many times the partner reports that a sudden odor or a foul-smelling discharge has dropped the desire of the act. So, good perineal hygiene is recommended.

You can be suffering from:
1. Vaginismus
2. Dyspareunia.
3. Hypertonic pelvic floor muscle dysfunction
4. Hypotonic pelvic floor muscle dysfunction
5. Reproductive organ pathology- fibroids, ovarian cysts

Don’t be a Silent sufferer:
• Pelvic Floor Physiotherapy, along with medical help is available and is evident to recover from disorders associated with sexual health.
• A Certified Female sexual rehab therapist can effectively help you bounce back. She will first need a detailed history of your problem and any associated problem to the pelvic floor.
• Various therapies targeting the tight pelvic floor such as soft tissue mobilization, pelvic floor ischemic compression, trigger point release, etc will help you break the tight bands at the opening of the vagina, making penetration and thrusting comfortable and pain-free.
• Also, for vaginal laxity concerns a set of exercises that work to increase the contraction or strength of the pelvic floor muscles, can help you develop the tone of the muscles.
• Advise on the correct sex position, emphasis on foreplay before the penetration, stimulation of the G spot (sweet spot) while fingering, use of lubricating gels can also help in pain-free sex.
• Lastly, an understanding between the 2 souls connecting during the act is most important.

So come out, talk about it, reach the right help, and avoid being a silent sufferer.