Did you know you can successfully cure painful intercourse with physiotherapy? Here’s how!

What is Dyspareunia?

Dyspareunia is pain that is persistent and re-occurring before, during or after sexual intercourse. Many women experience painful intercourse, studies have shown that it can affect anywhere between 20% and 50% of women. However, these numbers most likely underestimate the true prevalence of dyspareunia, many women do not seek medical treatment.

What Causes Dyspareunia?

There are a number of different causes that may lead to dyspareunia some include:

  • Injury to the pelvic floor: childbirth, post surgical conditions, pelvic inflammatory disease, endometriosis, scar adhesions
  • Musculoskeletal dysfunction: the pelvic floor muscles become overactive and don’t fully relax, they may also contract when they should be relaxing.
  • Psychosocial factors: stress, depression, anxiety, sexual or physical abuse

How Can Physiotherapy Help?

The goal of physiotherapy in treating dyspareunia is to:

  • Reduce vaginal pain by reducing the overactive pelvic floor musculature
  • Improve patient awareness and ability to control these muscles
  • Improve ability of the vaginal tissues to stretch
  • Teach appropriate techniques for penetration

Physiotherapy interventions to treat dyspareunia are:

  • Education: by helping to describe the role of the pelvic floor musculature in the pain cycle and provide techniques that can be used in the home environment
  • Manual therapy: to mobilise muscle and soft tissue, normalize overactive muscles, improve circulation and desensitize areas
  • Exercise: with the focus of relaxation through the pelvic floor
  • Biofeedback and Electrical stimulation: assists in reducing overactive muscles

What to do at Home

Avoid repetitive contractions of the pelvic floor muscles such as “kegal’s”, when doing so you are only causing increased tension in the muscle resulting in potentially increased pain. Exercises initially should be focus on relaxation of the pelvic floor muscle with diaphragmatic breathing and imagery.

A good position to start is in a seated position with feet flat on the ground feeling. Bring awareness to where your sit bones are then taking a deep breath in imagine the sit bones moving away from each other, as you exhale feel the gentle gliding of the sit bones moving inward without performing a contraction. The hand positions if the picture show the movement of the pelvic floor.


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