Sexual dysfunction can be really hard to talk about, both for women and for men as well.  So many of these problems go untreated, leaving women feeling like their issues are rare or something to be embarrassed by.   The truth is there are a wide range of sexual problems (either psychological or physical) and they affect many people,  at least 30% of young and middle-aged women and up to 50% of older women.

There are many different types of sexual dysfunction:

Pain with intercourse (dyspareunia)
Genito-pelvic pain disorder
Vulvodynia (pain around the opening of the vagina)
Reduced sensations with intercourse, low libido or lack of interest in sex
Inability to achieve orgasm
Inability to achieve penetration
Persistent sensation of arousal

And these can be caused by a wide variety conditions.

Physical causes may include conditions like diabeticsheart disease, neurological diseases, hormonal imbalances, menopause, chronic diseases such as kidney disease or liver failurealcoholism, and some antidepressant medications.
Psychological causes include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, or the effects of a past sexual trauma.

Pain or some form of discomfort during intercourse is very common and could be caused by:

Hormonal changes
Skin or nerve condition
Malignant Tumors
Involuntary spasm of the pelvic floor muscles
Scar tissue

It is important to note that sexual dysfunction is not just pain during intercourse, but another very common problem is the loss of desire for sex, low libido and lack of sexual sensation or arousal.

Any sexual health problem can be treated, but it’s important to find the right healthcare practitioner in order to get the right type of help.  The right help may be a gynecologist, a psychologist, a sex therapist or maybe a physiotherapist.

How can Physiotherapy help?

If your problem involves pain, or muscle spasms or incontinence for example, a physiotherapist may be the right healthcare provider to see.
The aim of physiotherapy treatments is to enable women to manage their pain or other symptoms by themselves at home and in between sessions. Besides providing education about the condition and giving advice with regard to managing things like stress and anxiety, a physiotherapist will also teach you various techniques depending on what symptoms are being treated;
1. How to relax your pelvic floor muscles
2. Breathing and relaxation
3. Stretching, strengthening, core and pelvic floor control exercises.

If you have pelvic pain with or without intercourse, physiotherapy can help. Following a detailed assessment of the pelvic floor, its muscles and functional control, we also examine the pelvis, hips, back and the spine in order to determine a program and a treatment specifically tailored to the diagnosis.

The treatment might include:

1.  Pain management & advice
2.  Manual release of the pelvis internal and external muscles
3.  Use of modalities such as biofeedback devices to retrain muscle use
4.  Self-exercises to contract and relax the pelvic floor muscles.  
5. Stress and anxiety management
Depending on the condition and the specific symptoms,  the treatment options will vary, so it’s always a good idea to see a professional.  A healthy sex life is important for every adult, so try to be very open about your concerns and your symptoms, and work with your doctor or therapist to create a path to a pain-free, healthy, fulfilled life.

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