Sexual Pain
Sex should not be painful. If it is, you deserve support, not silence.
Pain during or after sex is one of the most common and least discussed pelvic health concerns affecting women. It causes significant distress, not just physically but emotionally, relationally and psychologically.
Many women wait years before seeking help, often because they don't know help is available, because they've been told it's normal, or because the topic feels too private to raise.
It is not normal. Help is absolutely available. And this is exactly the kind of conversation we have every day at Fitt Physiotherapy.
Causes of sexual pain
Sexual pain can arise from a number of conditions, often overlapping, and almost always involves the pelvic floor in some way.
Vaginismus Involuntary contraction or spasm of the pelvic floor muscles at the vaginal opening, causing pain, difficulty or inability with penetration. This can affect tampon insertion, gynaecological examinations and sexual intercourse. Vaginismus affects approximately 1 to 6% of women, though many cases go unreported and undiagnosed.
Dyspareunia Persistent pain during or after sexual intercourse. Can be superficial, at the vaginal entrance, or deep, related to the cervix, uterus or pelvic structures. Deep dyspareunia is commonly associated with endometriosis.
Vulvodynia Chronic pain localised to the vulva or vestibule, the area surrounding the vaginal opening. Characterised by burning, stinging, aching or rawness, occurring spontaneously or in response to touch or pressure. Vulvodynia is more common than most people realise and highly treatable with the right approach.
Overactive pelvic floor An overactive or hypertonic pelvic floor, where the muscles are chronically tight or shortened, is one of the most common contributors to sexual pain. Research indicates that up to 57% of women with overactive pelvic floor muscles experience pain during sex. A tight pelvic floor is not a strong pelvic floor and relaxation training is a key component of treatment.
Postpartum sexual pain Pain during sex after birth affects up to 62% of women in the postpartum period. It can be related to perineal scar tissue, hormonal changes from breastfeeding, pelvic floor tension or prolapse. It is very treatable and very worth addressing.
You are not alone
Sexual pain can feel isolating. It can affect your relationship, your sense of self and your mental health in profound ways.
At Fitt Physiotherapy our physiotherapy and psychology team work together to address both the physical and emotional dimensions of sexual pain. You will be met with warmth, expertise and complete confidentiality and you will never be made to feel embarrassed or dismissed.
You deserve to have a sexual life that is comfortable, pleasurable and free from pain.
How we assess and treat
Your assessment will include:
✦ A detailed history of your pain — onset, location, character and triggers
✦ A gynaecological and medical history
✦ Pelvic floor assessment — muscle tone, sensitivity, trigger points and coordination
✦ A discussion of contributing factors and your individual goals
Treatment is highly individualised and may include:
✦ Pelvic floor manual therapy and trigger point release
✦ Progressive desensitisation, gradual, guided treatment to reduce pain with touch and penetration
✦ Dilator therapy, used progressively as part of a structured treatment program
✦ Relaxation and pelvic floor down-training
✦ Pain education and nervous system strategies
✦ Scar tissue treatment for postpartum perineal scarring
✦ Hormonal advice in collaboration with your GP or gynaecologist
✦ Collaborative psychology support, addressing the emotional and psychological impact of sexual pain
✦ Referral to sexology, gynaecology or other specialists where appropriate
You don't have to keep putting up with this.
Sexual pain is treatable and you deserve care that takes it seriously.