A bacterial or fungal infection of the vagina, genital area or urinary tract can cause pain.
Inflammation or skin problems Inflammation or severely dry skin such as eczema can lead to painful initial penetration. Skin diseases such as lichen sclerosis or lichen planus can affect the vaginal area and lead to pain. Check out this video for more info on painful sex after pregnancy.
A condition that can result in severe pain and sensitization on the area of the vestibule when touched or with initial penetration.
An allergic reaction to clothing, spermicides or douches can cause painful intercourse. It can be seen on the vuval area and or inside the vagina on the mucosal lining. referral to a dermatologist specialising in Vulvo-vaginal conditions is the ideal pathway.
Sexually transmitted infections s can cause blisters and sores that make intercourse painful. Uterine and other pelvic conditions
Certain conditions of the uterus can lead to painful intercourse. These conditions include retroverted uterus, endometriosis, pelvic inflammatory disease, fibroids, ovarian cysts, and interstitial cystitis.
A prolapse of the bladder (cystocele), uterus (uterine prolapse), rectum (rectocele), or intestine (enterocele) can cause a deep pain during intercourse.
Previous surgeries to the pelvic area can cause scarring that may lead to painful intercourse.
Childbirth tearing of deep pelvic floor muscles or fascia; or an episiotomy during vaginal delivery may lead to painful intercourse. It is wise to delay sex until after your 6-week check-up and then only when you and your partner feel ready. I encourage my mums to talk about how they feel to me and to their partner. Often the partner is very anxious about penetration and causing ‘any pain’. take things slow, use lubrication and try being on top for this first time so that you can control the depth of penetration. Some women are not ready to have sex for a long while after a difficult vaginal delivery.
Come and see your Women’s health physio so that she can examine you and then discuss your concerns.
Treatments for cancer Chemotherapy and radiation to the pelvic area can lead to painful intercourse.
Other traumas from sport or road traffic accidents and injuries to the pelvic area can cause changes to joints and muscles around the hips and pelvis. Over time this may cause chronic muscle tensions ligament, tendon and fascial tightness in and around the pelvis. This can lead to painful intercourse. Women’s health Physios treat muscles, joints and tendons.
Emotional factors can also contribute to painful intercourse. Emotions and stress are important for sexual arousal and greatly affect the amount of lubrication and the tightness of the pelvic floor. Psychological issues such as anxiety, depression, and fear of intimacy can be a factor with dyspareunia. Additionally, any history of sexual abuse can lead to problems with dyspareunia. Women’s health physios with a special interest in treatment of this condition can, as part of a multi -disciplinary team do a great deal to help with musculoskeletal changes that impact on pain and function.
An involuntary tightening of your superficial pelvic floor muscles during initial penetration. Primary vaginismus is a spasm or dysfunction of the superficial pelvic floor muscles that can be helped with specific pelvic floor physiotherapy. Specific skills in the treatment of internal and external trigger points in muscle and releasing techniques directed to fascial and scar tissue help in the rehabilitation of this condition. Education of pelvic anatomy and an understanding of the ‘central sensitization of pain’ will all help individual women to overcome CPP.