Breaking the Silence:

Let’s Talk About Sex, Painful Sex

Here is a topic, in my opinion, that we don’t talk enough about, pain with sex. I get it, it can be uncomfortable even with your closest family and friends. But here’s the thing, this is a common condition and you are not alone if this is something you’ve been trying to navigate.

Two common conditions that relate to painful sex:

Dyspareunia (dis-puh-ROO-nee-uh) and vaginismus (va-juh-niz-muhs) are two distressing conditions that affect many individuals. These conditions can significantly impact one's quality of life, relationships, and mental well-being. However, with the right understanding and approach they can be effectively managed and treated.

What is dyspareunia and vaginismus:

Dyspareunia, as described in “Your Pelvic Floor” is the persistent or recurrent genital pain when sexual intercourse or other sexual activity that involves penetration is attempted. The pain can be felt at the surface or deeper within and can occur before, during or after sex.

Vaginismus, on the other hand, is a type of pelvic floor muscle spasm characterized by involuntary muscle tightening. These spasms can cause burning or make penetration painful or even impossible, leading to anxiety and avoidance of sexual activity. Vaginismus is when the muscles contract only in anticipation of penetration. In “The Vagina Bible” Dr. Jen Gunter uses the analogy of a clenched fist to describe this. Vaginismus is clenching only when someone tries to shake your hand.

There are various factors that can contribute to the development of dyspareunia and vaginismus:

• Infections or inflammation of the genital area

• Hormonal imbalances

• Scar tissue from childbirth, surgery, or injury

• Pelvic floor dysfunction

• Endometriosis or other gynecological conditions

Psychological and emotional factors such as past trauma, anxiety, stress, or negative sexual experiences can also play a significant role in both dyspareunia and vaginismus.

So where do you go from here?

The first thing that I would recommend anyone experiencing these conditions do is to speak with a pelvic floor physiotherapist or your healthcare provider if you feel comfortable to do so. Gaining more knowledge and recognition is key in addressing and validating your health concerns.

Various treatment options are available and will be specific to each individual. One treatment option that I would like to focus on is corrective exercise therapy as it pertains to pelvic floor muscle training and its continuation to a treatment plan from a pelvic floor physiotherapist.

Corrective exercise therapy can be an effective approach for treating dyspareunia and vaginismus in reducing symptoms. This specialized form of exercise therapy focuses on assessing the body and body mechanics through movement analysis and thereby prescribing exercises to improve specific dysfunction.

The goals of corrective muscle therapy for dyspareunia and vaginismus may include:

• Relaxing and releasing tense pelvic floor muscles through breathing techniques and mobility practices.

• Strengthening weak pelvic floor muscles to improve support and coordination as recommended by a pelvic floor physiotherapist.

• Educating individuals about their anatomy, proper posture, and techniques to enhance relaxation and reduce pain during intercourse.

• Addressing any underlying physical or biomechanical issues contributing to pelvic pain and dysfunction.

• Providing resources for emotional support and counseling within your community to address psychological factors and promote a positive mindset towards sexuality and intimacy.

Corrective muscle therapy offers several benefits for individuals experiencing dyspareunia and vaginismus:

• Improved sexual function and enjoyment.

• Reduced pain and discomfort during intercourse.

• Increased pelvic floor awareness and control.

• Enhanced overall pelvic health and function.

• Better communication and intimacy within relationships.

What can we take away from this?

Dyspareunia and vaginismus can have profound effects on physical and emotional well-being, but they can be treatable conditions. Along with many other treatment options, exercise therapy offers an approach to addressing the underlying factors contributing to pelvic pain and dysfunction, allowing individuals to reclaim their sexuality and enjoy fulfilling intimate relationships. If you or someone you know is struggling with dyspareunia or vaginismus, seeking the guidance of a qualified professional can be the first step towards healing and recovery. Remember, you are not alone and help is available.

1) Vopni, K. (2021). Your Pelvic Floor. Watkins Publishing. pg 97-99.

2) Gunter, J. (2019). The Vagina Bible. Random House Canada. pg 297, 300, 303.

Disclaimer:

This Movement to Bloom blog post is for informational purposes only and is not intended to offer medical advice, or replace the recommendations of your Doctor, Midwife, Physical Therapist, Psychologist, or Medical Practitioner. Always consult your Doctor before beginning any exercise program. Movement to Bloom will not be held responsible in any way for circumstances, conditions or injuries that result directly or indirectly from information provided.