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Female Sexual Pain Syndromes
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Female Sexual Pain Syndromes

Female sexual pain syndromes causing painful intercourse can occur for a number of reasons. A high percentage of women experience painful intercourse at some point in their lives.

Below you will find a number of articles that discuss the types of sexual pain syndromes that we treat. Click on any title or "Read More..." link for detailed info on each diagnosis.

Painful Bladder Syndrome / Interstitial Cystitis:

This pain or discomfort is perceived to be related to the bladder upon filling or often immediately after emptying. Symptoms include urinary urgency with pressure, burning and aching pain along with increased frequency, > 8 times per day, and > 3 months duration.

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Endometriosis and Chronic Pelvic Pain

How Endometriosis can cause or contribute to chronic pelvic pain, and what pelvic floor therapy can do to help alleviate it

What is Endometriosis?

Endometriosis is a condition where endometrial-like tissue grows outside of the uterus (endometrial tissue is tissue that usually grows inside of the uterus and sheds each month). The most common area for it to grow is in the abdominal cavity, where it can implant on the surface of other structures including the ovaries, bladder, rectum, and along the walls of the abdomen and pelvis.

The true prevalence of endometriosis is unknown since it takes a laparoscopic procedure to confirm the diagnosis, and many women either have no symptoms or seek no treatment (Signorello, Harlow, Cramer, Spiegelman, & Hill, 1997). However, up to 78% of women undergoing laparoscopic investigation for infertility and up to 82% of women investigated for pelvic pain were found to have endometriosis in one study (Schenken, 1996; Wellbery).

Actress Lena Dunham has been vocal about her experiences with endometriosis, most recently publishing an essay in American Vogue on electing to have a total hysterectomy after years of chronic pain due to the condition.

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Dyspareunia:

From Wikipedia:
"Dyspareunia is painful sexual intercourse due to medical or psychological causes. The symptoms are significantly more common in women than in men. The pain can primarily be on the external surface of the genitalia, or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface. Understanding the duration, location, and nature of the pain is important in identifying the causes of the pain."

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Vulvodynia:

Vulvodynia means “vulvar pain” or pain of the external female genital region. Symptoms include burning, stinging, and irritation of the tissues in this region. Light touch or pressure can cause severe pain with sitting, walking, riding a bicycle, and sexual intercourse. Vulvodynia is a general term, and there are many subtypes, including vulvar vestibulitis (inflammation of the vulvar vestibule), vestibulodynia (pain in the vulvar vestibule) and clitorodynia (painful clitoris).

PHYSICAL THERAPY TREATMENTS FOR PELVIC PAIN SYNDROMES:

Most pelvic pain syndromes such as vulvodynia are related to overactivity of the pelvic floor muscles.

These muscles may have a high resting tone, shortening of the muscle and exhibiit difficulty with relaxation. When muscles are short, this can also lead to overall muscular weakness. However, strengthening a muscle that is already short will only feed in to the pain cycle, so Kegel exercises (pelvic floor muscle contractions) are typically not indicated in the earlier states of rehabilitation for pelvic pain (including vaginismus, vulvodynnia, vestibulodynia, endometriosis, interstitial cystitis / painful bladder syndrome, and others).

Trigger points are commonly found when palpating these muscles. They contribute to the urologic and gynecological pain syndromes listed above, preventing painfree sexual intercourse and other painfree activities of daily living.

Physical therapy treatments play an integral part in restoring optimal muscle function with manual therapy interventions, stretching/strengthening exercises, pain management strategies, patient education, and home program instruction.

Biofeedback is often utilized when appropriate to restore the normal functioning of painful muscles.

Links to more information:

http://www.vulvodynia.com
https://issvd.org/wp-content/uploads/2015/09/concensus-terminology-of-Vulvar-Pain-V5.pdf

Resources:

Sex Without Pain: A Self Treatment Guide to the Sex Life You Deserve for immediate PDF download (helpful for painful intercourse and generalized vulvar pain)

Dilators - Sex Without Pain book and Dilators from Soul Source.

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Vaginismus Recovery - Diagnoses and Treatments

Is it painful to insert a tampon, get through a gynecological pelvic exam, or engage in intercourse? Have you always just thought maybe it’s just supposed to hurt and began to shy away from it all? You’re not alone. There are many women who have felt and thought the same things. What you are feeling is real and the culprit may be a condition called Vaginismus.

What is Vaginismus?

The definition of Vaginismus has been debated over the years and was first introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition in 1980. It was defined as a “recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse”.1 And now in the DSM, Fifth Edition categorized as a disorder in which any form of vaginal penetration or insertion such as tampons, a digit, gynecological exams, vaginal dilators and intercourse is painful or impossible. Women have described it as “hitting a wall”. This disorder has been put under the umbrella of genito-pelvic pain/penetration disorder (GPPPD) in conjunction with dyspareunia (“recurrent or persistent genital pain associated with sexual intercourse”).2

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Vulvar Vestibulitis/Vestibulodynia:

Vulvar Vestibulitis/Vestibulodynia is a form of vulvodynia with tenderness specific to the vulvar vestibule. This occurs with pressure to the site causing pain at the vaginal opening with touch or attempted penetration (provoked vestibulodynia) or can also present as constant or frequent pain, irritation, or itching of the vulvar vestibule (unprovoked vestibulodynia). Tissues may also be red or swollen at times.

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Anorgasmia (No Orgasms)

Anorgasmia is the persistent inability to achieve orgasm despite responding to sexual stimulation. There are variations within its larger definition that are listed below. 

The Mayo Clinic further defines it as a lack of orgasm that distresses you or interferes with your relationship with your partner:

By definition, the major symptoms of anorgasmia are the inability to have an orgasm or long delays in reaching orgasm that's distressing to you. But there are different types of anorgasmia:

  • Lifelong anorgasmia. You've never had an orgasm.
  • Acquired anorgasmia. You used to have orgasms, but now have difficulty reaching climax.
  • Situational anorgasmia. You're able to have an orgasm only in certain circumstances, such as during oral sex or masturbation or only with a certain partner.
  • Generalized anorgasmia. You aren't able to have an orgasm in any situation or with any partner.

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What They Say About Us

  • Testimonials

    • Testimonial by Ann V.

      I wish i could give this place 10 stars!! 
I have been suffering from vaginismus for 5 years and never found the cure to it. I had seen an ob/gyn and he diagnosed me with vaginismus and told me i needed a surgery to cure my condition,  which i refused to do. He also referred me to a PT that he works with, i had given them multiple calls and they never responded back to me, so i started searching yelp for another PT. I am SO HAPPY I found Heather's office! I was working with Laureen, and with her...

      Read more Testimonial by Ann V.

  • Testimonials

    • Testimonial by M.M.

      My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

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