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how dyspareunia causes pain during sex
Image courtesy of Giddy
Giddy author Tabitha Britt penned an in depth article on how dyspareunia causes pain during sex, and she reached out to me for my opinions in this wide ranging exposé on this common issue. Here is a brief synopsis of the article with some of my thoughts, and I encourage you to read the full article at the link below.

Heather Jeffcoat, DPT

Find Out How Dyspareunia Causes Pain During Sex

Intercourse shouldn't hurt, but if it does, find out why and how you can reduce the discomfort.

As the article states, if you experience pain during sex, you're far from alone. Dyspareunia, or painful intercourse, affects about 3 in 4 women. Although this condition is most often associated with women, studies have shown about 1 percent to 5 percent of men suffer from pain from intercourse, too.

The article goes deep into the potential causes of painful sex, which can include endometriosis, adenomyosis, uterine fibroids, a retroverted uterus, interstitial cystitis / painful bladder syndrome, vaginismus, clitoral phimosis, postorgasmic illness syndrome, chronic bacterial prostatitis, and more.

So as you can see, dyspareunia is really a blanket term for any type of pain associated with penetrative sex. Tabitha points out how dyspareunia can be broken down into two types, superficial and deep:

  • Superficial dyspareunia, known as entry dyspareunia, refers to pain felt at the vaginal or rectal opening during initial penetration.
  • Deep dyspareunia, known as collision dyspareunia, refers to pain felt at deeper points in the vagina and/or rectum during sexual stimulation or penetration.
  • Some people experience both types of dyspareunia.

She then mentions how common symptoms can show up in several forms, such as:

  • Constant pain that begins at the start of sexual intercourse
  • Pain after a period of pain-free sex
  • Pain during all sexual activity, including arousal, penetration and orgasm
  • Pain that occurs when there is a change in the physical, emotional or hormonal state during sex

Click here to browse all of our articles on Dyspareunia.

What causes pain during sex?

Pain with sex can happen for a variety of reasons, many of which overlap. Some common causes include:

  • Endometriosis
  • Adenomyosis - Similar to endometriosis, adenomyosis occurs when endometrial-like tissue invades the muscular wall of the uterus. This tissue growth causes heavy, prolonged periods, chronic pelvic pain, and pain during or after sex.
  • Uterine fibroids
  • Retroverted uterus
  • Interstitial cystitis / painful bladder syndrome (IC-PBS)
  • Vaginismus
  • Clitoral phimosis - an anatomical disorder involving the hood of skin around a woman's clitoris being fully or partially disabled, such as being too tight. A 2002 study published in the Journal of Sex & Marital Therapy suggested 22 percent of women suffer from clitoral phimosis.
  • Postorgasmic illness syndrome (POIS) - a rare and under-researched condition characterized by a sudden onset of flu-like symptoms, including nausea, dizziness, weakness and fatigue, shortly after having an orgasm. These symptoms can endure for an hour to several days.
  • Chronic bacterial prostatitis

Treatment options

Tabitha lists a number of treatment options that include medications, desensitization therapy, and sex therapy. But it's her last tip that hits home with us:

A pelvic floor physical therapist may also be able to help you normalize the activity of your pelvic floor muscles to reduce any discomfort you may be experiencing during intercourse.

Tips for coping and improving your sex life

She offers a number of options that can improve the situation aside from the treatments mentioned, with an emphasis on switching things up - including different positions and not relying on penetrative sex alone. There is much more to learn at the full article here on the Giddy website. And if you think you're ready to take the plunge with one of our trained physical therapists, click here to schedule an appointment with us.

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Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

Read more: Testimonial by R.M., Age 40

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by J.H.

My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

Read more: Testimonial by J.H.

Testimonial by S.H., age 24

I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be.

It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally over. I really feel that Fusion Wellness is a team of people you can call family and are there to root for you and cheer you on until you reach your goals. There is nothing better than knowing I accomplished this with you guys by my side and as calmly and patiently as I needed. Thank you from the bottom of my heart for always being there and helping me reach my goals.

S.H., age 24

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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