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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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What Our Patients Have to Say

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Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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