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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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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.

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Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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!

Read more: Testimonial by M.M.

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

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