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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 M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by T.C.

While pregnant with my twins, Heather took care with keeping me on my feet and pain free. She saved my back, my sanity and the holidays! I would recommend her to every “mom” looking to stay on her feet during pregnancy and post-partum.

-- T.C.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

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 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 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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