If you experience pain with intercourse or internal exams and/or have difficulty using tampons, you are not alone. It is not uncommon for women to experience pain with insertion at some point or even chronically, but this shouldn’t be ignored and, fortunately, there is treatment available. There are many reasons why women might experience pain, called "Dyspareunia" or be unable to tolerate penetration, including the following:

• Endometriosis
• Scar tissue from surgery, trauma, or child birth
• Dryness or insufficient lubrication
• Decreased arousal caused by stress, birth control, hormonal imbalances, or some medications
• Fibroids or cysts
• Vaginismus, the involuntary spasms of muscles
• Anxiety, depression, or stress
• Infections or inflammation
• Vaginal Atrophy
• Vaginal Agenesis or other congenital abnormality

What is Dyspareunia?

The medical term for painful sex that occurs just before, during, or after intercourse, is Dyspareunia. You may experience pain at the opening of your vagina, deep pain, and/or pain with any type of insertion. Pain may be described as burning, aching, throbbing, or sharp and it could be brief or last for hours.

How Do You Treat Dyspareunia?

It is important to first discover the cause of your pain and schedule a visit with your doctor or nurse practitioner. If no infection or pathology is present, pain is likely due to pelvic floor dysfunction, vaginal tissue sensitivity, or hormonal imbalances.

There are many simple ways to decrease and resolve pain with insertion at home and there are medical professionals who specialize in treating this type of pelvic pain.

Insufficient lubrication is a common cause for pain with sex and can occur with lack of arousal and hormonal changes. Using a non-irritating lubrication that works well with your body can be a first step in treatment. If this pain persists, consult with your gynecologist to develop a treatment plan that may include: vaginal balms, hormone replacement therapy, and dietary changes.

Stress and anxiety can lead to Vaginismus and muscle tension resulting in pain with sex. Taking time for self care, meditation, and activities that lower your stress can help improve your libido and decrease pain. Specific yoga poses, mindfulness, and learning pelvic breath work can all help decrease pain and increase arousal.

If you think you have Dyspareunia or have been diagnosed with a condition that can cause pain with insertion, talk to your doctor about treatment options available to you. Pelvic Physical Therapists are highly trained professionals that offer treatment options including: education, relaxation techniques, biofeedback, dilator training, manual therapy, yoga, therapeutic exercise and more. Additionally, Sex Therapists and counselors can help you find the root cause of your pain and create individualized treatment programs for you or your partner. To get started, talk to your doctor or nurse practitioner, search your local providers, or use the directories below.

Can Dilators Help?

Vaginal Dilators are commonly used in conjunction with breathing techniques and other treatment options as a way to reduce pain. Vaginal Dilator Therapy is a gentle way to stretch the vaginal tissue, improve the mind body connection, and teach the muscles to relax. The VWELL Dilator Set comes with different sizes to progressively improve flexibility and decrease sensitivity to insertion. Learn more about these extra soft, body safe, medical grade silicone dilators here.

Post written by Dr. Cassandra Sharp PT, DPT

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