Let’s talk about something that affects more women than you may realize: Dyspareunia and chronic pelvic pain.
If your eyes are already glazing over and you’re about to click away because this info doesn’t apply to you, just do me a favor: Keep this blog post in mind for someone who could use the information and support. SHARE THIS POST with someone who needs it, and/or send me an email if you want further information. You can also read my book, Lady Bits. Although Lady Bits was not specifically written to treat dyspareunia, the information included — particularly in the “Relaxation” section of Chapter 21 — can be helpful for women who suffer from painful intercourse.
When Sex Hurts:
Dyspareunia and Chronic Pelvic Pain Syndrome
If you suffer from dyspareunia, or pain with intercourse, you are not alone. Unfortunately, dyspareunia is often left untreated since many women are embarrassed to talk about it, ashamed of their condition, or left to think that it’s “normal” for sex to hurt. Read on to learn more about dyspareunia and chronic pelvic pain syndrome, including tips that can help you (or a loved one) cope.
Fear. Anxiety. Pain. Burden.
Sex probably does not come to mind when you read these words, but for many women with dyspareunia, these words define sex. Women who suffer from dyspareunia may not want to have sex, but feel obligated to participate for the sake of her partner.
If you have dyspareunia you may have brought the issue up with your doctor and been left to think that it’s all “in your head” or that the condition will resolve on its own. You may feel like your provider does not care or is not listening to you, but it might be that he or she is not aware of the symptoms of dyspareunia or the broader category of pelvic pain (which often contributes to painful intercourse): chronic pelvic pain syndrome, or CPPS. CPPS is a mystery to many healthcare providers because the cause is not often clear and the symptoms can vary widely.
CPPS can result from a variety of factors including traumatic injury such as car accidents or falls, injuries sustained during pregnancy or childbirth, a history of painful periods or endometriosis, a history of chronic urinary tract infections or yeast infections, interstitial cystitis (painful bladder syndrome), psychological trauma, or a history of physical or sexual abuse. Often, CPPS it the result of one or more of these issues and the net result is tense, overactive pelvic floor muscles. Overactive pelvic floor muscles can make intercourse incredibly painful. Painful intercourse leads to anxiety about intercourse, which leads to more muscle tension and more pain.
If this sounds familiar, please seek help. Do not feel like you need to be “strong” about the pain – it may not resolve on its own. The following tips may help you or a loved one cope if you are living with dyspareunia or CPPS:
Finding a relaxation technique that works for you is a key strategy for dealing with dyspareunia or CPPS. Deep breathing, stretching, meditation, listening to music, lighting a candle… Every woman is unique, and what works for one person may not work for another. Find a technique that calms you and use it before and during sex. Click here to try my pelvic drop for pelvic floor relaxation.
Let your partner know that you need plenty of time to “warm up” before game time if he wants it to hit it out of the ballpark! Be honest with him about strategies you may need to take to RELAX during intercourse, including time-outs for breathing exercises or simply a moment to pause, rest, and “regroup” before continuing. Open communication about your needs will help you and your partner feel at ease about your personal journey toward recovery. ***FYI, recovery from dyspareunia and CPPS is completely reasonable to expect with proper training and treatment!
“Woman on top” requires more hip, thigh, and pelvic floor muscular activation, which is why this position should be avoided – at least initially – if your pelvic floor muscles tend to be tense or hyperactive. You may be more comfortable in sexual positions that allow you to fully relax; for example, lying on your side. Some women with tense pelvic floor muscles do well on their hands and knees, or resting on their elbows and their knees. In this position (elbows and knees), the muscles of the pelvic floor are slightly stretched which may make intercourse less painful.
Find a healthcare practitioner who is sympathetic to your condition. In most cases, a multidisciplinary approach can be incredibly helpful. This may include – at the very least – a gynecologist (or certified nurse midwife, nurse practitioner, or naturopath) and a women’s health physical therapist. Sometimes medication will be prescribed such as antidepressants or muscle relaxants. You may also want to include the services of a psychologist or counselor to help with the emotional aspect of dyspareunia and CPPS. If you prefer to look “outside the box” of conventional western medicine, consider seeking help from a chiropractor, massage therapist, or acupuncturist. You can also take matters into your own hands and experiment with restorative yoga for relaxation and guided imagery such as this this beautiful 12-minute guided meditation for pelvic pain from Your Pace Yoga.
Always remember that you are not alone if you suffer from pelvic pain that makes sex difficult or impossible. It is not your fault, it is not a flaw, and there is help.
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~Dr. Bri, PT, DPT