Dyspareunia, or pain associated with intercourse, can be experienced during penetration, with thrusting, or both. It can also be used to describe the pain felt after intercourse, which may or may not be accompanied by pain during intercourse. Pain with penetration is usually described as very sharp with burning, ripping or tearing sensations. The pain with thrusting can be sharp, or dull and achey. Deep dyspreunia on thrusting can also be described as putting pressure on a tender bruise. Pain after intercourse will often be described as an intense aching or soreness, sometimes with severe burning and occasional sharp stabs of pain.
The majority of time, pain during or after intercourse can be caused by:
- Myofascial Trigger Points
- Connective Tissue Dysfunction
- Skin disorders in the vulva
- Episiotomy Scars
- Post-partum trauma caused by forceps, or other extraction devices
- Pudendal Neuralgia
- Sensitized Visceral organs such as the bladder or uterus
- Sensitive Nervous System
These are all areas that can be addressed by Pelvic Health Physiotherapists and should be seen conservatively before medical or surgical intervention is considered.
Especially in the post-partum period, unresolving dyspareunia needs to addressed by a pelvic health physiotherapist, or one of the self-help books described in the section on Myofascial Trigger Points.