Dyspareunia

Dyspareunia is the medical definition of difficult or painful vaginal penetration or intercourse. This pain can occur during initial penetration, with thrusting, or with both. The term 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 May Be Described As:

• Sharp
• Burning
• Ripping or tearing
• Dull
• Achy
• Stabbing

Dyspareunia Can Be:

• Superficial (at the opening)
• Deep (internal)

Dyspareunia Can Be Classified As: 

• Primary Dyspareunia: Experiencing pain at first attempt of vaginal penetration or insertion.
• Secondary Dyspareunia: Experienced pain-free sexual penetration or insertion prior to the development of painful vaginal penetration.

Pain During or After Intercourse Can Be Caused By:

• Overactivity of the pelvic floor.
• Poor lubrication.
• Connective tissue dysfunction.
• Skin disorders in the vulva.
• Episiotomy scars.
• Post-partum trauma caused by forceps, or other extraction devices.
• Sensitive nervous system.

Patients May Have Other Conditions Such As:

• Endometriosis
• Vulvodynia 
• Lichens sclerosis
• Vaginismus 
• Pudendal neuralgia

Pelvic health physiotherapy has been shown in research to be an integral part of the multidisciplinary treatment of symptoms associated with dyspareunia.

Treatments for Dyspareunia May Include:

• Vulvar skin health education.
• Education on moisturizers and lubricants.
• Bowel and bladder education.
• Pain education.
• Diet modification to address constipation.
• Therapeutic exercise.
• External myofascial techniques.
• Internal myofascial techniques.
• Use of dilators/accommodators.
• Treatment of the nervous system.