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5 Reasons For Painful Sex


About 20 percent of women in the US experience dyspareunia, which is defined as persistent and current painful sexual intercourse, at some point in their lives. It can contribute to feelings of depression and anxiety and have a significant impact on intimacy and personal relationships. Hormonal changes, pelvic diseases, and physical/ emotional trauma can cause dyspareunia. It can be described as an entry and/or a deep pain. Pelvic floor physical therapy can help treat the soft tissue and muscles that become affected over time from these conditions. 

  1. Menopause. About half of postmenopausal women suffer from painful sexual intercourse. Drop in estrogen can lead to vulvar atrophy and dryness. The tissue outside of the vagina becomes fragile and can tear with friction. Topical creams, vaginal moisturizers, and lubricants are useful in treating the effects of menopause. 
  2. Breastfeeding. If you are breastfeeding, you can also develop vaginal dryness due to the decreased levels of estrogen in your body. Vaginal moisturizing products can help as well as increased hydration and incorporating certain types of food with good fats into your diet, such as avocados.
  3. Endometriosis. Endometriosis is a disease where endometrial like tissue grows outside of the uterus, most often in the abdominal and pelvic regions. This can lead to painful adhesions and scar tissue around the uterus, bladder, rectum, ovaries, and fallopian tubes. Muscles of the hip, abdomen, and pelvic floor can become tight in response. 
  4. Physical or Emotional Trauma. Over time, our bodies react and adapt to trauma, leading to tightness of the pelvic floor, chronic pain, and increased sensitivity/ decreased threshold to pain. Physical trauma includes episiotomies and perineal tearing from a vaginal birth. 
  5. Abdominal Surgery. Undergoing a total abdominal hysterectomy or a cesarean results in scarring and adhesions of the abdominal wall. Besides weakening of the abdominal muscles, the pelvic floor can also become tight and weak, inhibiting or making intercourse painful. 

Reach me if I can answer any questions on physical therapy, serving you locally in New York City or anywhere online virtually through “telehealth“.

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Pelvic floor disorders impact 1 in 3 women and many are surprised to learn pelvic floor physical therapy doesn’t only deal with the pelvic floor. Because our pelvic floors connect to so many other muscles and joints, it can affect many other parts of the body as well. Hence that hip or lower back pain may actually be due to pelvic floor dysfunction.  The good news—pelvic floor dysfunction is not considered a normal part of aging and can be treated successfully. Subscribe and receive my tips along with insights on the latest advancements on physical therapy including pelvic health.

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