What is Painful Sex? 

Painful sex, or dyspareunia (dis-puh-ROO-nee-uh) is pain in your genitals or pelvic area occurring before, during, or after sexual intercourse. 

Sexual intercourse comes in a wide and unique variety of forms and may mean different things to different people. This can include genital-to-genital, mouth-to-genital, and toy-to-genital contact as well as penetration and stimulation of the anus.  

Although painful sex can affect all kinds of folks, today’s post will be focusing on dyspareunia experienced by people with vulvas and vaginas that involves the act of penetration by a penis, fingers, or toys.  

Is Painful Sex Normal? 

According to the American College of Obstetrics and Gynecologists (ACOG) painful sex is a very common problem with 3 out of 4 women and female identifying people experiencing painful sex at some point in their lives.  

Some people may experience painful sex for a short period of time, while for others this can be a lifelong problem that can severely impact relationships, quality of life, and mental health.  

Although painful sex is common, it’s not normal.  

There are multiple reasons why you might be experiencing pain during sex. It’s important you always speak to a medical professional to help you identify the reason, or multiple reasons, why you’re experiencing pain as the first step towards pain-free sex. 

What Does Painful Sex Feel Like? 

If you’re experiencing painful sex, you may feel pain in your vulva, the area surrounding your vagina called your vestibule, within your vagina, and in your perinium.  

Dyspareunia can be experienced as:  

• Entry Pain (intraorbinal or superficial) is pain you feel at the entrance of the vagina with penetration 
• Deep pain (collision) is pain you feel with deep penetration in your cervix or lower abdomen, this can worsen with different positions 

Painful sex is also sometimes categorized as primary, secondary, complete, or situational: 

• Primary pain is pain that you’ve always experienced since becoming sexually active  
• Secondary pain is pain that develops after having a time of experiencing pain free sex  
• Complete pain is when you experience pain every time you have sex or with any insertion including a finger, tampon, or toy 
• Situational pain is when the pain only happens in certain situations or positions 

Some sensations of painful sex include:  

• Stabbing or sharp pain with penetration  
• Deep pain with thrusting  
• Aching or throbbing after intercourse  
• A feel of burning  
• Pelvic cramps that feels like menstrual cramping  
• A feeling a muscle spasms or tightness 

What Causes Painful Sex? 

Some causes for painful sex include:  

• Vulvodynia 
• Vaginismus 
• Vaginal atrophy or dryness caused by medication, menopause or other hormonal issues  
• Radiation induced vaginal atrophy  
• Vaginal infections like yeast infections  
• Endometriosis  
• Uterine fibroids 
• Pelvic inflammatory disease   
• Sexually transmitted infections (STIs)  
• Intercourse too soon after childbirth  
• Injury to the vulva or vagina including tears or cuts  
• Skin allergy or irritation  

How Is Painful Sex Treated? 

Treatment will depend on your diagnosis and what your underlying issues are.  

Some common treatments include:  

• Medications to treat infections and allergies  

• Estrogen creams or tablets for vaginal dryness or atrophy caused by decreased hormone levels 
• Vaginal dilators to help to gradually stretch and relax the pelvic floor muscles  
• Pelvic floor physiotherapy  
• Talk therapy with a certified professional  

One thing to remember is that if you are experiencing painful sex, you are not alone. Everyone will take their own time to get to the amount of sexual activity they prefer. The most important thing is to listen to your body.    

 

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 Is there a blog topic you’d like us to cover? Reach out today to let us know. 

 

Here at Hyivy Health, we’re dedicated to helping you down there and everywhere. The purpose of this blog post is to offer resources and education about pelvic health and is not intended to serve as medical advice. The information provided above is not a substitute for the treatment, advice, or opinion of a medical professional. Always consult with a certified health professional before starting any treatments.

 

What is Endometriosis? 

Endometriosis is a chronic condition in which tissue similar to endometrial tissue grows outside of the uterus (womb), causing scar tissue and/or adhesions in the pelvic region including the ovaries and fallopian tubes.  

Over 70% of people with chronic pelvic pain have endometriosis and it is one of the most common pelvic diseases.  

Even though this tissue is outside of where it belongs, it continues to behave as it would if it was in your uterus, so with your menstrual cycle this endometrial tissue thickens, breaks down, and bleeds. 

Since this blood has no way to exit your body, it becomes trapped. When endometriosis affects your ovaries, cysts called endometriomas may form. In your pelvic area, the surrounding tissue becomes irritated, eventually developing scar tissue and bands of fibrous tissue that can cause areas of your pelvic and organs to stick together.  

Recordings and research go as far back as the 1700s with descriptions of “chocolate cysts” in the female reproductive system, and in the 1930s saw the discovery of the rare cases when endometriosis is found in other parts of the body including the lungs, bowels, colon, rectum, bladder, lymph nodes, and cervix.  

Despite the fact that we’ve known about endometriosis for centuries, it is still a commonly misdiagnosed condition with many people waiting up to 10 years for their official diagnosis. 

What are the Signs and Symptoms of Endometriosis? 

One of the most common symptoms of endometriosis is chronic pelvic pain. Although it’s normal to have some cramping and discomfort during your period, pain that causes you to miss out on work, school, or social activities isn’t normal. 

In addition to chronic pelvic pain, signs and symptoms of endometriosis include:  

• Mild to severe pain in your back, abdomen, and pelvis during menstrual periods 
• Pain with sexual intercourse (dyspareunia) 
• Painful bowel movements and/or urination  
• Heavy bleeding during menstrual periods 
• Nausea, fatigue, depression, and anxiety  
• Fertility complications such as increased difficulty in getting pregnant  

How is Endometriosis Diagnosed? 

The current standard of care when it comes to an endometriosis diagnosis is a laparoscopic surgery (also known as keyhole surgery) where a small incision is made your abdomen where a small telescope is inserted so that your doctor can look for adhesions and then potentially remove them. 

Some people with endometriosis don’t have any symptoms at all and are only diagnosed if abnormal tissue is discovered during a routine procedure or surgery.  

 

How is Endometriosis Treated? 

Treatment for endometriosis is a personalized plan that includes medications and surgery. Currently there is no cure for endometriosis. Only a certified medical professional can figure out the right course of action for you.  

When it comes to managing and treating chronic pelvic pain, a Pelvic Floor Physiotherapist (PFPT) can provide hands on treatment to help manage your pain and reduce pelvic floor tightness (hypertonicity) which can help with your pelvic pain, back pain, painful urination, and painful bowel movements.  

The tightening of these muscles can also lead to painful intercourse, which a PFPT has a range of in-clinic and at-home techniques including vaginal dilators to massage, relax, and breakdown scar tissue and relieve pain.  

Where Can I Get More Information About Endometriosis? 

If you are currently dealing with, or suspect you have endometriosis, you are not alone. There are a variety of organizations you can join or check out to get more information, share your story, connect with others, and get support:  

• Nancy’s Nook  
• EndoBlack 
• The Endometriosis Network Canada 
• Endometriosis Association 
• Endometriosis.org 
• Endometriosis Foundation of America     

 

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 Is there a blog topic you’d like us to cover? Reach out today to let us know. 

 

Here at Hyivy Health, we’re dedicated to helping you down there and everywhere. The purpose of this blog post is to offer resources and education about pelvic health and is not intended to serve as medical advice. The information provided above is not a substitute for the treatment, advice, or opinion of a medical professional. Always consult with a certified health professional before starting any treatments.

There are many reasons why you might be experiencing issues with your pelvic floor. You might have symptoms that are mild and annoying, or you might have gotten to the point where your symptoms are interfering with your daily life.

In this post, we’re going to outline what the pelvic floor is, the differences between a hypertonic and hypotonic pelvic floor, and why it’s important to get appropriate treatment for both conditions.

WHAT IS THE PELVIC FLOOR?

Your pelvic floor muscles are a group of muscles that stretch from the tailbone to the pubic bone at the front and between the sitz bones from one side to the other. They act as a hammock, providing support for your pelvic organs.

One way to feel your pelvic floor is to imagine picking up a cherry with your vagina (if you have one) – you’d be using your pelvic floor muscles to do that!

WHAT IS A HYPERTONIC PELVIC FLOOR?

A hypertonic pelvic floor occurs when your pelvic muscles are too tight or tense and can’t relax. Hypertonic pelvic floor is also known as pelvic floor tightness or hypertonicity. Signs and symptoms of a hypertonic floor include:

• urge or overflow urinary incontinence – impacting frequency (having to pee often), urgency (a sudden, strong need to pee), or hesitancy (having trouble starting the stream or keeping it going)
• painful urination
• incomplete emptying of the bladder
• constipation or straining during bowel movements
• pain during or after bowel movements
• unexplained pain in your low back, pelvic region, hips, genital area, or rectum
•  pain during or after sexual intercourse (dyspareunia), sexual stimulation, orgasms, or vaginal penetration
• uncoordinated muscle contractions causing the pelvic floor muscles to spasm

 

There isn’t one single reason or cause for a hypertonic pelvic floor. However, some contributing activities or conditions that have been linked to pelvic floor hypertonicity include:

• repeatedly holding your urine or feces for long periods
• tensing the core muscles in workouts
• sexual trauma
• high levels of stress or anxiety that might cause you to frequently tense your pelvic floor
• chronic pain caused by endometriosis or irritable bowel syndrome (IBS) that can cause you to tense your pelvic floor muscles
• conditions like interstitial cystitis, pudendal neuralgia, or vulvodynia
• birth trauma, including scarring or one-sided pelvic floor tears
• cancer treatments, such as internal and external radiation
• surgeries to the pelvic area

It’s very important to see a specially trained doctor or pelvic floor therapist if you are experiencing any of these symptoms so that they can identify the root cause of your hypertonic pelvic floor. Once diagnosed, a pelvic floor therapist may offer you:

• suggestions for pelvic muscle relaxation, including breathing techniques
• advice on bladder and bowel habits (for example, no straining)
• pelvic floor and abdominal massage techniques
• scar tissue massage techniques
• pelvic and hip stretches

WHAT IS A HYPOTONIC PELVIC FLOOR?

A hypotonic pelvic floor occurs when your pelvic muscles are too weak to function how they’re supposed to and aren’t able to properly support the pelvic floor organs.

Hypotonic pelvic floor is also known as pelvic floor weakness or hypotonicity. Signs and symptoms of a hypotonic pelvic floor include:

• stress urinary or fecal incontinence (leaking of urine or feces)
• pressure in your pelvic area that can lead to pain
• pelvic organ prolapse (when one or more organs drop against the vagina)
• decreased sensation (feeling less) during sexual intercourse

There isn’t one single reason or cause for a hypotonic pelvic floor. However, some contributing activities or conditions that have been linked to pelvic floor hypotonicity include:

• trauma to the pelvic floor (such as a car accident)
• pregnancy and giving birth
• chronic constipation
• interstitial cystitis , which can cause pain in the pelvic floor muscles and loss of muscle strength
• menopause and aging

Once diagnosed, a pelvic floor therapist may offer you:

• specialized exercises to help to strengthen the pelvic floor (kegels)
• use of a biofeedback device

WHY IS IT IMPORTANT TO KNOW THE DIFFERENCE?

It’s important to know the difference between hypertonic and hypotonic pelvic floor because they’re both treated very differently.

Many people think that when they start to experience pelvic pain, urinary incontinence, or leaking that all they need to do is start kegel exercises or buy a kegel trainer to tighten their pelvic floor muscles. However, if you have a hypertonic pelvic floor, these exercises can make the problem worse. Ignoring your symptoms or just waiting to see if they go away can also lead to worsening symptoms.

When in doubt, remember to put your health and wellness first by seeing a certified health professional who’s trained specifically to diagnose and treat the pelvic floor.

Hopefully after you read this article you will feel more empowered to understand the difference between the hypertonic and hypotonic pelvic floor and understand why it’s so important for you to know the difference.

 

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 Is there a blog topic you’d like us to cover? Reach out today to let us know. 

 

Here at Hyivy Health, we’re dedicated to helping you down there and everywhere. The purpose of this blog post is to offer resources and education about pelvic health and is not intended to serve as medical advice. The information provided above is not a substitute for the treatment, advice, or opinion of a medical professional. Always consult with a certified health professional before starting any treatments.

What is the Pelvic Floor?

The pelvic floor is a group of muscles that stretch from the tailbone (also known as the coccyx) to the pubic bone at the front and between the sitz bones from one side to the other. 

Think of your pelvic floor as a hammock just under your core, making sure everything stays in place. The 36 muscles that make up your pelvic floor all work to support pelvic organs like the vagina, cervix, uterus, bladder, urethra, uterus, prostate, and rectum.  

 

What does the Pelvic Floor do?

The pelvic floor muscles provide the main support for the pelvic organs, but serve multiple other functions, including:  

• Urinary continence 
• Fecal continence 
• Sexual intercourse 
• Orgasms and erections 
• Vaginal delivery during childbirth 

The pelvic floor isn’t an isolated group of muscles that handle going to the bathroom and reproduction and sexual function. Pelvic floor muscles also provide stability for your core and involve complex coordination between somatic and autonomic motor nervous systems. Somatic motor functions are voluntary actions like standing or sitting, and autonomic motor functions are involuntary like breathing or blinking. 

For example, you don’t have to think about the pelvic floor muscles that are working together to keep your pelvic organs like your bladder or uterus in place. But now think about stopping urine midstream when you’re peeing – those are some of your pelvic muscles at work.  

Now imagine you’re trying to pick up a cherry from the floor with your pelvic floor muscles. You’re going to have to voluntarily squeeze some of them, right? (You’re also probably never going to look at a cherry the same way again!)

 Hyivy Health’s 5 Pelvic Floor Vital Signs 

The purpose of this list is to give you a sense of the various ways your pelvic floor can be thought about, felt, monitored, and cared for:

 1. Sensation 

The pelvic floor has a wide range of physical reactions and sensations, including sexual response and orgasm. The symptoms to look out for when you may need to consult a clinician are: chronic pain (pain that continues for more than three months), loss of libido, inability to achieve arousal, or discomfort.

2. Lubrication 

The level of moisture in the pelvic floor is subject to hormonal changes and there is a unique level of discharge and lubrication for every individual.

The symptoms to look out for when you may need to consult a clinician are: irregular discharge including watery consistency, abnormal color, or increased frequency, and chronic vaginal dryness (dryness that continues for more than three months). 

3. Incontinence 

The pelvic floor is responsible for both urinary and bowel control.

The symptoms to look out for when you may need to consult a clinician are: pain with urination, increase in urinary frequency (overactive bladder), or loss of urinary or bowel control. 

4. Health of tissues 

Usually, we don’t notice the health of tissues until something is wrong.

The symptoms to look out for when you may need to consult a clinician are: stenosis (narrowing and shortening of the vagina), sores and rashes, thinning of the skin in the vagina or on the vulva, redness, irritation, itching, bleeding, or atrophy.

5. Muscle control and response 

The inability to correctly relax and coordinate your pelvic floor muscles is called pelvic floor dysfunction.

The symptoms to look out for when you may need to consult a clinician are: pelvic muscle weakness (hypotonic) and overactive pelvic muscles (hypertonic). For more in-depth details on these symptoms, check out our blog post on the difference between a hypertonic and hypotonic pelvic floor. 

 

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 Is there a blog topic you’d like us to cover? Reach out today to let us know. 

Here at Hyivy Health, we’re dedicated to helping you down there and everywhere. The purpose of this blog post is to offer resources and education about pelvic health and is not intended to serve as medical advice. The information provided above is not a substitute for the treatment, advice, or opinion of a medical professional. Always consult with a certified health professional before starting any treatments.