How to heal pelvic pain and dyspareunia in women

The problem with pelvic pain is that it can’t be seen and it’s hard to diagnose. Women will often suffer for many years before finding help.

You may have been diagnosed with vaginismus, vulvodynia, endometriosis, pudendal neuralgia, bladder pain syndrome or coccydynia…or not.

Either way, this is distressing, both physically and emotionally. You are not alone.

1 in 5 women experiences pelvic pain or dyspareunia (sexual pain).


The pelvic floor muscles attach from the pubic bone in the front to the tail bone at the back, much like a sling.

These muscles play an important role in sexual, bladder and bowel function. If you have difficulty relaxing your pelvic floor muscles, sex can be painful. Chronically tight or overactive muscles can lead to ongoing pain.

The pelvic floor muscles may spasm involuntarily in response to or in anticipation of pain or penetration, leading to an overactive pelvic floor. This may happen with endometriosis, following pelvic surgery, in women with a history of abuse, infection, over-active abdominal muscles, and nerve damage or injury.

Let’s not underestimate the impact stress can have on your symptoms, as well as the hormonal changes associated with breastfeeding and menopause.


  • Pain during intercourse
  • Pain on tampon insertion or having a PAP smear
  • Involuntary pelvic floor spasm
  • Vulval pain with sitting and tight clothing
  • Painful periods
  • Pain with a full bladder
  • General chronic pelvic pain that may be related to endometriosis
  • Coccyx pain


There is sound evidence to support physiotherapy in reducing pain through the treatment of possible pelvic floor muscle tension/over-activity. We can help you to understand your pain and embrace life.

Some techniques I find useful are:

  • Pain education
  • Optimisation of vaginal mucosa through the use of vaginal moisturisers or referral to GP for vaginal estrogen
  • Touch de-sensitisation and manual therapy
  • Relaxation, mindfulness and breathing techniques
  • Use of vaginal trainers

As a Women’s Health Physiotherapist, I understand this complex problem and will work with you to achieve your goals.

If you are suffering from pelvic pain or dyspareunia, please call/WhatsApp on 9780 7274 or get in touch over email to learn how we can work together or to get on top of things (pun intended).

You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.


Fall, Magnus & Baranowski, A.P. & Fowler, C-J & Lepinard, V & Malone-Lee, James & Messelink, Bert & Oberpenning, Frank & Osborne, J.L. & Schumacher, Stefan. (2005). EAU Guidelines on Chronic Pelvic Pain. European urology. 46. 681-9. 10.1016/j.eururo.2004.07.030.

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