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Partnering for Pleasure: Working with Physiotherapy for Dyspareunia

Many women endure years of suffering in silence before seeking help when dealing with pelvic pain, as it presents a unique challenge of being an ‘invisible issue’ that can be difficult to diagnose. Whether you’ve received a diagnosis of vaginismus, vulvodynia, endometriosis, pudendal neuralgia, bladder pain syndrome, coccydynia, or remain undiagnosed, the distress is both physical and emotional. Whatever it may be you are feeling, please remember that you are not alone. One in five women experiences pelvic pain or dyspareunia (sexual pain), and we are here for you.

WHAT IS THE ROLE OF THE PELVIC FLOOR IN PELVIC PAIN AND DYSPAREUNIA?

The pelvic floor muscles, forming a sling from the pubic bone to the tailbone, play a vital role in sexual, bladder, and bowel function. If these muscles struggle to relax, it can result in painful intercourse. Persistent tightness or overactivity of these muscles may contribute to ongoing pain. It is important to keep these relaxed.

Involuntary spasms of the pelvic floor muscles, creating an overactive pelvic floor, can occur in response to pain or anticipation of penetration. This may be associated with conditions such as endometriosis, pelvic surgery, a history of abuse, infections, overactive abdominal muscles, and nerve damage or injury.

It’s important to recognise the influence of stress on symptoms, along with changes in hormones related to breastfeeding and menopause.

 

 

WHAT ARE THE SYMPTOMS OF PELVIC OR SEXUAL PAIN?

 

Symptoms of pelvic or sexual pain can manifest in various ways, including:

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

HOW CAN PHYSIOTHERAPY HELP OVERCOME SEXUAL AND PELVIC PAIN?

While there is no concrete and solid research that physiotherapy is the ultimate treatment of dyspareunia, our expertise in women’s health and treatment of pelvic floor muscle tension are treatments that can definitely help. More importantly, we understand the reality of this and want you to understand and embrace what you feel.

As per physiotherapy, the following have been useful:

  • Pain education
  • Optimisation of vaginal mucosa through the use of vaginal moisturisers or referral to GP for vaginal oestrogen
  • Touch desensitisation and manual therapy
  • Graded exposure
  • Relaxation, mindfulness, and breathing techniques
  • Use of vaginal trainers

As a women’s health physiotherapist, I understand this complex problem and want to work with you in achieving your goals. If you are suffering from pelvic pain or dyspareunia, please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg and let’s get on top of things!

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The information provided on this website is for informational purposes only and is not intended to serve as individual medical advice.

 

References:

  1. 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.
  2. https://www.embracephysio.sg/what-is-vaginismus-how-physiotherapy-can-help-your-symptoms/
  3. https://www.embracephysio.sg/what-is-vulvodynia/
  4. https://www.embracephysio.sg/how-can-physiotherapy-help-my-endometriosis/
  5. https://www.embracephysio.sg/what-is-interstitial-cystitis-or-bladder-pain-syndrome/
  6. https://www.embracephysio.sg/what-is-coccydynia-and-why-its-a-pain-in-a-butt/
  7. https://www.embracephysio.sg/what-is-the-pelvic-floor/
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I highly recommend Preet & Embrace Physiotherapy. It took me wondering if this was as good as it gets after my first birth to find her and book an initial appointment. I'm very happy to share, NO, it gets much better when you have professional expertise and knowledge to guide you on your post-natal (and pre-natal) journey. I'm more aware of my body and what it's capable of after working with Preet. I'm also aware of what is normal/abnormal for post-natal women. I felt listened to, cared for, and really appreciated the straight-up information. If you're out East or near - this is the women's physio for you!

Jemma Hooykaas Avatar Jemma Hooykaas
July 13, 2021

I saw Preet for a few months with my concerns. She is highly knowledgeable in her field and has incredible bedside manner. Her guidance through my journey has been gentle and she addressed my concerns with a very holistic approach. Every consultation has given me great insight about my issues and I felt heard every step of the way. The clinic also feels warm, cozy and welcoming and makes me look forward to my appointments. Reception is always very friendly and it's a breeze to schedule appointments. Communication has always been easy and fast. Highly recommend Preet and her team!

Jo Lee Avatar Jo Lee
April 26, 2024

I saw Preet throughout my pregnancy and postnatal period. She is the BEST. She saved my body and provides free emotional support whole she's at it. Preet obviously knows what she's doing and could identify the root source of the pain and assigned exercises to address it. She also doesn't make you feel bad if you fail to do them. I highly, highly recommend Embrace.

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December 15, 2023

Embrace life. Embrace Physiotherapy.

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