Pelvic Pain Conditions
Pain with intercourse, endometriosis.
Common Chronic Pelvic Pain conditions are endometriosis, bladder pain syndrome, interstitial cystitis, pelvic floor muscle pain, coccydynia, vulvodynia, anal pain syndromes, pudendal neuralgia.
What is it?
Involuntary contractions and tightening of the pelvic floor that can constrict the opening of the vagina. This can be restrictive, sensitising and painful. It can be associated with anxiety around intercourse and other health conditions like IBS, endometriosis and persistent back pain.
How does it present?
It can make it difficult to insert a tampon, it can make it painful to have penetrative sex and can impact on your bladder and bowel function causing both issues with leakage and constipation.
How to treat?
For this group of women, strengthening can make the problem worse and can lead to increased pelvic pain and anxiety related to intercourse. Treatment involves first ruling out any other causes of pain at the entrance to the vagina. A thorough history is undertaken in order to consider other experiences and fears that may be contributing. The aim of treatment is then to desensitise and gently improve the length of the pelvic floor muscles. Assessment will at some stage involve a pelvic exam but this is not always done initially if pain is too severe. The patient is taught ways in which they can improve this condition with devices and self directed treatment if physio intervention is not yet feasible.
If you are suspicious of an overactive or tight pelvic floor we would recommend you get assessed by a women’s health physiotherapist to build some strategies to help with this issue.
Endometriosis is a very common condition affecting women. Endometriosis is a leading cause of chronic pelvic pain in women that can lead to significant long term consequences for contraception, fertility and pain.
It is a condition that is characterised by irregular tissue growth, similar to that of the uterine tissue, that grows outside of the uterus. It is still not fully understood but we know is increasingly prevalent in Australian women. It can involve
Management needs to be holistic incorporating medical input and conservative management to improve symptom management. This may involve physiotherapy to improve urine control, bowel dysfunction, sexual implications and back and pelvic pain. We understand there can also be a component of nervous system overactivity and changes to sensisity of the pelvic floor. Our treatment is multifaceted and focused on improving wellness and long term management.
Pain with intercourse
Pain with intercourse (also known as dyspareunia) is a common condition affecting women both at the entrance of the vagina and with deep penetration. It can be related to all sorts of conditions or stages of life and can be troubling for your sexual enjoyment out of your current or future relationships.
The physiotherapy management is dependent on the type of pain that you report and what has potentially caused the discomfort to develop. It may be something that has happened after childbirth (both vaginal and caesarean births) and be associated with hormonal changes (both around childbearing and menopause).
We can utilise treatment options including empowering you to understand how to manage the pain, using dilators or muscle release techniques, finding exercise that helps to relax the pelvic floor, and if required referral on to other sexual health providers. We understand this can be a difficult condition to discuss but we will make you feel comfortable and safe and respected whilst you are here. If you have questions please feel free to reach out and let us know what we can do to help you feel more comfortable with the process.