Author: Dr. Kimberlee Leishear, of PRM in Troy, Michigan
Intimacy and sexual satisfaction are fundamental aspects of many intimate relationships. However, for many individuals, the joy of engaging in sexual activity can be marred by the experience of pain during intercourse. This condition, known as dyspareunia, affects people of all genders and can have a significant impact on both physical and emotional well-being. Understanding why sex is painful and how to lessen pain during intercourse is key in maintaining a healthy sex life.
What causes pain during intercourse?
Pain during intercourse is common but not normal! Most of my female patients have some degree of painful intercourse that can range anywhere from some discomfort with insertion or with certain positions to being so painful that they are unable to achieve any penetration. It is important to understand that there are ways we can treat it whether it started after childbirth or it has been going on for many years.
There are many things that may cause pain during intercourse. Sometimes the vaginal tissues can become thinner and dryer due to a decrease in hormones. There may be restrictions in the fascia and muscles at the opening of the vagina as well as deeper in the vagina that may contribute to pain during intercourse. Muscles in the pelvic floor may be tight that may cause pain during intercourse including during initial insertion and with deep intercourse or with certain positions.
These restrictions can limit blood flow to the area that can contribute to pain. The nerves in the pelvic floor and nerves that go to the vagina (internally or externally) can get irritated and inflamed to cause pain. This can happen after pregnancy and childbirth. This can also happen due to any underlying inflammation in the pelvis including endometriosis, adenomyosis, PCOS, and interstitial cystitis. Over time, the irritated pelvic nerves can cause the brain (central nervous system) to become more sensitive to pain signals which can also add to or enhance pain during intercourse.
A past sexual encounter that was painful as well as a history of trauma or abuse can also contribute to pain during intercourse.
Pain During Intercourse Causes For Men
Pelvic pain can be a cause of sexual pain in men. Like women, men can also experience dyspareunia, which refers to pain during or after sexual intercourse. Here are a few potential reasons why sexual intercourse can be painful for men:
- Prostatitis: Inflammation of the prostate gland, known as prostatitis, can cause pelvic pain and discomfort during sexual activity. This condition can be caused by infection, injury, or other underlying medical conditions.
- Pelvic Floor Dysfunction: Dysfunction of the pelvic floor muscles can contribute to pain during intercourse in men. These muscles play a crucial role in supporting the pelvic organs and controlling bladder and bowel function. When the pelvic floor is tight, weak, or imbalanced, it can lead to pain and discomfort during sexual activity.
- Peyronie’s Disease: Peyronie’s disease is characterized by the development of scar tissue within the penis, resulting in a bent or curved erection. This condition can cause pain or discomfort during sexual intercourse due to the changes in penile shape and rigidity.
- Psychological Factors: Emotional and psychological factors, such as anxiety, stress, or past traumatic experiences, can contribute to sexual pain in men. These psychogenic factors can lead to muscle tension, reduced arousal, and difficulty maintaining an erection, ultimately resulting in pain during intercourse.
How is pain during intercourse treated?
Since the cause of pain during intercourse can be multifactorial, the most effective treatment option is a multimodal approach that targets many different contributing factors including treating irritated muscles and nerves in the pelvis as well as treating the whole body. This is truly a holistic approach that is offered by Pelvic Rehabilitation Medicine! The PRM Protocol™ is a treatment that typically consists of a combination of office-based treatments, managed pelvic floor physical therapy, behavioral health, nutrition, and medications.
The treatment is tailored for the individual and is based on what is causing the pain and focused on getting to the root of the problem. The sooner patients start treatment the better the overall outcome.
At Pelvic Rehabilitation Medicine, our goal is to get patients better faster so they can improve their function including optimizing sexual function which is an important part of life!
