Let’s Talk About Painful Intercourse (aka Dyspareunia)

Painful intercourse can be difficult to talk about. If you’re experiencing painful  intercourse, you may wonder if the pain is all in your head or the result of something you’re  doing wrong in bed. After all, sex is supposed to be pleasurable, right?

The truth is that sex isn’t pleasurable or pain-free for all women all the time. In fact, many women experience painful intercourse at some point in their lives, due to muscle tension, dryness, and fragile connective tissue.


Dyspareunia is persistent or recurrent genital pain that occurs just before, during or after intercourse and that causes you personal distress.

Painful intercourse is worth talking about; physical therapy can help you get this very special and important part of your life back.


What is Dyspareunia?

Dyspareunia is pain before, during, or after intercourse.  It may affect 20-50% of women, although this number is likely smaller than the actual number as many women are hesitant to seek medical treatment.

One common cause:

  • Musculoskeletal dysfunction of the pelvic floor: over-activity of muscles of the pelvic floor including the levator ani.
  • Overactivity of the levator ani muscles is a condition in which these muscles do not relax completely or contract when they should relax.
  • Overactive, nonrelaxing muscles are painful to touch, and the pain itself may cause spasms of the levator ani muscles, preventing intercourse entirely.


In other words, it’s like a “charlie horse” in the muscles surrounding your vagina.

How can physical therapy help with Dyspareunia?

  • The goal of physical therapist intervention for   dyspareunia is to reduce vaginal pain by:
  • reducing over-activity of the pelvic floor muscles
  • improving your ability to control these muscles
  • increasing the ability of the vaginal tissue to tolerate a stretch.


Treatments include:

  • manual therapy
  • neuromuscular re-education
  • exercise
  • soft tissue mobilization
  • vaginal dilators.


vag dilators.PNG


Guess what your “private parts” are made of?

Muscles, tendons, ligaments, and bones.  So when a specially trained women’s health physical therapist performs an examination and initiates treatment, she is treating a dysfunction of muscles, tendons, ligaments, and bones.

superficial and deep pelvic floor muscles


What can you expect from your first visit with a pelvic floor physical therapist ?

  • A private, professional, comfortable space.
  • Courteous, professional staff who understand women’s health issues.
  • Women’s health trained licensed physical therapists.
  • A private room.
  • An initial conversation with your therapist where you will have a chance to describe everything you are going through and ask any questions you may have.
  • A physical examination which will first be explained in detail and over which you will have complete control.
  • The latest equipment and products.






Published by Dr. Cora T Huitt

Cora T. Huitt, PT, DPT, BCB-PMD ~Thirty seven years of clinical practice, specializing in women's health for fifteen years. ~BS Degree in Allied Health Professions, Ohio State University, '72. ~Master of Arts in College Teaching (MACT) focus in Physical Therapy & Therapeutic Exercise, University of North Carolina, '76. ~ Doctorate of Physical Therapy, Alabama State University, 2010 ~Attended multiple courses offered in Women's Health Physical Therapy, including Pelvic 1, 2, 3 Course in Women's Health Section APTA. ~Member of VPTA and APTA, Women's Health Section. ~BCIA-PMDB Biofeedback- Pelvic Muscle Dysfunction Biofeedback. ~Certified Pilates instructor, ProHealth. ~Affiliate member of the American College of Obstetrics and Gynecology. ~Member of International Continence Society. ~Member of National Vulvodynia Association. ~Adjunct Clinical Faculty for student affiliation at multiple universities. ~Director of APTA Women's Health Residency since 2007, credentialed in 2008. (only other residency at Duke Unviersity)

2 thoughts on “Let’s Talk About Painful Intercourse (aka Dyspareunia)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: