Pain with sexual intercourse
Many women experience sexual difficulties, for some these symptoms develop out of the blue and for others they have always been present. Symptoms can include painful sexual intercourse (dyspareunia), pelvic floor muscle over activity (vaginismus) or vulval pain (vulvodynia). Sexual intercourse can become impossible due to severe pain and many ladies describe 'a block' or 'barrier' which prevents penetration.
Many of these conditions are caused/affected by the pelvic floor muscles and treatment by a women's health physiotherapist can be extremely successful in reducing symptoms. Physiotherapy will focus on assessment of the pelvic floor muscle for length, areas of overactivity and discomfort. Pelvic floor muscle relaxation techniques, manual muscle/fascia techniques and vaginal dilators are used in treatment.
Women frequently report reduced vaginal sensation and laxity/looseness following a vaginal birth. This can affect sexual pleasure and have an impact on libido.
The pelvic floor muscles, surrounding the vagina, play an important role in maintaining vaginal tone. A weaker pelvic floor muscle will produce a lower tone and sensation. In this case physiotherapy focuses on strengthening the resting and contraction strength of the pelvic floor muscles.
Episiotomy or scar sites
Following vaginal birth or gynaecological surgery, perineal and vaginal scar tissue can become hypersensitive and restricted in its movement. This can cause localised pain and sensitivity.
Physiotherapy can desensitise and mobile scar tissue and suggest simple tips to follow as you start to resume a sexual relationship