The very best approach to painful intercourse is a comprehensive team of a physician (who has experience treating painful intercourse), a pelvic physical therapist (who looks beyond your vagina) and a psychologist (who has experience in sex therapy and pain). There is such a great influence between emotion and sexual function that it is really important to involve all of these providers in the treatment for painful intercourse. Pain is not just in your body, it is in your brain as well. The way we experience pain and perceive its threat will determine how we respond to a similar situation over time. Especially if there is any history of trauma, big or small.
How Do You Treat Painful Intercourse?
We treat any musculoskeletal problems we find, whether that is the neck and jaw or the hip and spine. Any dysfunction anywhere in the body can cause changes in the pelvis, so it is imperative we examine the muscles and joints away from the pain, too. We do internal vaginal trigger point work, muscle retraining and educate the patient on how to use tools at home to do their own trigger point work. This may involve their partner or it may not, it is up to the patient. There are many options, and we choose what is best for the patient. We incorporate meditation, mindfulness, positive affect and many different exercise approaches depending on the patient and their activities.
Do Patients Get Better?
They do get better! For some women it takes six weeks, for others it takes months, but yes, they do get better. What we do at FC is spend a great deal of time educating our patients. We want them to understand the condition, and to feel that they have a number of tools to help them manage.