In the title, I purposely did not use the word pain. Working with women over the last 22 years, I have learned that RARELY will women use the word pain. During my evaluations, my question used to be "Is intercourse or penetration ever painful?" and the response was usually no. However, further into the assessment, they would share with me that tampons are uncomfortable, and they try to avoid pelvic exams at all costs. Again I ask - " but intercourse is not painful?" they say no. So I learned to ask " is sex uncomfortable?" The response is typically "yes isn't it for everyone?" The answer is NO!
At Trumble Pelvic Physical Therapy, we evaluate 5-6 new patients a week, with the complaint of intercourse being uncomfortable. Sometimes, they are here for hip pain, or incontinence, but when the questions comes up regarding intercourse (now that I ask it correctly) is often yes. The women in their 20-30's, believe that is how sex is supposed to feel, they have never known differently. Some are in their mid 40-50's, who thought it was normal for sex to get uncomfortable as they approach menopause. Some are in their 60- 70's that believe the myth, that you aren't supposed to have much sex when you get older. They are often very disappointed that they did know this. How were they supposed to know? This makes me both very sad and angry. I am not exaggerating when I tell you relationships have been ended, marriages adversely affected, and avoidance of intimacy has become the norm for many of these women.
So, I want to get the word out to you, your sisters, your friends, your moms and aunts. If you would like to engage in sexual relations, you should not be limited by or have to endure penetration that is UNCOMFORTABLE! Please tell everyone you know. Part of the issue why this misinformation continues is that we will not share this piece about our lives out of shame, embarassment, or it's just too personal.
There are many causes to the symptom of uncomfortable penetration. So to be clear- uncomfortable penetration is a SYMPTOM, it is not a diagnosis. For insurance purposes there is a label of vulvadynia, vestibulitis or dysparaunia, that you could look up on google and get some information. What you won't find is that , the symptom can also go along with inability to use tampons, painful pelvic exams, constipation or history of UTI's.
Why? The pelvic floor muscle is a large muscle that spans the entire bottom of your pelvis, from tailbone to pubic bone and laterally, sit bone to sit bone. The rectum, the vagina and the urethra all exit the pelvic floor. Very often the pain has to do with the nerves and the muscles becoming hypersensitive and or the muscle has become shortened, or trigger points have developed in it. This is why women can have vaginal, rectal and/or urethral SYMPTOMS.
The medical community is in agreement that the cause can be complicated, usually not clear cut and often multifactorial - but is treatable.
My purpose of this blog is not to give you a seminar on the causes. I just want you to know that uncomfortable intercourse/penetration is not normal, should not be tolerated, and can be treated - no matter how old you are! Please get the word out.