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What is Female Sexual Pain?

Female sexual pain is characterised as pain in the genital region, pain experienced during sex, the inability to tolerate penetration, difficulty inserting a tampon, or even significant setbacks with procedures such as pap smears. There are a number of conditions that may be diagnosed, including Genito-Pelvic Pain Disorder (GPPD), Vaginismus, Provoked Vulvodynia or Vestibulodynia. These are experienced by as many as 1 in 5 women at some stage, and can be broadly referred to as female sexual pain. Vestibulodynia affects as many as 10-20% of women, while Vaginismus is experienced by an estimated 1% of women.

What are the Symptoms of Female Sexual Pain?

Female sexual pain is often experienced by sufferers as a stinging, burning, stabbing, or blockage, and can be caused by a wide range of conditions including:

  • Genito-Pelvic Pain Disorder (GPPD) is characterised by pain during attempted penetration
  • Vaginismus refers to the unintentional tightening of the pelvic floor muscles during attempts of vaginal penetration
  • Provoked Vulvodynia is persistent and unexplained vulva pain
  • Vestibulodynia is characterized by pain and sensitivity in the vulva. This may be provoked i.e. pain from attempts of penetration or touch of the vulva; or unprovoked.

In each instance, these conditions are typically experienced by a cycle of pain, which involves:

  1. Anticipation of pain
  2. Automatic tightening of the vaginal walls
  3. Difficult penetration due to tightness
  4. Pain that reinforces reflex responses
  5. ‘Bracing’ worsens
  6. Avoidance of intimacy develops
  7. The cycle begins again

What Causes Female Sexual Pain?

Risk factors can include mental triggers such as anxiety, stress, relationship problems, and even a fear of this pain itself. Physically, vaginal trauma including child birth, UTI’s or pelvic surgery are all thought to contribute.

What’s Involved in Diagnosing Female Sexual Pain?

In diagnosing any form of female sexual pain, a health provider will first take a complete history in order to rule out potential causes including infection. If infection is present, treatment will be provided for this and symptoms should hopefully desist. If not, a gentle physical examination will be utilised to investigate the function of the pelvic floor muscles, alongside extensive questions surrounding the experiences of the individual.

What is the Treatment for These Conditions?

Treatment for female sexual pain is really dependent on the specific condition involved, but most often revolves around the responsive nature of the pelvic floor muscles. Largely, treatment will involve teaching a patient how to tune into their pelvic floor and turn off those reflexive responses, most commonly through the introduction of either graded exposure to penetration, or even techniques that help to develop bodily familiarity like the intimacy and exploration ideas listed on sites such as OMGYes! ‘Progressive desensitisation’ techniques that utilise kegel exercises may also be used for conditions like vaginismus, while conditions like vestibulodynia may require medications such as steroids or even surgery.

Are There Any Home-based Treatment Options?

All treatments should be implemented alongside at-home additions including ongoing and regular pelvic floor exercises and stretches.

5 Tips to Prevent & Manage Female Sexual Pain

  1. Get to know your anatomy
  2. Don’t rush into penetrative sex
  3. Try relaxing pelvic floor muscles throughout the day
  4. Be mindful of your body before penetration
  5. Explore sexual pleasure alone

Your Sydney Pelvic Clinic Physiotherapist can help you implement the strategies above.

Common Myths about Female Sexual Pain

Myth #1: Female pain is a sign that there’s something seriously wrong with me.
Truth: Pain is a warning message, but it is not proportional to tissue damage or other serious physical complaints.

Myth # 2: I can’t satisfy my partner if I have a condition such as GPPD or vaginismus.
Truth: Penetrative sex is just one component of sexual play, and satisfaction is possible even without penetration.

Myth # 3: Sexual pain is normal.
Truth: Sexual pain is common but it’s definitely not normal and is a treatable issue that you should never leave unaddressed.

Get Treatment for Female Sexual Pain?

If you’re experiencing any of the conditions discussed here, or are finding penetration increasingly difficult, then don’t hesitate to book an initial consultation with our physiotherapists today.