What is Disparenuria and its common symptoms?

Disparenuria is defined as pain with sexual intercourse or other types of vaginal penetration (pap smear, gynecological exam, or tampon insertion).

Women with dyspareunia may have pain in the vagina, clitoris or labia. Women can experience pain at the entrance of the vagina, or deeper pain during penetration or thrusting. The level of pain can vary from a strong discomfort to a severe sharp pain that can last a few seconds or a long time ofter the event. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus. 

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What are the common of causes of Disparenuria?

Some of the most common causes of Disparenuria include but are not limited to:

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• vaginal dryness 

• tight pelvic floor muscles

• painful or tight episiotomy scars

• pelvic organ prolapse into vaginal opening

• endometriosis - an often painful condition in which tissue from the uterine lining migrates and grows abnormally inside the pelvis

• older age - decreased estrogen levels causing the tissues to become frail and lubrication to be diminished 

• an allergic reaction to clothing, spermicides or douches

• psychological trauma, often stemming from a past history of sexual abuse or trauma

• infection, sexually transmitted disease, or Inflammation of the area at vaginal opening called vulvar vestibulitis

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How long should I wait before I seek treatment for Disparenuria?

Although sexual intercourse may be uncomfortable the very first time, it should never be painful. If you suddenly begin having pain before, during or after intercourse, seek treatment as soon as possible. It is important to seek care early, before you begin to avoid sexual intercourse or feel anxious in anticipation of your partner.

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How can physical therapy help with  Disparenuria?

Your physical therapist will perform a detailed examination to determine to cause of your pain. Your therapist also will determine whether you should be referred to a physician for additional tests.  

Based on the evaluation results, your physical therapist will individualize treatments to help manage your symptoms and relax your pelvic floor muscles in order to  improve their function.

In addition, general exercise is often prescribed to improve overall physical health and well-being. 

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What are my therapy sessions going to be like?

Your physical therapist will perform a detailed examination to identify the causes of your symptoms. Your therapist also will determine whether you should be referred to a physician for additional tests.  

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The treatment for pelvic organ prolapse will mainly focus on strengthening all of the muscles around the pelvis to help support the organ from further descent and help to alleviate your symptoms. We will also provide education on how to modify your every day activities to prevent symptom worsening. This may include lifting techniques, protection techniques with sneezing/coughing/getting up from a chair and providing education on specific intercourse positions. We also use a variety  of manual therapy techniques to treat scars, connective tissue, and abdominal/pelvic organs.

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Depending on your symptoms and level of discomfort, your physical therapist may use biofeedback to make you aware of how your pelvic-floor muscles work and how you can control them better. Electrodes attached vaginally or rectally will provide measurements of muscle activity and display them on a monitor, and the therapist will work with you to help you understand and change those readings. The therapist also may use electrical stimulation to improve your awareness of your muscles and increase muscle strength.

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How soon can I expect to see improvements?

Each patient is unique, so this time frame can vary greatly. Research shows that depending on the severity of your condition, it takes from 2 weeks to a few months of treatment to improve symptoms of dispareniria. We most often request a frequency of 2-3 times a week for 12 total visits. That is why our office staff will ask you to schedule all 12 of your sessions before starting therapy. If you need more than 12 sessions, your therapist will discuss this with you after you have completed 12 visits and you will decide together whether continuing with therapy would benefit you or not. If so, your therapist will reevaluate you and send a progress note to your physician requesting an extension.

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What are the credentials of my uro-gynecologycal physical therapist?

Uro-gynecological physical therapists have been trained in internal vaginal and rectal evaluation and treatment techniques and are by our state license legally allowed and qualified to perform these procedures.

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All licensed physical therapists have had to apply and be selected to attend Physical Therapy school. It is a very competitive process and only those will the highest grades and best potential are selected. Doctors of physical therapy have invested a minimum of 7 years into their undergraduate and graduate training at universities. Once they graduate, they have to sit for a State Board Exam and pass to receive their license to practice. In order to keep their license active, they must dedicate a certain number of hours to continuing education each year.

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At Anchor Physical Therapy we also require that therapists attend multiple post-graduate continuing education courses every year to stay up to date with latest research and continuously enhance their treatment skills in order to achieve the best possible treatment outcomes for our patients.

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