Dyspareunia, Vaginismus and Vulvodynia: sexual and genital pain
Dyspareunia, Vaginismus and Vulvodynia: What do the terms mean?
Dyspareunia is defined as painful sexual intercourse. Although men can experience this problem, in practice almost all patients that present complaining of dyspareunia are women.Dyspareunia usually begins with a physical cause and is generally thought to be a physical rather than an emotional problem, although an emotional component will often develop due to the distress this condition can cause.
It can be difficult to separate dyspareunia from vaginismus, since vaginismus may occur following a history of dyspareunia, and mild vaginismus is often accompanied by dyspareunia. Dyspareunia can develop at any stage of life. It can occur from the first attempt at penetrative sex, after childbirth due to temporary hormonal changes and scar tissue from stitches, and after menopause due to the loss of eostrogen and hence elasticity and lubrication of the vagina.It can occur during every sexual contact, or only in certain situations. It can be felt around the opening of the vagina or deep within it.
Treatment can include the use of lubrication; eostrogen replacement creams for the vagina; and physiotherpay to help downtrain tight pelvic floor muscles with stretching, massage and breathing / relaxation techniques; progressive vaginal dilation with vaginal dilators or trainers and sometimes working with a psychologist to resolve any issues that may be contributing.
Vaginismus occurs when the pelvic floor muscles contract involuntarily to prevent vaginal penetration, making sexual intercourse painful or impossible.
Vaginismus can be described as primary (that is, a woman has never been able to engage in any activity that involved vaginal penetration) or secondary (where the problem has developed, perhaps in response to painful or difficult earlier experiences or hormonalchanges following childbirth or menopause).
Although there have been few controlled trials for the treatment of vaginismus, a number of uncontrolled studies have shown that psychological and physical treatments can be helpful. Studies have achieved success rates of 90% and over when using desensitisation techniques such as vaginal dilators of increasing size. Amielle Comfort Vaginal Dilators have been the specific subject of two such studies. (Smith, Murina)
Vulvodynia is the specifc term for vulvar pain, and is used when other possible physical causes (such as yeast infections or sexually transmitted infections) have been ruled out. It can occur in women of any age, and the process of diagnosis often involves discounting other conditions until vulvodynia is the only possible diagnosis.
Treatments can include pain releiving drugs, changes in hygiene, self-care and diet, surgery, and physical therapies such as the use of vaginal dilators and pelvic flor muscle releases .
Remember that you should always consult your health practitioner before embarking on a course of self-help, in order to ensure that the cause of your pain has been fully investigated and appropriately diagnosed.
The material presented here is intended as an information source only. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and are advised to verify all relevant representations, statements and information. The information should not be considered complete and should not be used in place of the advice of a health care provider. Pelvic Floor Exercise does not accept liability to any person for the information or advice provided , or for loss or damages incurred as a result of reliance upon the material contained herein.
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