Common Sexual Dysfunctions and Treatments for Female, Male, Transgender and Gender Expansive Patients
Vaginismus:
Vaginismus definition: the involuntary muscle spasms involving the superficial pelvic floor muscles that typically cause painful entry, limiting or preventing intercourse, tampon insertion or pelvic exams. Many women will also describe “a wall” that limits penetration, that may or may not be painful. This is not a lifelong condition and can be cured. The most successful vaginismus treatment is a combination of manual treatment, corrective exercises and home instruction. Most women will use vaginal dilators as a part of their home program to treat vaginismus. More information on our female-based services including vaginismus can be found on our women’s program website at Femina Physical Therapy.
Vulvodynia:
One of the more common sexual dysfunctions in women is Vulvodynia, which is defined as “vulvar pain” or pain of the external female genital region. Symptoms include burning, stinging, and irritation of the tissues in this region. Light touch or pressure can cause severe pain with sitting, walking, riding a bicycle, and sexual intercourse. There are many subtypes of vulvodynia, including vestibulodynia, vulvar vestibulities and clitorodynia. More information on Vulvodynia can be found on our women’s services site here.
Vulvar Vestibulitis/Vestibulodynia:
Vulvar Vestibulitis/Vestibulodynia is a subtype of vulvodynia with tenderness specific to the vulvar vestibule. This occurs with pressure to the site that causes pain at the vulvar vestibule with touch or attempted penetration. Tissues may be red or swollen at times. Vulvar vestibulitis is used when there is inflammation present at the vestibule. Vestibulodynia strictly refers to pain at the vestibule. Vestibuloydynia may be further subclassified as Provoked or Unprovoked…
Endometriosis:
When endometrial-like tissue grows outside of the uterus, an inflammatory cycle is set up, scar tissue before begins to form and both of these things can affect bowel, bladder and sexual function. This chronic cycle of inflammation can also lead to muscle guarding, pelvic pain, postural changes, decreased activity and in severe cases, social withdrawal. 1 in 10 women have endometriosis, and 70% of girls with painful menstrual cramps also have endometriosis… Read more at Femina Physical Therapy.
Interstitial Cystitis / Painful Bladder Syndrome
Painful Bladder Syndrome (formerly known as Interstitial Cystitis) is pelvic pain, pressure, or discomfort related to the bladder, typically associated with persistent urge to void or urinary frequency, in the absence of infection or other pathology…
Prostatitis:
Prostatitis is one of the more common sexual dysfunctions in males, and includes acute or chronic bacterial or non-bacterial inflammation in the epididymis of the male genitalia…
Pudendal Neuralgia:
Pudendal neuralgia is severe, sharp pain along the course of the pudendal nerve. There are five essential criteria for diagnosis of pudendal neuralgia:
- Pain in the anatomical territory of the pudendal nerve
- Worsened by sitting
- The patient is not woken at night by the pain
- No objective sensory loss on clinical examination
- Positive anesthetic pudendal nerve block
Testicle Pain, Ejaculation Pain:
Once medical or organic reasons for these pains have been ruled out, a thorough musculoskeletal and neuromuscular assessment should be performed by a physical therapist, as pelvic floor muscle overactivity is usually to blame.
Summary:
Pelvic floor muscles are very important in the physiology of an individual’s sexual response. Physical therapists play an important role in the multidisciplinary team when dealing with sexual dysfunctions. Arousal and orgasmic disorders, erectile dysfunctions, ejaculatory dysfunctions and sexual pain are areas that pelvic floor physical therapy specialists can assist patients in restoring sexual health and pleasure.
