By Dr Elna Rudolph, sexual health practitioner; image from Freepik.com

Also, the treatments themselves aren’t painful either…

Do you find sex painful?

One in five women experiences discomfort during sex on a regular basis – and for some, the pain is so severe that they can’t have sex at all. Many remain in sexless relationships, but it can be even worse for those who do manage to push through the pain. The consequences of grinding and bearing it are disappointment, low self-esteem, damaged relationships, broken hearts, unnecessary surgeries, depression and even attempted suicide.

READ MORE: 2 Gynae-Approved Ways To Tell If Your Vagina Is Too Weak Or Too Tight

For years gynaecologists and psychologists have been trying to help, but two forms of treatment have become available: pelvic floor physio and – wait for it – Botox.

1. Botox

Botox is injected into the vaginal muscles that are in spasm (which is what causes the pain), paralysing them. The best part: you may only need one shot because, while the Botox is actively affecting the muscles, over-stimulation of the nerves stops and the couple can have normal sex immediately. Then, by the time the Botox has worn off (usually after two or three months), the muscles often don’t go back into spasm.

2. Pelvic floor physio

Specialised pelvic-floor physios (there are only a few in South Africa) also treat the muscle spasms around the vagina, making the area less sensitive and pain-free penetration possible. A consultation usually starts with an extensive interview about symptoms, pain scores, medical history and lifestyle, followed by an evaluation of posture and assessment of the back, abdominal, buttock and thigh muscles.

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After all this, the pelvic floor is evaluated. This feels like a gynaecologist’s examination, but while the gynae focuses mainly on the cervix and ovaries, physiotherapists focus on the muscles around the lower third of the vagina. The physio looks for muscle spasm, trigger points and what are known as myofascial bands, then treats the area either manually or by using special instruments.

Women who experience pain during sex should consult a sexual pain specialist if the problem can’t be solved by their own gynae. According to the specific diagnosis, well-researched treatment options are used first and only if this fails should Botox be considered. Medical aids usually cover pelvic floor physios, but not Botox.

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