What is intimacy / sexual pain?
Intimacy / sexual pain (dyspareunia) is pain that is experienced in the vulva, vagina or around the pelvis during intercourse, this pain may or may not be accompanied by the inability to tolerate any vaginal penetration including inserting a tampon. The fear and anticipation of pain can result in the tightening of your pelvic floor muscles which adds to the difficulty with penetration during sex.
Signs and symptoms?
- Do you experience pain in and around the vulva, vagina or pelvis during intercourse?
- Do you have trouble inserting a tampon
- Do you experience anxiety around sexual intimacy?
- Do you feel like there is a physical barrier that you cannot get past?
Contributing factors to Intimacy / Sexual pain (Dyspareunia)?
- Overactive pelvic floor muscles. This occurs when the pelvic floor muscles are constantly contracted, and they do not relax between each contraction
- When the pelvic floor muscles fail to relax, they can create muscle spasms and tension, and they can therefore become painful just like any other muscle in our body
- Hormonal changes including menopause or breastfeeding
- Vulval skin disorders
- Your emotions like anxiety, stress or a fear of pain
- Relationship problems
- Medications that reduce sexual desire
- Physical trauma like childbirth or surgery
How can we help?
Physiotherapy for intimacy / sexual pain (dyspareunia)?
Your physiotherapist may treat you as part of a healthcare team along with a sex therapist or psychologist. Treatment for Dyspareunia may include
- Pelvic Floor muscle relaxation techniques
- stretches to help relax the muscles around the pelvis, hips and pelvic floor
- Touch Desensitisation
- Dry needling to tight muscles
- Transcutaneous Electrical Nerve Stimulation (TENS) to help calm the overactive nerves in the area
- Vaginal dilators - progress in size
- Vaginal vibrators to reduce touch sensitivity
- Advise around vaginal moisturisers and lubricants right for you
Other Pelvic Pain conditions
Related Blogs
The Role of Pelvic Floor Physiotherapy After a Hysterectomy A hysterectomy is a significant surgical procedure, and while it can be necessary for a range of medical conditions, recovery requires careful consideration. The pelvic floor and core do not automatically restore their previous function following surgery. Regardless of whether the procedure was performed via an abdominal, vaginal, or laparoscopic approach, targeted rehabilitation is often essential. Pelvic floor physiotherapy provides evidence-based strategies to optimise healing, restore function, and support long-term pelvic health. Below is an outline of how a physiotherapist may assist across the different stages of recovery. Early Recovery (0–6 Weeks) Focus: Education, Protection, Gentle Awareness During the initial post-operative phase, the priority is to protect healing tissues and establish safe movement patterns. A physiotherapist may provide: Pelvic floor education — guidance on how surgery has altered pelvic support, biomechanics, and bladder/bowel function. Breathing and core coordination — gentle diaphragmatic breathing techniques to reduce tension, support circulation, and minimise swelling. Safe movement and postural strategies — instruction on bed mobility, transfers, and walking to avoid unnecessary strain. Scar and tissue healing advice — information to optimise scar recovery, reduce the risk of adhesions, and monitor for signs of complications. Mid Recovery (6–12 Weeks) Focus: Activation, Strengthening, Confidence Once surgical healing is established, rehabilitation progresses to restoring muscle activation and movement control. This may include: Pelvic floor muscle retraining — graded internal or external exercises focusing on coordination, endurance, and strength. Core muscle activation — re-education of deep abdominal muscles, particularly the transversus abdominis, in synchrony with the pelvic floor. Postural alignment and movement retraining — addressing compensatory patterns or protective guarding to optimise pelvic loading. Scar mobilisation — manual therapy to improve tissue mobility, circulation, and sensitivity. Later Recovery (3+ Months) Focus: Return to Function, Fitness, and Lifestyle The longer-term phase of rehabilitation supports a safe return to higher levels of activity and addresses ongoing pelvic health needs. This may involve: Exercise progression and return-to-sport planning — individualised advice for safely resuming walking, lifting, gym training, Pilates, or sport while minimising risk of prolapse or core dysfunction. Bladder and bowel retraining — management of urgency, leakage, or constipation, which may present post-surgery. Support for intimacy and pelvic pain — rehabilitation for dyspareunia, vaginal tightness, or scar-related discomfort. Prolapse prevention and long-term pelvic health — strategies to manage intra-abdominal pressure and maintain pelvic organ support. Why Consult a Pelvic Floor Physiotherapist? Pelvic floor physiotherapists are trained to assess not only the muscles, but the integration of breath, core, scars, posture, and daily movement patterns following surgery. This holistic assessment allows for a tailored rehabilitation plan to support both short- and long-term recovery. Importantly, it is never too late to commence pelvic floor physiotherapy. Whether a patient is six weeks or six years post-hysterectomy, physiotherapy can assist in improving function, comfort, and quality of life.
Understanding Clitorodynia: Yes, It’s Real—And Yes, There’s Help Let’s talk about something that doesn’t get talked about enough: Clitorodynia . Clitorodynia is a condition involving chronic clitoral pain , and for many, it can feel isolating, confusing, and incredibly frustrating. If you’ve experienced burning, aching, or stabbing sensations around the clitoris—especially during everyday activities like sitting, walking, or even showering—you’re not alone. And more importantly, you're not imagining it. What Does Clitorodynia Feel Like? Clitorodynia can show up in a variety of ways, including: Burning or stinging sensations Sharp, stabbing pain Itching, irritation, or rawness Throbbing or tenderness Pain during movement, sexual activity, or even at rest Sometimes numbness or tingling that spreads to the pelvis For some, symptoms may come and go. For others, they’re persistent. Even things like urination or using certain soaps can trigger discomfort. If you ever experience severe pain along with symptoms like a fever or rapid heart rate, it’s important to seek urgent medical attention. The Good News: You Don’t Have to Suffer in Silence At Pelvic Health Melbourne , we understand how deeply clitorodynia can impact daily life—and how often it's misunderstood or dismissed. That’s why our approach is rooted in empathy, education, and evidence-based care. Our team works with you to tailor a plan that supports healing and comfort. Some of the tools and techniques we use include: Mindfulness and breathwork to soothe the nervous system TENS therapy (gentle electrical stimulation) for pain relief Gentle stretching and pelvic floor downtraining Internal muscle release techniques , when appropriate Personalised advice on skincare, pain triggers, and referrals for further support, including medications or imaging if needed You’re Not Alone—and You’re Not Making It Up If you’ve ever been told “it’s all in your head” or felt dismissed by healthcare providers, we want you to know: we see you . Clitorodynia is real, and help is available. You deserve answers. You deserve relief. And at Pelvic Health Melbourne, we’re here to help you find both.
Understanding Menopause: How a Pelvic Health Physiotherapist Can Help You Thrive Through the Change At Pelvic Health Melbourne, we know that menopause isn't just a stage of life—it’s a deeply personal transition that can impact your body, confidence, and quality of life in ways you may not expect. As pelvic health physiotherapists, we’re here to support and empower you with respectful, evidence-based care tailored to your needs. What Is Menopause and Perimenopause? Menopause marks the end of your menstrual cycle, officially diagnosed when you haven’t had a period for 12 consecutive months. The years leading up to this, known as perimenopause, are when many of the most noticeable symptoms begin normally from 40 years old During this time, fluctuating hormone levels—particularly a drop in oestrogen—can lead to a range of physical and emotional changes. Some are widely known, others less talked about, but all are valid and worthy of care. Common Symptoms of Perimenopause and Menopause Increased blood loss during periods Weight gain and bloating - especially new weight deposits around the stomach Low libido or sexual discomfort - our vagina shrinks both in length and width Bladder urgency, frequency, or leakage Vaginal dryness or pelvic discomfort - use silicon based lubes as water based just absorb in too easily Pelvic organ prolapse or heaviness Hot flushes and night sweats Mood swings, anxiety, and low mood Fatigue and disrupted sleep - waking for a few hours in middle of night then exhausted in morning Brain fog and memory changes These symptoms can feel overwhelming, but you are not alone—and you don’t need to suffer through them in silence. How Pelvic Health Physiotherapy Can Support You At Pelvic Health Melbourne, our experienced physiotherapists work with you holistically to address the physical changes of menopause that affect your pelvic floor, bladder, bowel, and sexual health. Here’s how we can help: 1. Pelvic Floor Rehabilitation We assess and treat pelvic floor muscle weakness, overactivity, or incoordination. This helps reduce urinary urgency, incontinence, heaviness, and discomfort. 2. Bladder & Bowel Retraining Menopause can alter bladder sensitivity and bowel regularity. We provide personalised strategies to restore control and confidence. 3. Sexual Wellness Support Painful intimacy or decreased sensation are common but treatable. We use gentle, respectful approaches including pelvic floor therapy, education, and support for vaginal tissue health including discussions about topical oestrogen therapy, vaginal dilation (if required), vibrators to assist blood supply and appropriate lubrication for stage of life. 4. Movement & Strength Programs Specific exercise program for you respecting non restorative sleep, need for more stretch and cardio allowing for adequate body recovery. 5. Education & Empowerment We take the time to explain what’s happening in your body, and why, so you feel more in control. Our goal is to help you make informed decisions about your health and wellbeing. Why Choose Pelvic Health Melbourne? At Pelvic Health Melbourne, we do more than treat symptoms—we care for the whole person. We offer: Longer, unrushed appointments Private, purpose-designed rooms Highly skilled and specialised clinicians An inclusive space and point of mond Care that respects your lived experience We believe every woman deserves dignity, support, and solutions—not dismissal or shame. Take the Next Step If you’re navigating perimenopause or menopause and feeling unsure where to turn, we invite you to start with us. Whether you’ve just started noticing changes or have been putting up with symptoms for years, now is the right time to seek support. Book an appointment with one of our experienced pelvic health physiotherapists today. Let’s work together to help you feel strong, supported, and at home in your body again.
Pelvic pain can be a distressing and often misunderstood condition, affecting both men and women. One lesser-known cause of chronic pelvic pain is pudendal neuralgia, a condition that occurs when the pudendal nerve, which supplies sensation and function to the pelvic area, becomes compressed or irritated. This can lead to debilitating symptoms that impact daily life, from sitting comfortably to engaging in intimate activities. Despite its significant impact, pudendal neuralgia is frequently underdiagnosed. In this blog, we’ll explore what pudendal neuralgia is, its symptoms, potential causes, and how pelvic health physiotherapy can play a crucial role in managing and alleviating symptoms. What is Pudendal Neuralgia? Pudendal neuralgia is a chronic pain condition that results from irritation, compression, or damage to the pudendal nerve. This nerve runs from the lower back through the pelvic floor and is responsible for sensation and function in the genitals, perineum, and anus. When compressed or irritated, it can lead to persistent and often severe pain. Common Symptoms of Pudendal Neuralgia Symptoms of pudendal neuralgia can vary from person to person, but common signs include: Burning, stabbing, or aching pain in the pelvic region Pain that worsens when sitting and improves when standing or lying down Numbness, tingling, or a “foreign object” sensation in the rectum or genitals Pain during or after sexual activity Bladder or bowel dysfunction , such as urgency, frequency, or difficulty emptying These symptoms can be frustrating and debilitating, often leading to emotional distress, anxiety, and a decreased quality of life. What Causes Pudendal Neuralgia? There are several potential causes of pudendal neuralgia, including: Prolonged sitting (especially on hard surfaces or during cycling) Pelvic trauma or surgery that affects the nerve Muscle tension or tightness in the pelvic floor Childbirth injuries Nerve entrapment or compression from scar tissue or inflammation Medical conditions such as endometriosis or interstitial cystitis Since pudendal neuralgia can have multiple contributing factors, proper diagnosis by a healthcare professional is essential for effective treatment. How Can Pelvic Health Physiotherapy Help? Pelvic health physiotherapy is a non-invasive and effective approach to managing pudendal neuralgia. A trained pelvic health physiotherapist can assess your symptoms and develop a personalized treatment plan that may include: Manual Therapy & Myofascial Release – Helps release muscle tension and improve blood flow to the affected area. Pelvic Floor Relaxation Techniques – Since tight pelvic muscles can contribute to nerve irritation, learning how to properly relax these muscles is key. Postural & Movement Retraining – Poor posture or movement patterns can put extra strain on the pudendal nerve. Physiotherapy can help correct these imbalances. Nerve Mobilization & Desensitization Exercises – These gentle techniques help the nerve glide freely and reduce pain. Lifestyle Modifications & Ergonomic Adjustments – Small changes like using a cushioned seat, avoiding prolonged sitting, and modifying certain activities can significantly reduce symptoms. Seeking Help & Finding Relief If you’re struggling with persistent pelvic pain, you’re not alone. Many people suffer in silence due to a lack of awareness and understanding about conditions like pudendal neuralgia. Fortunately, pelvic health physiotherapy can provide significant relief by addressing the root cause of pain and improving function. Don’t let pelvic pain control your life. If you suspect you have pudendal neuralgia, consider consulting a pelvic health physiotherapist to explore treatment options tailored to your needs.
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