Sexual dysfunction refers to ongoing challenges with sexual response, desire, orgasm, or pain. Integral to sexual function are the pelvic floor muscles, which play crucial roles in both men and women. In men, these muscles help maintain erection rigidity, while in both sexes, they contract rapidly during orgasm, typically without discomfort, enhancing sexual pleasure.
However, when pelvic floor dysfunction occurs, it can replace pleasure with pain and disrupt normal sexual function. These symptoms understandably cause distress, but there is hope: pelvic floor physical therapy offers effective treatment.
The Facts
- Approximately one in three premenopausal women will encounter painful intercourse during their lifetime.
- Between 15% and 72% of men under 40 years old report symptoms of erectile dysfunction.
- Around 52% of men aged 40 to 70 years old experience mild to moderate erectile dysfunction.
- Up to 80% of men may experience erectile dysfunction following prostate surgery.
- About 60% of menopausal women do not disclose painful intercourse to their doctors due to embarrassment.
- Certain medications, such as oral contraceptives and acne treatments, can lead to vulvar pain and reduced natural lubrication.
- Even 18 months after giving birth, about 65% of postpartum women continue to experience painful intercourse.
Sexual dysfunction refers to ongoing challenges with sexual response, desire, orgasm, or pain. Integral to sexual function are the pelvic floor muscles, which play crucial roles in both men and women. In men, these muscles help maintain erection rigidity, while in both sexes, they contract rapidly during orgasm, typically without discomfort, enhancing sexual pleasure.
However, when pelvic floor dysfunction occurs, it can replace pleasure with pain and disrupt normal sexual function. These symptoms understandably cause distress, but there is hope: pelvic floor physical therapy offers effective treatment.
The Facts
- Approximately one in three premenopausal women will encounter painful intercourse during their lifetime.
- Between 15% and 72% of men under 40 years old report symptoms of erectile dysfunction.
- Around 52% of men aged 40 to 70 years old experience mild to moderate erectile dysfunction.
- Up to 80% of men may experience erectile dysfunction following prostate surgery.
- About 60% of menopausal women do not disclose painful intercourse to their doctors due to embarrassment.
- Certain medications, such as oral contraceptives and acne treatments, can lead to vulvar pain and reduced natural lubrication.
- Even 18 months after giving birth, about 65% of postpartum women continue to experience painful intercourse.
Symptoms
*Sexual dysfunction in people with a penis
- Erectile dysfunction: includes difficulties with erection quality, achieving or maintaining erection, and premature ejaculation.
- Reduced force or difficulty ejaculating.
- Climacturia: involuntary urine leakage during orgasm.
- Post-ejaculatory pain: discomfort in the tip or shaft of the penis, perineum, or scrotum.
- Discoloration in the penis, scrotum, or perineum.
*Sexual Dysfunction in people with vulvas/vaginas
- Difficulty or reduced ability to lubricate.
- Pain during vaginal penetration, particularly with deep penetration, or continuous pain during penetration.
- Clitoral pain or hypersensitivity to touch.
- Pain or burning sensations after sexual activity.
- Difficulty achieving orgasm or reduced intensity of orgasms.
- Urinary incontinence during sexual activity.
- Climacturia, which involves involuntary urine leakage during orgasm.
Postpartum Sexual Dysfunction
- Reduced lubrication during breastfeeding.
- Perineal pain upon touch due to episiotomy or perineal trauma.
- Decreased or absent orgasm.
- Incontinence during orgasm or intercourse.
- Pain during sexual intercourse.
Menopausal Sexual Dysfunction and Post-gynecologic cancer treatment
- Reduced vaginal lubrication.
- Difficulty achieving or problems with vaginal penetration.
- Painful intercourse during and/or after.
- Decreased or absent orgasm.
Symptoms
*Sexual dysfunction in people with a penis
- Erectile dysfunction: includes difficulties with erection quality, achieving or maintaining erection, and premature ejaculation.
- Reduced force or difficulty ejaculating.
- Climacturia: involuntary urine leakage during orgasm.
- Post-ejaculatory pain: discomfort in the tip or shaft of the penis, perineum, or scrotum.
- Discoloration in the penis, scrotum, or perineum.
*Sexual Dysfunction in people with vulvas/vaginas
- Difficulty or reduced ability to lubricate.
- Pain during vaginal penetration, particularly with deep penetration, or continuous pain during penetration.
- Clitoral pain or hypersensitivity to touch.
- Pain or burning sensations after sexual activity.
- Difficulty achieving orgasm or reduced intensity of orgasms.
- Urinary incontinence during sexual activity.
- Climacturia, which involves involuntary urine leakage during orgasm.
Postpartum Sexual Dysfunction
- Reduced lubrication during breastfeeding.
- Perineal pain upon touch due to episiotomy or perineal trauma.
- Decreased or absent orgasm.
- Incontinence during orgasm or intercourse.
- Pain during sexual intercourse.
Menopausal Sexual Dysfunction and Post-gynecologic cancer treatment
- Reduced vaginal lubrication.
- Difficulty achieving or problems with vaginal penetration.
- Painful intercourse during and/or after.
- Decreased or absent orgasm.
Associated Diagnoses
Conditions like Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, Lichen Sclerosus, Lichen Planus, Pelvic Floor Dysfunction, post-prostatectomy complications, and Genitourinary Syndrome of Menopause are all linked to pelvic pain and sexual dysfunction.
Associated Diagnoses
Conditions like Endometriosis, Vulvodynia, Interstitial Cystitis/Painful Bladder Syndrome, Pudendal Neuralgia, Chronic Pelvic Pain Syndrome/Male Pelvic Pain, Lichen Sclerosus, Lichen Planus, Pelvic Floor Dysfunction, post-prostatectomy complications, and Genitourinary Syndrome of Menopause are all linked to pelvic pain and sexual dysfunction.
Causes of Sexual Dysfunction
- Pelvic pain syndromes associated with pelvic floor dysfunction (above)
- Childbirth
- Medications
- Obesity
- Cardiovascular disease
- Menopause
- Jelqing
- Genital mutilation, genital cutting
- Surgically-induced
- Pelvic Floor Reconstruction
- Prostatectomy
- Gender affirming surgery
- Episiotomy
- Vestibulectomy
- Pudendal Nerve Decompression
- Mesh excision
Causes of Sexual Dysfunction
- Pelvic pain syndromes associated with pelvic floor dysfunction (above)
- Childbirth
- Medications
- Obesity
- Cardiovascular disease
- Menopause
- Jelqing
- Genital mutilation, genital cutting
- Surgically-induced
- Pelvic Floor Reconstruction
- Prostatectomy
- Gender affirming surgery
- Episiotomy
- Vestibulectomy
- Pudendal Nerve Decompression
- Mesh excision
Diagnostic Challenges
Recent research indicates that a significant number of healthcare providers feel uncomfortable discussing sexual health with their patients, and similarly, many patients are hesitant to broach the topic with their doctors. Studies also highlight discrimination faced by the LGBTQ community, adversely affecting their sexual health. As a medical community, it is imperative that we strive for improvement.
At PHRC, our mission is to ensure that every patient feels safe and supported in all aspects of pelvic health. It’s crucial to recognize that sexual health is now a specialized field within medicine, with comprehensive support available. Sexual pleasure involves both physical and psychological factors, and effective care often requires a multidisciplinary approach, combining medical management, behavioral health services from psychologists, and pelvic floor physical therapy.
Diagnostic Challenges
Recent research indicates that a significant number of healthcare providers feel uncomfortable discussing sexual health with their patients, and similarly, many patients are hesitant to broach the topic with their doctors. Studies also highlight discrimination faced by the LGBTQ community, adversely affecting their sexual health. As a medical community, it is imperative that we strive for improvement.
At PHRC, our mission is to ensure that every patient feels safe and supported in all aspects of pelvic health. It’s crucial to recognize that sexual health is now a specialized field within medicine, with comprehensive support available. Sexual pleasure involves both physical and psychological factors, and effective care often requires a multidisciplinary approach, combining medical management, behavioral health services from psychologists, and pelvic floor physical therapy.
Treatment:
How We Can Help You
If you’re experiencing sexual dysfunction, seeking a tele-evaluation from a pelvic floor physical therapist can provide valuable insights into how your pelvic floor may be contributing to your symptoms. During the virtual evaluation, the therapist discusses your medical history, current symptoms, past diagnoses, and the effectiveness of previous treatments. Understanding the frustrations that often accompany these issues, we aim to provide compassionate care tailored to your needs.
During the examination, the physical therapist assesses muscles, tissues, joints, nerves, and movement patterns to understand your condition comprehensively. After completing the examination, your therapist discusses their findings with you and develops an assessment that outlines the factors contributing to your symptoms. Together, you establish short and long-term treatment goals.
Typically, virtual therapy sessions occur one to two times per week over approximately 12 weeks. You receive a personalized home exercise program to supplement your sessions. Your physical therapist also collaborates with other members of your treatment team to ensure comprehensive care and support throughout your recovery journey. Our goal is to support you in achieving recovery through telehealth and living your best life.
Treatment:
How We Can Help You
If you’re experiencing sexual dysfunction, seeking a tele-evaluation from a pelvic floor physical therapist can provide valuable insights into how your pelvic floor may be contributing to your symptoms. During the virtual evaluation, the therapist discusses your medical history, current symptoms, past diagnoses, and the effectiveness of previous treatments. Understanding the frustrations that often accompany these issues, we aim to provide compassionate care tailored to your needs.
During the examination, the physical therapist assesses muscles, tissues, joints, nerves, and movement patterns to understand your condition comprehensively. After completing the examination, your therapist discusses their findings with you and develops an assessment that outlines the factors contributing to your symptoms. Together, you establish short and long-term treatment goals.
Typically, virtual therapy sessions occur one to two times per week over approximately 12 weeks. You receive a personalized home exercise program to supplement your sessions. Your physical therapist also collaborates with other members of your treatment team to ensure comprehensive care and support throughout your recovery journey. Our goal is to support you in achieving recovery through telehealth and living your best life.
How Can We Help You?
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