The painful intercourse (in women)
The painful intercourse, painful obstruction during the course of the sexual act, is a problem that involves quite a high percentage of patients.
This type of problem is traditionally tackled from both the gynecological and the psychological point of view.
However, in a high number of cases, a problem of osteopathic type is mainly the basis of this disorder.
In fact the pain to penetration is often simply due to a state of contraction of the wall of the vagina or, more frequently, of the pelvic floor.
As you can see from the picture the vagina and the urethra pass through a muscular ring formed by the annular portion of the levator ani muscle (red arrow). The rectum remains in a back situation.
This muscle, beyond the function of the same name, is an integral part of the pelvic floor, ie the floor muscle which closes down the small basin.
Vagina, rectum and urethra transit therefore in the whole of its fibers finally opening outwards.
A state of contracture by this muscle can go to strangle these organs creating problems of transit inside them.
Of course, the vagina during sexual intercourse is engaged in a very different way compared to the above mentioned organs concerning the performance of their functions.
Therefore, such an eventuality can undoubtedly cause painful intercourse without affecting excretory aspects.
In other cases, the dysfunction of sacrum and coccyx are responsible for changes in the dynamics of the pelvic floor and then for a problem of local contracture.
More rarely, the responsibility for this problem is due to a contraction of the wall of the vagina.
The assessment must be made from time to time but in any case problems of this type all have an osteopathic basis.
Concerning the mode of action, it depends on the type of problem that is encountered in the examination phase.
Incidentally, however, internal maneuvers are very rare because mostly related to vaginal dysfunctions of primary type, quite rare in fact.
I'll describe the case of a patient aged 55 that had a problem of painful intercourse associated with high degree of low back pain.
Osteopathic examination showed a significant restrictionof the right zygomatic arch with a sacral anterior rotation always on the right side,she also had a restriction on the right-hand quadrant of the pelvic floor and external rotation of the right tibia.
After correcting the dysfunctions both problems have disappeared because they were expressions of the same dysfunctional framework.
That is, the block of the sacrum and the contraction of the pelvic floor were responsible for both the back pain that pain at the time of intercourse.
In any case, it is correct to inform that a good percentage of these patients may suffer from somato-emotional problems as well as specific of the gynecological field.
However, with the exception of that event, an osteopathic consult is strongly recommended for painful intercourse problems.