Pelvic & Sexual Health

Many couples who seek treatment at RSC for infertility care might also be struggling with issues related to pelvic pain and sexual intimacy. These issues may have developed due to the stress of trying to start a family or they may always been a part of the patients’ health and relationships.

While the specialists of RSC can treat patients for a wide array of reproductive health problems, we might refer patients to marriage counselors, physical therapists, or sex therapists who specialize in the complex issues of pelvic pain and sexual intimacy. Their expert treatment can be very successful. Even if the couple becomes pregnant, some of these situations will not likely improve without treatment.


Pelvic health overview

The muscles of the pelvic floor are the gatekeeper of the pelvis and they must relax, contract, and maintain a healthy level of tone in order to perform their jobs properly, which include:

  • Childbirth
  • Low back and pelvis stability
  • Urinary and fecal continence
  • Orgasm ability and sexuality
  • Organ support

Causes of Pelvic Pain

A number of body systems may be involved in pelvic pain, such as the reproductive, urinary, gastrointestinal, neurological, psychological, and musculoskeletal systems. Situations that that can trigger pelvic pain include:

  • Childbirth, vaginal or cesarean section
  • Surgery, abdominal, pelvic, or spinal Trauma, such as a car accident or sexual abuse
  • Injury, such as a fall on the sacrum or tailbone
  • Habitual or repeated postures, positions, or movements

These situations often affect the muscles, connective tissues, organs, nerves, blood supply, and joints of the pelvis. Muscles, ligaments, tendons, and connective tissues can get overstretched, partially torn or cut during trauma, childbirth, injury or surgery. Muscles can become weak or tight, joints may be hypomobile (unable to move as much as it should) or hypermobile (allowing too much motion).

Habitual postures, positions, or movements can slowly stretch or tighten structures around the pelvis that lead to dysfunction and pain. Organs have particular movements and rhythms and may be scarred or overused affecting their function. If the abdominal, low back, pelvic floor, and hip muscles weaken or tighten, the pelvis will respond accordingly and develop many kinds of dysfunction and pain.


Sexual health overview

A woman’s sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships, her self-esteem, and potentially her fertility.


Sexual dysfunctions in women

Women can experience a variety of sexual problems, such as lack of desire (the most common sexual problem for women), difficulty becoming aroused, difficulty having an orgasm, or pain during sex. When a physical or emotional problem associated with sex persists, it’s important to seek treatment with a professional.

Causes of Sexual Dysfunction

There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences.

Causes of Painful Sex

Dyspareunia

Dyspareunia, or pain during or after intercourse, occurs in nearly two out of three women at some time during their lives. Like other sexual disorders, it can have physical and/or emotional causes. The most common cause of pain during sex is inadequate vaginal lubrication occurring from a lack of arousal, medications or hormonal changes. Painful sex also can be a sign of illness, infection, cysts or tumors requiring medical treatment or surgery.

Vaginismus

The involuntary spasm of the muscles at the opening of the vagina, making anything entering the vagina painful. Vaginismus can have medical causes, including:

  • vaginal scars from an injury, childbirth, or surgery
  • irritations from douches, spermicides or latex in condoms
  • pelvic infections

Vaginismus also can have psychological causes. It can be a response to a fear, such as fear of losing control or fear of pregnancy. It can also stem from pain or trauma such as rape or sexual abuse.

Vulvodynia

Defined as any pain in the vulva. It could be outside the vulva on the labia or an itching, burning or sharp pain within.


Sex therapy

Women who discuss their sexual needs and concerns with their partners have a better chance at a more satisfying sex life. If a sexual problem persists, however, most sexual problems can be successfully treated by professionals. A sex therapist may be a psychiatrist, a marriage and family therapist, a psychologist, or a clinical social worker who is specially trained in sex therapy methods over and above the basic training required for each of their licenses.

Sex therapists have much greater than average knowledge about the physiological processes that are a part of human sexuality and work collaboratively with physicians to address the entirety of the causes of a patient’s sexual concerns. Sex therapists discuss sexual issues by specifically addressing them through conversation. It is not assumed that when individuals in a relationship resolve their relationship conflicts, their sex will just fall into place.


Further resources

The Center for Women’s Continence and Pelvic Health at the John Muir Women’s Health Center

Learn more about sexual health from the American Society of Reproductive Medicine’s video below:

The Reproductive Science Center of the Bay Area is a leading pioneer in infertility treatments including IVF with egg donation and LGBTQ family building. We’ll work with you to help you achieve your dreams of having a baby.

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