Pain with Sex Archives - Dr Andrew Orr

Sex is something that nearly every human on this planet gets to experience, and for each person, the experience of sex can be different. Many people have different perceptions on this important topic, so lets talk about sex, how often, what’s normal and how to boost that libido in those having issues.

As a healthcare practitioner who is a Master in Women’s Health Medicine and a Master of Reproductive medicine, I have to talk about the topic of sex on a daily basis. A lot of people come into my clinic (both men and women) with varying expectations and thoughts on what is normal, when concerning sex. Unfortunately a lot of people are way off the mark when it comes to a healthy sex life and what a healthy libido should be.

Libido is influenced by our health

If you do not have a healthy libido, there could be something wrong with your health. Yes, what you eat, think, do etc, all plays a part in your sexual appetite. But, we can all have differing libido’s and it is important to understand this and seek help if you are having issues. A healthy libido is a sign of a health body and healthy mind.

What defines a healthy sex life

The average healthy human being in a healthy relationship should be having sex at least 1-3 times per week, depending on age etc. I know a lot of you are lucky to be having sex 3 times per month.

What’s concerning about this is, some of these people are trying to have a baby and can’t understand why they aren’t falling pregnant. The answer is obvious, but, I’ll say it anyway, you have to have sex regularly to fall pregnant and it has to be at the right time. You need to be trying every day, or every second day of your cycle as we now know ovulation just doesn’t take place mid-cycle only.

Clinical research shows that more than 70% of people are ovulating before day 10 and after day 17 of their cycle. So if you are just trying it that small window of day 10-16, this could be the reason you aren’t falling. Btw, don’t stop having sex just because you are doing IVF. Sex (climax in particular) helps with implantation so stopping having sex is only hindering your chances of conception. I have talked about this is a previous post (click here to read)

We also now know that sperm also play a part in a health menstrual cycle as they help to trigger certain hormones to trigger ovulation and thus help with regulation of the menstrual cycle. It may explain why women using barrier methods of contraception have more issues with irregular cycles and menstrual issues. Not that we are promoting unsafe sex mind you. This is for couples in a healthy relationship. I have spoken about this is a previous post too (click here to read)

Why is climax/orgasm so important

Climax also stimulates blood flow into the uterus; helps trigger certain hormones and also helps with implantation. Climax also helps ones libido and it can even help in the treatment of depression.

We also hear the jokes about men and their ever-constant desire to have sex, but most of the time this is greatly exaggerated. In practice I am actually seeing that women are now the ones with the higher libidos and it is the men that are having all the problems. Stress is a big factor these days. We are also seeing many men with testosterone deficiency. Being overweight and unhealthy physically and mentally can be a factor also.

It has also been shown that regular sex, even if scheduled, actually helps with the libido and helps with the desire around wanting more sex.

Understanding differing libido’s

Men and women are different when it comes to libido and the desire around sex. Men need to understand that it can often take all day for a woman to arouse her desire around wanting sex. Men need to know that women need to be wooed, given playful thoughts, mind play and a place to feel safe to get her into the mood for sex. Guys, apparently helping out around the house also helps (hint, hint)

Intimacy is more than just sex

Remember sex is a healthy part of a relationship and a healthy libido shows good health. Sex is also a way of connecting with your partner and couples should find way to prioritise each other so that this connection happens regularly. It is also about intimacy and that sacred intimacy, which is on a whole other level to the physical act of just having sexual intercourse.

What affects a libido?

Many people do talk about having differing libido’s, or having trouble with libido, and it is important to understand what may be affecting ones sex drive.

So, what are some of the main things that effect libido?

The Pill – First and foremost, the pill for women. Anything that decreases fertility can decrease your sexual desire. The pill also turns off certain receptors responsible for conception, which can then turn off the libido.
Stress – Constant low grade, or high grade stress, is a big problem when it comes to loss of libido. It can cause impotence & erectile dysfunction in men and loss of libido and menopausal symptoms in women.
Medications – Drugs such as anti-depressants, the pill, anti-inflammatories, and lots of other medications can ruin your sex life. They can also delay or stop orgasm. There are some that can improve it too. Not many!
Alcohol and recreational drugs– This one is pretty self explanatory. We’ve all heard the saying ‘Fosters flop’ from drinking too much beer. Drugs such as marijuana, speed, and other illicit drugs can all impair libido
Sexual Abuse– A history of sexual abuse can definitely affect the sex life. This needs to be dealt with by speaking to a counsellor, psychologist or sex therapist.
Health Problems– Health problems such as Low Thyroid, Diabetes, being overweight, depression, eating disorders, can interfere with your libido and sex life.
STD’s– Some STD’s are often undetected and cause pain and discomfort during sex, which leads to not wanting to have sex. Many of these can be cleared up with medication so that your sex life can return to normal. Some STD’s are there for life but can be controlled. STD’s such as herpes and HIV don’t have to stop your sex life.
Gynaecological issues – Some gynaecological disease states such as Endometriosis and Adenomyosis can make sex painful and cause a lack of desire. Have a read of my article about painful sex. Women with PCOS can have low libido as a result of hormonal fluctuations and insulin resistance.
Diet– This is a big one. If you eat the wrong foods the body will respond accordingly. Your sex life can be ruined by what you put in your mouth to sustain your body.
Exercise– Over-exercising can stop you getting a period and cause fertility issues in both men and women. Reduce the exercise and the libido will respond accordingly. Exercise can also increase libido. It is about moderation.

Final Word

If you are having trouble with your libido there are many medical and natural products that have been shown to assist with low libido and help with a healthy sex life for both men and women. It is important that you talk to a qualified healthcare practitioner about issues to do with sex and libido. You need to see an expert who is trained to know issues that may be causing your particular issues. The can also give you dietary and lifestyle advice to help in this area too.

If you do need help with issues around sex and libido, please give my friendly staff and call and find out how I can assist you. I also have a great network of sex therapists, psychologists and medical specialists I work in with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Women’s Health Experts

Pelvic floor hypertonus is a condition that not many people hear about, or even know about. Often when we talk about pelvic floor dysfunction many people will automatically think of weak pelvic floor muscles often created from having children, or part of the aging process. This is where the pelvic floor muscles are too relaxing and need tightening and strengthening.

However more and more we are now seeing women, especially young women, with pelvic floor muscles that are too tight and non-relaxed and this is leading to chronic pelvic pain and other pelvic health and sexual health issues. This is called Pelvic Floor Hypertonus. For this article I will be talking about how Pelvic Floor Hypertonus affects women, even though men can have this as well.

What is Pelvic Floor Hypertonus?

Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles.

Pelvic floor hypertonus is not widely recognized and can often go on undiagnosed. It is certainly on the missed and dismissed list. Unlike in pelvic floor disorders caused by muscles too relaxed and are easily identified (such as pelvic organ prolapse or urinary incontinence etc), women affected by pelvic floor hypertonus may present with a broad range of nonspecific symptoms mentioned previously and below. All these related symptoms require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. Many of these symptoms can really affect the quality of woman’s life.

The signs and symptoms of pelvic floor hypertonus

The main and typical symptom of pelvic floor hypertonus is pelvic pain, or pelvic muscular pain. There can be a wide range of other symptoms including the following:

Urinary issues such as urge frequency, frequent urination or painful urination
Incontinence
Slow flow, hesitancy, or delayed start of urination
Constipation and straining when emptying the bowels.
incomplete emptying of the bowels
pressure feeling in the pelvis and rectum
pain in the pelvis, genitals or rectum
chronic pelvic pain
muscles spasms in the pelvis, or pelvic floor
low back pain
hip pain
coccyx pain
painful sex
vaginismus

If left untreated pelvic floor hypertonus can lead to long term health issues, colon and bladder damage and can also cause infection.

What causes pelvic floor hypertonus?

There is no one defining cause of pelvic floor hypertonus. Many things can cause non-relaxing pelvic floor muscles ranging from sitting too much, exercising too much, obesity, stress and also chronic inflammatory disease states. Here are some of the causes of pelvic floor hypertonus:

Endometriosis
Adenomyosis
Interstitial cystitis
Irritable Bowel Syndrome
Pudendal Neuralgia
Vulvodynia
History of holding onto the bowels, or bladder too long
Over exercising and over exercising the core muscles
Being sedentary, or over-sitting too long
High levels of stress, fear and anxiety
Obesity or being overweight
Child Birth, or Birth Trauma
Injury to the pelvic floor
Sexual and emotional abuse
Surgery
Nerve Damage

It is very important to identify the cause of pelvic floor hypertonus individually and why it is so important to see a healthcare expert, or pelvic floor specialist that specialises in this area. As with many other inflammatory conditions, a multimodality treatments approach is needed and may involved several modalities, or practitioners working together to help the individual. A pelvic floor physiotherapist may also be needed to help with exercises to relax the pelvic floor along with other modalities such as acupuncture to help with pain, relaxation and stress relief.

What are some of the things that can benefit pelvic floor hypertonus?

As mentioned before, it is important to see a healthcare expert who can identify what the cause of the pelvic floor hypertonus is and recommend a management and treatment plan moving forward. This will usually require a multimodality treatment approach, which could involve the following:

Pelvic floor muscle relaxation techniques
Mindfulness and meditation techniques
Breathing techniques
Pilates and yoga to help with stretching
Advice on better bladder and bowel habits
Pelvic floor and core muscle releasing abdominal massage
Specific stretches for the pelvis, hips and sacrum
The use of vaginal dilators, and/or vaginal eggs to help with relaxing and stretching the pelvic floor muscles
Acupuncture to help with pain, stress and relaxation, alongside medical interventions.
Massage to help with internal scar tissue (done by a pelvic floor physiotherapist)
Warm baths and self care
Use of TENS and electro-neuro stimulators to help with pain
Biofeedback therapy
Pain medications and muscles relaxants
Complementary medicines (prescribed by a qualified healthcare professional)
Surgery

Outlook and importance of seeing an expert

The main goal of treating and managing pelvic floor hypertonus is to relax the muscles of the pelvic floor to relieve pain and other associated symptoms.

Although living with pelvic floor hypertonus embarrassing or sometimes painful, non relaxing pelvic floor dysfunction is a highly treatable condition. It is important that you talk to a healthcare expert in this area, or a pelvic floor specialist. It’s important not to self-diagnose your symptoms, or try to Dr Google your symptoms, because left untreated pelvic floor hypertonus can lead to long term pain and health issues and also irreparable damage.

There are many conservative management approaches that can be used before resorting to hard-core pain medications, muscle relaxants and surgery. Your healthcare expert will be able to discuss all these options and ongoing healthcare management and treatments with you. The main thing is booking a consultation with a proper healthcare expert to get a proper diagnosis.

If you need help and assistance with pelvic floor hypertonus, or pelvic pain, please give my friendly staff a call and find out how I can assist you.