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Sexual Dysfunction

What is sexual dysfunction?

It is often spoken of like this:

“It hurts to have sex. I’m dry down there and my partner doesn’t want to use lubrication. I don’t have sex anymore. I’ve never been able to orgasm. I hate having gynecologic exams, they’re so painful. I guess I’m just tight down there. Ever since I had prostate cancer treatment, I can’t get/maintain an erection”

 

How does pelvic floor dysfunction affect sex?

Pelvic floor muscles have a huge impact on sex. Muscles that are shortened or tight and are unable to elongate will not allow for good blood flow into the genitals. Scar tissue may be hypersensitive or tight. This can result in pain, weaker erections, diminished sensation, inability to orgasm, and even decreased lubrication. Menopause, surgery, and radiation therapy can cause tightness, dryness, and pain.

 

What can pelvic physical therapy do about it?

Treatment options include:

  • Manual therapy addresses soft tissue restrictions, scar tissue, and asymmetries

  • Biofeedback can help to retrain muscles that are chronically tight or overactive

  • Education: includes sexuality education, self care, and exercises designed specifically for you.

  • Referral to another professional. I’ll work with my network of providers—physicians, naturopaths, Chinese medicine practitioners, psychotherapists, and others—to help you find the resources which will help you improve your function.

  • Evaluation of the external and/or internal pelvic floor to assess muscle function, tone, sensory awareness, coordination and check for strength.

  • Specific pelvic floor treatment which will include strengthening if/when you are able to selectively isolate the pelvic floor muscles. The traditional Kegel exercise has a place, but there is much more to the pelvic floor—and about 50% of women do Kegels the wrong way! I will design a program based on your own function and functional needs.