Q&A with Pelvica Physical Therapy regarding painful intercourse
In this two-part sponsored-post series, we cover a topic not normally discussed, even among friends: Painful Intercourse. Meri Meloyan, MPT, founder of Pelvica Physical Therapy in Santa Monica answers questions regarding this subject. Also, check out her previous sponsored post, Seven Reasons Why you should see a Women’s Health Physical Therapist during and after pregnancy.
In regards to painful intercourse issues, do patients generally wait long before seeking help?
There is a huge variance as to how long women wait before they get help. It ranges from a few weeks, to months, to years. Generally, I see patients at about one year postpartum who continue to complain of having painful intercourse.
When is a good amount of time to determine if the problem will go away on it’s own or not?
If the pain persists for greater than three to four months postpartum (given there are no known complications) from my clinical experience, I’d say that there is a good chance that the issue won’t go away on it’s own and they’ll likely need professional help.
Is painful intercourse something that oftentimes accompanies other issues? If so, what are they?
It depends on the underlying causes as well as any additional health issues such as endometriosis, PCOS, etc. However, at postpartum, painful intercourse can be associated with pelvic organ prolapse, low back and hip pain, as well as sacroiliac joint or pubic symphysis dysfunction.
What are some methods you suggest to patients to help with painful intercourse?
As a first line of defense after having a baby, women should use either a water-based or oil-based lubricant. Due to a drop in estrogen level at postpartum, the tissues have decreased blood flow and lubrication, which often times results in painful intercourse. Also, if there was tearing or episiotomy was performed, scar tissue can accumulate and lead to pain or burning sensation. Mobilizing those scars is a great way to improve tissue elasticity and improve blood flow in the perineal area. Additionally, having sex for the first time after delivery is often a very scary idea and the anticipation itself may be anxiety provoking. This can create tension in the pelvic floor muscles leading to muscle spasms. Practicing gentle yoga and meditation as well as bringing awareness to the pelvic floor and learning how to relax these muscles is a great way to address the tense and spasming pelvic floor muscles. And if a woman has been cleared by her Ob/Gyn to resume intercourse and has tried all of these methods, yet she continues to have painful intercourse – pelvic physical therapy is then indicated.
How important is it for your patient to share what she’s learned in therapy with her partner? Do you suggest ways to discuss?
I do encourage communication between partners. It is imperative for the couple to understand that experiencing various levels of discomfort and pain is very common. That expectation to resume pre-baby sexual activity at six weeks postpartum can be daunting and may put a strain on the relationship. It is important to understand that there is no medical significance to that deadline, and while a some lucky couples may be able to enjoy intercourse at that time, many more take longer to recover. Scientific studies have shown us that vaginal delivery is very similar to sustaining an athletic injury and the trauma to the pelvis and the pelvis floor muscles and ligaments is very real. Depending on many of factors (such as duration of labor, baby’s size, degree of medical assistance, etc.) the severity of trauma can vary, thus the duration of recovery and the return to pervious level of physical activity will differ accordingly. Without getting into couple’s therapy territory too much, I’ll say that it is not uncommon for the other partner to feel neglected (because all the attention is on the baby) and for the woman to feel guilty (because she’s not able to satisfy her partner). The key here is keep an open dialogue between partners to make sure that both people are feeling heard, supported, and understood. Those few weeks immediately post delivery are a crucial time for recovery as the body goes through rapid changes. I strongly urge women to take a few minutes daily to stop and listen to their body. Instead of pushing through the aches and pains, to try to understand what is it that they need in order to nourish their physical and emotional scars and promote healing.
About Meri Meloyan, MPT
Meri received her Master’s Degree in Physical Therapy from the California State University – Long Beach following her Bachelor’s Degree in Biochemistry and Molecular Biology from the University of California – Santa Barbara.
She completed her clinical internships at Methodist Hospital of Southern California as well as the renowned Rancho Los Amigos National Rehabilitation Center where she participated in the Leadership for Effective Intercultural Practice program.
Within the physical therapy profession,Meri has found her passion in women’s health and has pursued specialization through the Herman & Wallace Pelvic Rehabilitation Institute. She has completed a course in Yoga for pelvic pain as well as a Pilates instructor training. She periodically attends continuing education courses and seminars in order to stay up-to-date with clinical research and provide her patients with the most current treatment methods.
Meri establishes trusting relationships with her patients and is driven by the positive changes in their lives. She has dedicated her entire practice to helping women because she knows and understands the difficulties and limitations when it comes to feminine healthcare.Meri creates a comfortable and nonjudgmental environment where she welcomes women to openly communicate about intimate and sensitive issues. She is calm and caring and will ensure that you and your concerns are being heard. She is proud to be part of the movement to improve women’s well being.
Pelvica Physical Therapy
Pelvica Physical Therapy is located at:
528 Arizona Avenue, Suite 319
Santa Monica, California 90401
on Facebook: facebook.com/pelvicapt