Need some understandable definitions for the array of sexual pain medical terms you are coming across? Let us help!
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- Chronic Pelvic Pain Disorders: Used to describe persistent pain felt in the pelvic region (all structures between mid-abdomen and mid-thigh such as muscles, nerves, and organs). Someone suffering from persistent pain in the pelvis may not be able to distinguish where exactly the pain is coming from within that area. The reason for this persistent pain likely has multiple causes, or triggers. Cumulative research has shown that this persistent pain in the pelvic region is triggered by the bladder and/or bowl function at least 80% of the time and by gynecological disorders alone only 20% of the time.
- Dyspareunia: The medical term for recurring painful intercourse. Varying underlying causes may be associated with painful sex so the term as a diagnosis is not very helpful.
- Endometriosis: When endometrial cells, normally found only in the uterus, become imbedded in locations outside the uterus. These locations are usually within the pelvic cavity on reproductive organs, supportive ligaments, or structural systems like the bladder or bowel. This misplaced tissue forms growths that look like dark spots. These growths respond to the menstrual cycle and break down and bleed each month, the same way the lining of the uterus does. This causes cyclical pain and inflammation. Additionally, the body’s immune response to this internal bleeding and breakdown of blood and tissues begins to cause scar tissue and adhesions (affected pelvic organs or structures adhering to one another) which can also cause ongoing pain. Endometriosis affects millions of women but is often over diagnosed as the primary cause of pelvic and sexual pain.
- Incontinence: Usually referring to either the bladder or the bowels. In either case meaning loss of control. So either loss of bladder control (urinary incontinence) or loss of bowel control (bowel incontinence). Loss of control doesn’t have to mean total loss of control, but somewhere on the spectrum of total loss of control and impaired ability to control. Incontinence is a symptom, not a disease in and of itself. Underlying issues could include weakening of the pelvic muscles that support these systems. Oddly enough, this weakness can result not just from pelvic floor muscles that are too loose but also from pelvic floor muscles that are too tight and tense. Evaluation by a women’s health physical therapist is a good place to start.
- Interstitial Cystitis: Also known as Painful Bladder Syndrome or IC. It is a very common disorder of the bladder, it is estimated that about one out of every six reproductive aged women have some degree of IC. This condition is caused by a loss of the “protective lining” of the inside of the bladder, allowing for an inflammatory reaction of the bladder wall. Since urine is ordinarily very acidic and with the protective lining already diminished, the acidic nature of the urine also causes an inflammatory response which in turn triggers off symptoms of urinary frequency, urgency, and pain, pressure or discomfort anywhere in the pelvic region.
- Irritable Bowel Syndrome: Also known as IBS, it is the most common disorder or the lower gastro-intestinal system. This disorder leads to abdominal pain, bloating, cramping, gas, bowel pattern changes, and trouble with constipation and/or diarrhea. Reasons why IBS develops are not clear. But it may result from or cause tightening, weakening, or in-coordination of the pelvic floor and abdominal wall muscles. The goal of treatment is to relieve symptoms. Stress reduction, dietary changes, fiber/water balance, and medication may be used in combination depending on the person as the conditions differ from one person to another. Digestive health and regularity can influence sexual pain because the back side of the vaginal wall and the front of the lower bowel wall are adjacent to one another and the external openings of each are in such close proximity.
- Hypertonicity: Or Pelvic Floor Hypertonic Dysfunction. A common syndrome of clenching and spasm of the pelvic floor and pelvic side wall muscles that result from, and ironically contributes significantly to, Chronic Pelvic Pain. *
- Hypotonicity: Or Pelvic Floor Hypotonic Dysfunction. In this case, the pelvic floor muscles are too loose. It can be associated with both loss of bladder control (urinary incontinence) and loss of bowel control (fecal incontinence) as well as prolapse or “dropping of the pelvic organs”.
- Myofascial Release: Specialized therapeutic massage working on trigger points, designed to release spasmed muscles and fascia (connective tissue fibers). *
- Overactive Bladder: Symptoms include urinary urgency (feeling unable to postpone urination) and frequency (the need to urinate often). Overactive Bladder is commonly not associated with pain.
- Painful Bladder Syndrome: See Interstitial Cystitis (IC)
- Pelvic Floor: All the muscles, ligaments, and connective tissue deep in the pelvis that surround and support the pelvic organs (uterus, bladder, and lower bowel).*
- Pelvic Floor Dysfunction: Inability to coordinate, relax, and/or control the pelvic floor and deep abdominal muscles. Consequently, the pelvic floor can lose its proper function and thus the ability to support the pelvic organs, which in turn can affect the proper function of these organs.
- Pelvic Pain: Could refer to Acute pain as apposed to Chronic Pain. Acute pain occurs as a direct result of tissue injury. It is a protective warning mechanism to alert us to such an injury. Chronic pain on the other hand, serves no physiological protection to the individual, for instance pain may be present long after the initial tissue injury is healed. Chronic pain is classified as being present over time (more than three months) and can be constant or intermittent, varying in intensity. *
- Perineum: The area of skin between the vaginal opening (in women), the base of the scrotum (in men), and the rectal opening. *
- Pudendal Neuralgia: The pudendal nerve provides sensations to the entire vulva from the clitoris back to the anal opening. This nerve arises from the same nerves that connect to the sensory nerves from all of the pelvic organs. When pain emanates from the pudendal nerve it is called pudendal neuralgia and this may be a significant contributor to vulvodynia (chronic pain the vulvar region) in some cases. *
- Semen Allergy (Human Seminal Plasma Protein Allergy or SSPA): A rare but real immune response to semen. Symptoms range from vaginal area inflammation, itching, and/or pain to typical allergic reactions that affect other parts of the body. Consider this diagnosis if you persistently experience these symptoms up to 8 hours after intercourse but these symptoms do not occur when using a condom.
- Trigger Points: Tender, hyper irritable spots in the skeletal muscles (muscles that work with the skeletal system to facilitate motion) that are associated with nodules that can be felt in taut bands of muscle fibers. (Think of the “knots” that can cause pain in the neck and shoulders).*
- Trigger Point Release: Various techniques to release trigger points in muscle tissue to reduce the activation of pain.*
- Trigger Point Injections: A procedure for treating painful areas that contain trigger points, or knots of muscle that form when muscles do not relax. A needle containing a local anesthetic is inserted into the trigger point to make it inactive and therefore alleviate the pain. Trigger Point Injections also loosen the muscles that are causing the pain, therefore enhancing the help that can be achieved with specialized pelvic floor physical therapy. Under the care of a trained specialist, this procedure is very safe and has minimal side effects.
- Urinary Incontinence: See Incontinence
- Urogynecologist: An OB-GYN who specializes in treating pelvic floor disorders and conditions that affect the pelvic organs and surrounding musculature.
- Vaginismus: Usually involuntary spasms of the pelvic floor muscles, sometimes resulting from the fear of pain because pain was previously experienced. This condition usually results in the inability to have any sort of vaginal penetration (intercourse, tampons).*
- Vestibule: The vestibule is the vaginal opening. It contains large amounts of pain receptors.*
- Vulva: The entire outer part of the female genitalia. It includes the opening of the vagina (the vestibule), the outer hair-bearing lips, the inner lips, and the clitoris. Its is bordered by the rectal opening. Vulvar
- Vestibulitis: See Vulvar Vestibulodynia
- Vulvar Vestibulodynia: Or vulvar vestibulitis. Pain in the vestibule, usually at the back part of the vaginal opening. It is thought to be generated by highly sensitized nerve endings and contributed to by pelvic triggers (conditions) such as IC or IBS. This condition is frequently misdiagnosed and treated as a vaginal infection.*
- Vulvodynia: Chronic pain in the vulvar region. This can be broken down into vulvar vestibulodynia and generalized vulvodynia. Generalized vulvodynia is less common and often very difficult to successfully treat. It is a deeper, more generalized pain. Pain can occur spontaneously (unprovoked) or in response to touch or pressure (provoked, such as by intercourse). Pain emanating from the pudendal nerve and its distribution may be a significant contributor to this condition in some cases (pudendal neuralgia). *
*All or a portion of definition from the book "Secret Suffering: How Women's Sexual and Pelvic Pain Affects Their Relationships" by Susan Bilheimer and Robert J. Echenberg, MD