Painful Sex & Dyspareunia Physiotherapy in Norwich
Dyspareunia means pain during or after sexual activity. Pain may be felt at the vaginal entrance, deeper in the pelvis, around scars, or afterwards as aching, burning, or muscle tension. It can affect intimacy, confidence, relationships, examinations, and fertility treatment.
Pain is not something you should be expected to push through. Pelvic health physiotherapy offers a private, consent-led assessment of pelvic floor and movement factors while working alongside medical or psychosexual care when needed.
Which Cliniko appointment should I book?
If this is your first appointment for this concern, choose Initial Pelvic Health – 60 mins (for women and men) or Initial Pelvic Health – 45 min Express Check (for women and men). If Ellie has already assessed you for this concern, choose Follow-up Pelvic Health – 45 mins or Follow-up Pelvic Health – 60 mins.
Possible contributors
- Pelvic floor muscle overactivity or difficulty relaxing.
- Vaginismus, vestibulodynia, or vulvodynia.
- Menopause-related dryness or tissue change.
- Endometriosis, bladder pain, or persistent pelvic pain.
- Birth injury, Caesarean or perineal scars, hysterectomy, or other surgery.
- Previous painful experiences, fear of pain, or protective muscle guarding.
How physiotherapy may help
Your appointment begins with conversation. An internal examination is not required and is only considered when useful and explicitly consented to.
Treatment may include:
- Pelvic floor relaxation and coordination.
- Breathing, movement, and nervous-system regulation.
- Gentle scar, muscle, or connective-tissue treatment where appropriate.
- Graded exposure or vaginal trainer guidance at your pace.
- Advice about positions, pacing, lubrication, and flare-up management.
- Liaison with your GP, gynaecologist, menopause clinician, vulval specialist, or psychosexual therapist.
Medical assessment matters
New bleeding, unusual discharge, sores, skin change, infection symptoms, unexplained pelvic pain, or bleeding after menopause requires medical assessment. Physiotherapy does not diagnose endometriosis, infection, or vulval skin disease.
FAQ
Will treatment involve penetration? Not unless you choose it. Useful assessment and treatment can begin externally.
Is painful sex always caused by pelvic floor tension? No. Tissue, hormonal, medical, surgical, emotional, and nervous-system factors may contribute.
Can I attend with my partner? You are welcome to bring a trusted person if that helps you feel comfortable.
What if I am not ready to return to sex? That is completely acceptable. Treatment follows your goals and does not use penetration as the only measure of success.
Further information
For care that respects your comfort and choices, view appointments and book.