Let's talk about sex baby!

By Gemma McGregor BSc (Hons) PGCert MCSP, a woman's health specialist, physiotherapist and educator.

Valentine's Day and love is all around. Romantic candlelit dinners, red roses, chocolates, and of course, sex is on everyone's mind. But is Valentines sex always a good thing or are we doing it because of the commercial pressures? Sex should be enjoyable, but what if it's not, what if it causes pain? What if your relationship isn't all shiny and smelling of roses?

Of course, Valentine's Day isn't really about just sex, it's just another day in our busy lives, but all these triggers might seem even more personal if you know sex isn't enjoyable anymore – for whatever reason.

The ladies of QueenBee have asked me to start this conversation about some of the topics around sex that ladies may be too scared or embarrassed to ask.

Painful sex in the medical world is called dyspareunia and it can be caused by a whole host of things. Sex should never be painful, so it is essential to speak with your doctor when you first notice new symptoms to rule out causes such as acute infection.

However, if the symptoms continue, it may be caused by other factors, either physical or psychological. When speaking to patients with these types of symptoms, we try and ask questions that help us to find out where the pain is coming from and what may be causing it? We want to know:

• Is the pain caused by infection such as thrush or urinary tract infection?

• Is the skin of the vulva or vagina becoming sore or dry?

• How are the muscles working?

• Is there any pelvic floor tightness or spasms (vaginismus)?

• Other conditions can also contribute to painful sex such as IBS, constipation, fibroids, or endometriosis.

Hormones can play a part in causing pain during sex and these vary throughout your cycle. Hormones also change dramatically during the menopause – thankfully, there are lots of treatments available.

Postnatal changes can be a cause of painful sex; if you've recently had a baby consider having a thorough postnatal check or a Mummy MOT with me or other qualified specialist to eliminate post birth perineal trauma causing any issues later on.

Psychological trauma from abuse or not feeling content with a partner sadly is sometimes a factor. Poor self-worth can also contribute and leave us feeling overwhelmed. Speaking to a professional healthcare provider such as a Women's Health physio, nurse or doctor will start you on your journey of recovery. We appreciate this is a sensitive topic, but it is an area we have chosen to specialise in, and we are here to offer help.

Regardless of your sexuality or gender identity, if you are experiencing problems within your sexual relationships, it's important to acknowledge not only the medical and physical causes but also the emotional, psychological, and social factors that can play a big part. Specialist counsellors and psychosexual therapists are out there and they can use various methods such as mindfulness, CBT, couples and individual counselling to support you.

When sex is good – it is great! But if you think there is a problem, seek help. Never feel pressured - not everyone is having it! Be comfortable and make sure you are open and honest in your relationships

Sex should be enjoyable, but what if it's not, what if it causes pain? What if your relationship isn't all shiny and smelling of roses?

For anyone looking for more information on any of these issues please do get in touch gemma@specialisedphysiotherapy.com Call: 07518 101700 or visit: www.specialisedphysiotherapy.co.uk