by Talli Y Rosenbaum
September 16, 2009
Introduction: Sexual pain disorders refer to conditions of genital pain that interfere with intercourse. They often have a musculoskeletal component related to the pelvic floor and are included in the DSM-IV as sexual dysfunctions.
Musculoskeletal pain (MP) that is not essentially genitally based often interferes with sex as well, yet is not considered a distinct sexual dysfunction.
Musculoskeletal pain is generally addressed by physiatrists, orthopedists, and rheumatologists who are not traditionally trained in sexual medicine, and therefore, the sexual concerns of women with musculoskeletal pain often go unaddressed.
Aim: The purposes of this review article were to describe how musculoskeletal pain is perceived in the literature as affecting sexual function, illustrate how specific musculoskeletal pain conditions prevalent in women may affect sexual function, and offer recommendations for clinical practice.
Methods: PubMed and Medline searches were performed using the keywords "musculoskeletal pain and sex," "lower back pain and sex," "arthritis and sex," and "fibromyalgia and sex."
Main Outcome Measure: Review of the peer-reviewed literature.
Results: Most studies cite fatigue, medication, and relationship adjustment as affecting sexuality much as chronic illness does.
While musculoskeletal contributors to genital sexual response and pain are considered relevant to sexual function, little is understood about how musculoskeletal pain syndromes specifically affect sexual activity.
Conclusion:
• Lack of mobility and musculoskeletal pain can restrict intercourse and limit sexual activity, and gender differences are noted in response to pain.
• Sexual and relationship counseling should be offered as a component of rehabilitative treatment.
• Physical therapists are uniquely qualified to provide treatment to address functional activities of daily living, including sexual intercourse, and offer advice for modifications in positioning.
Source: The Journal of Sexual Medicine, Sep 14, 2009. PMID: 19751383, by Rosenbaum TY. Inner Stability, Ltd-Urogynecological Physiotherapy, Bet Shemesh, Israel. [E-mail: tallir@netvision.net.il]
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