The treatment of sexual dysfunctions is based on collaboration between specialists from various fields. It is most commonly associated with the care provided by a sexologist, psychotherapist, and gynaecologist, but increasingly, physiotherapists are also becoming involved in this process.
Urogynecological physiotherapists, whose area of expertise focuses on the pelvic region, are trained to work with people experiencing difficulties in the sexual sphere, such as penetration disorders associated with pain or difficulties achieving orgasm.
Assessment and therapy of the pelvic floor muscles, which play an important role in the sexual response cycle, provide an opportunity to offer even more effective support to patients. However, it should be emphasised that physiotherapy in sexology is not limited to the pelvic area — it also involves working with the patient’s entire body.
It is important to remember that sexual difficulties can affect anyone at different stages of life, including after childbirth or gynaecological surgery. They can also affect men.
The pelvic floor muscles close the lower part of the bony pelvis, forming a structure similar to a hammock that surrounds the urethra, vagina, and anus. Their functional activity involves both activation — closing these three openings and drawing them upwards towards the navel — as well as appropriate relaxation.
Intentional activation of the pelvic floor muscles during sexual activity improves blood flow in the area, increasing the amount of blood reaching the clitoris. Conscious relaxation of these muscles is one of the key skills that supports pain-free penetration, while during orgasm these muscles rhythmically contract and relax.
Therefore, improving sensation and mobility in the perineal area, as well as throughout the pelvis, is an important element of physiotherapy for sexual dysfunctions.