Vaginismus physical therapy: pelvic physical therapy and vaginal dilators

Vaginismus physical therapy: pelvic physical therapy and vaginal dilators

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We need to talk about physical therapy for vaginismus! A sassy person with black skin and yellow hair looks upwards with a slightly pursed friendly grin.
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Vaginismus physical therapy: pelvic physical therapy and vaginal dilators

Vaginismus physical therapy may help if you have sexual pain. Erin’s true story of how vaginismus physiotherapy helped her enjoy sex again.

The following conversation has happened countless times in the last four months of my life:

“I can’t, I have physical therapy.”

“Oh, for what?”

“My vagina.”

I’m sure you can imagine the look on people’s faces when I decide to tell them what my appointments are really for.

I struggle with something called vaginismus, which essentially means I can’t control the muscles in my vagina. Like, no matter how mentally or physically relaxed I am, my vagina doesn’t follow suit. My vagina spasms involuntarily, and if I attempt to insert something during a spasm, it feels like I’m being stabbed in the vagina. Even tampons can cause pain on a bad day.

 

Let’s talk about vaginismus physical therapy

It wasn’t until after attempting to have sex and then experiencing excruciating vaginal pain after sex for four years that I finally got an answer to my question: why does my vagina hurt so much. And that answer came after two weeks filled with four different gynecologists. I had vaginismus.

When the doctor told me that one way to reduce or eliminate pain in the vagina would be vaginismus physical therapy (vaginismus physiotherapy), which usually involves a combination of pelvic physical therapy and vaginal dilators, I nearly passed out! I had no idea what that would entail. It’s not something I’ve heard anyone else talk about before until then. It sounded embarrassing and painful.

So, I’m here to tell you what vaginismus physical therapy – pelvic floor physical therapy and vaginal dilators – looks like, for anyone who is curious.

Before my first vaginismus physical therapy appointment, I was practically shaking in the waiting room. I had no idea what to expect – was it just going to be stretches and yoga? Or was she going to physically, forcibly, you know…stretch my vagina? I was nervous, to say the least.

What is vaginismus?

Vaginismus, classified under the umbrella term of genito-pelvic pain/penetration disorders, is a penetration disorder where women experience persistent difficulty achieving vaginal penetration. It is frequently characterized by the involuntary contraction of the pelvic floor muscles in response to physical contact or pressure. This contraction prevents non-painful sexual intercourse.

Vaginismus is usually classified being either primary or secondary.

  • Primary vaginismus refers to cases when a female has never been able to have comfortable penetration. And, in some cases, has never achieved penetrative intercourse. This has implications for the consummation of marriage and fertility.
  • Secondary vaginismus occurs after a period of normal sexual relations before the onset of symptoms. For example, this may occur after a traumatic event such as abuse or having a baby.

Some women’s symptoms are caused by physical or psychological abuse. For other women, the underlying cause of vaginismus might be due to medical conditions such as endometriosis, fibroids, or UTIs. And in some women, there may be no identifiable cause whatsoever.

Source: Health Direct Australia

 

 

What does vaginismus physical therapy entail?

When I met the physical therapist, all my worries washed away. She came out with a bright smile on her face and welcoming me back to the treatment room, where we spent forty minutes talking about my vaginal pain, the causes of it, and various treatment options. We spoke of yoga stretches, about treatment timeline, and different topical treatments. She answered all of my questions and told me everything I would need to know about pelvic floor physical therapy and vaginal dilators as a form of physical therapy for vaginismus.

Pelvic floor physical therapy entails both external and internal work once a week, plus there’s a ton of homework. We do stretches, and then, when it comes to internal work, she plays relaxing music and gives me heating pads while she literally, yes, stretches out my vagina. It sounds really strange, and it is, but at the same time, I’ve never felt so empowered and in control of my body.

She makes me feel more autonomous than any medical professional ever has before. I obviously can’t speak to all pelvic floor physical therapists in the world – but if they’ve received training similar to mine, then I bet they’re awesome.

Physical therapy for vaginismus at home

For home therapy for vaginismus, I have to use vaginal dilators, which is a whole process on its own. I have to get myself relaxed (i.e., grab my heating pad and watch Netflix), use TONS of lube, and use the dilators. They’re basically plastic dildos that come in six different sizes, and my goal is to make it up to the biggest size.

For reference, the smallest one is about the size of a tampon. For anyone who is trying out dilators to treat painful sex – I highly recommend doing something fun while dilating. Otherwise, your brain will just continue to associate insertion with pain and discomfort.

If you binge a Netflix show while doing it, sure, it’ll be uncomfortable and probably painful, but your brain will also associate dilating time with whatever you’re currently binging. Positive reinforcement for the win!

Despite spending time in college on the Health and Wellness Crew, studying women’s health, and educating myself as best as possible, I hadn’t heard of vaginismus until I watched a YouTube video about the condition. According to my pelvic floor physical therapist, it’s not uncommon at all. It’s just not talked about because women are told that pain during sex is normal and healthy (spoiler alert: it’s not).

If you or anyone you know is struggling with painful vaginal sex, there are treatment options. Physical therapy for vaginismus (pelvic floor physical therapy) is just one of them – there are also topical numbing treatments, vaginal dilators on their own, even surgery.

You’re not a lost cause, and you’re not alone. And by talking about physical therapy for vaginismus, I hope that I can educate people about painful sex because sex is NOT supposed to be painful, and if it is, there are ways to treat it.

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Article by
Erin Moynihan

Erin Moynihan is a content writer from Seattle, WA who loves making people uncomfortable.

Caption:

When the doctor told me I would have to go to physical therapy for my vagina, I nearly passed out, because I had no idea what that would entail. It's not something I've heard anyone else talk about before. So, I'm here to tell you what pelvic floor physical therapy looks like, for anyone who is curious.

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