Vaginismus is a painful feeling of discomfort or inability when inserting a tampon, finger, penis or during a doctor’s internal pelvic exam. It occurs when there are involuntary contractions of the muscles in the outer third of the vagina with no abnormalities in the genital organs. The tight muscle contraction makes sexual intercourse or any sexual activity that involves penetration painful or impossible. The vaginal muscles tighten involuntarily despite women’s desire for sexual intercourse. Vaginismus usually begins when women first attempt to have sexual intercourse and it is painful which leads to emotional distress and fear of being in pain with every attempt. Because intercourse may be painful, women fear it. This fear makes muscles even tighter and causes or increases pain when sexual intercourse is attempted.

Primary Vaginismus: when a woman has never been able to have pain free intercourse due to pelvic floor muscle spasm

Secondary Vaginismus: pain that develops sometimes later in life after a traumatic event such as childbirth, surgery, or a medical condition.

With Vaginismus, there is usually significant Connective Tissue Dysfunction that needs to be addressed first before any internal work. It is suggested that you follow up the self-help treatment for connective tissue dysfunction before relying on the stretching exercises with the dilators.

Diagnosis

Usually, women need to be treated before a pelvic examination can be done. Doctors look for scars, infections, or other abnormalities to determine whether they could be causing the symptoms. When vaginismus is the problem, no such abnormalities are found.

Treatment of Vaginismus

Sex therapy and counseling

Education typically involves learning about your anatomy and what happens during sexual arousal and intercourse. You’ll get information about the muscles involved in vaginismus too. This can help you understand how the parts of the body work and how your body is responding.

Vaginal Dilators

Our registered Physiotherapist may recommend learning to use vaginal dilators under the supervision. Place the cone-shaped dilators in your vagina. The dilators will get progressively bigger. This helps the vaginal muscles stretch and become flexible. To increase intimacy, have your partner help you insert the dilators

Pelvic floor exercises and Desensitisation techniques

Our pelvic health registered physiotherapist may be able to teach you pelvic floor exercises, such as squeezing and releasing your pelvic floor muscles, that can help you gain control over the muscles causing the vagina to close involuntarily. Occasionally, a technique called biofeedback may be recommended. A small probe is inserted into your vagina, which monitors how well you are doing the exercises by giving you feedback as you do them.

· Teach the client posture strategies that may help to relax the muscles that are contracting involuntarily

· Teach the client appropriate timing of the contraction and relaxation of the pelvic floor muscles.

· Educate the client about the condition and why it might be occurring, and reoccurring.

· Teach the client various strategies for getting the muscles to relax

· Use manual therapy to release the muscles either externally and/or internally that are causing the contractions.

The vaginismus treatment kit has been reviewed in the American Physical Therapy Association’s Journal Of Women’s Health Physical Therapy and is recommended for use by therapists with all vaginismus patients.

Some general points about pelvic floor muscle exercises:

• Choose a convenient time and place where you can exercise regularly.

• Put a reminder about pelvic muscle exercises somewhere obvious to you (or set an alarm on your watch or mobile phone).

• Avoid quick pelvic floor muscle exercises where you don’t hold the contraction, as these tend to cause an increase in pelvic floor muscle resting tone.

• Be aware that it will take 6 to 8 weeks of regular exercise before you can expect to see a possible improvement, and approximately 3 months for the pelvic muscles to strengthen (or indeed for you to feel more confident that you are releasing them effectively) to a remarkable degree.

• You could try inserting one finger into the vagina to check the strength of your squeeze as you pull in the pelvic muscles. Alternatively, if this is daunting, you may be able to feel a pelvic floor contraction if you place the tip of your index finger on the perineal body (on the outside, between the vagina and back passage).

• If you are overweight, try reducing your weight.

• Try not to become constipated, as a full bowel will put pressure on the bladder, and straining to empty your bowel will weaken the pelvic muscles.

• If your job involves lifting, think of your pelvic muscles as well as your back – pull up your pelvic muscles when lifting a heavy weight.

• If you smoke, consider giving up, since constant coughing puts a strain on the pelvic

• muscles.

Our registered physiotherapist at Curezone physiotherapy, Mississauga near heartland will help you achieve your goals and have a painfree pelvic floor. Call us now to book an appointment or a 5 min free consultation @ 905 997 4333.