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Vaginismus and How Physiotherapy Can Help with Your Symptoms

Have you ever found it difficult to insert a tampon, undergo a PAP smear or have penetrative intercourse?

If you said yes to any of these, there’s no need to worry. You are not alone, and help is here.

WHAT IS VAGINISMUS?

Vaginismus is a condition that makes the vaginal entrance appear smaller and makes vaginal penetration difficult for women. It can be described by the involuntary contraction of pelvic floor muscles in response to physical contact or pressure, thus preventing pain-free sexual intercourse.

According to research, vaginismus is experienced by 5% to 20% of women (Spector & Carey 1990). However, there may be more as some women may not be comfortable expressing their challenges with the condition due to fear or embarrassment.

WHAT ARE THE TYPES OF VAGINISMUS?

  • Primary vaginismus refers to the condition when a female has never had comfortable penetration and, in some cases, has never achieved penetrative sex. This type of vaginismus can have 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.

WHAT ARE THE SYMPTOMS OF VAGINISMUS?

Symptoms can stem from physical or psychological abuse, a conservative upbringing or certain medical conditions. These medical conditions can include endometriosis, hormonal fluctuations, UTIs, recurrent thrush and constipation.

For some, however, there may be no identifiable cause. Worry not, physiotherapy can help!

HOW CAN A WOMEN’S HEALTH PHYSIOTHERAPIST HELP WITH VAGINISMUS?

The symptoms of vaginismus can be resolved. As your physiotherapist, I will first run through your medical and sexual history. Some questions we tend to ask our patients include the following:

  1. Have you ever been successful with inserting a tampon?
  2. Have you ever had sexual intercourse or penetration of any kind?
  3. Have you had a history of abuse (sexual, emotional, physical) that you are aware of?
  4. Have you had recurrent yeast infections or UTIs?
  5. Do you have a history of painful or difficult periods?
  6. Are you fearful of vaginal penetration?

After this, we will often talk about the vaginismus cycle of pain.

SHOULD I PERFORM KEGELS OR PELVIC FLOOR CONTRACTIONS?

Kegel exercises are not the solution. Contracting pelvic floor muscles that are already tight will make the condition worse and cause muscle spasms. This will perpetuate the cycle of pain.

We will guide you in relaxing your muscles. Teach you stretches, introduce graded touch and tissue desensitisation techniques, and recommend a dilator program. We will also discuss other approaches to a fulfilling intimate relationship while you are undergoing treatment.

We also adopt manual therapy as one of the methods to help calm the pelvic floor muscles, tummy, buttocks, legs and back. Some cases may also require dry needling or Botox to relax your tight muscles.

SHOULD I SEEK ADVICE FROM OTHER HEALTH PRACTITIONERS?

When it comes to resolving women’s health issues, a team approach is always best. Working alongside your doctor, psychologist or sex therapist will help identify the best course of treatment for you. This will also help address any fear or anxiety with what you are experiencing.

Whenever possible, we also encourage our patients to be open to their partners about what they are experiencing. This can help create a better healing journey for the women and create a sense of intimacy between partners.

If you are experiencing symptoms of difficult penetration, please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as personal medical advice.

References:

  1. Spector, IP & Carey, MP 1990, ‘Incidence and prevalence of the sexual dysfunctions: a critical review of the empirical literature’, Arch Sex Behav, vol. 19, no. 4, pp. 389-408.
  2. https://www.nhs.uk/conditions/vaginismus/#:~:text=What%20is%20vaginismus%3F,have%20no%20control%20over%20it.
  3. https://www.embracephysio.sg/what-is-the-pelvic-floor/#content
  4. https://www.embracephysio.sg/how-can-physiotherapy-help-my-endometriosis/#content
  5. https://hopeandher.com/pages/vaginismus-causes
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