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Painful Intercourse: Pelvic Therapy can help Vaginismus

April 2024 - Barbara Green and Beth Siler - Barbara Green Physical Therapy

Did you know that over 30% of women of all ages have pain with intercourse, and sometimes it is so bad that they are unable to have intercourse at all. Often this is blamed on lack of lubrication or menopause and sometimes that is the case. But so often, with our clients, the pain comes from tight muscles.

Vaginismus is defined as muscle spasms around the opening of the vagina.

Yes, there are big muscles that make up the Pelvic Floor. And just like any other muscle, if it stays clenched or contracted too long, there will be lactic acid that builds up and burns and the muscles can become tight or shortened. Think about your biceps, if you do lots of bicep curls you will feel the burn. Or your neck, when you sit at a desk for a long time, your neck is stiff and sore. Muscles and joints need to move to feel normal. Lots of people have the habit of clenching; it can be your teeth, hands, or pelvic floor. Sometimes it is stress, and sometimes it is just a habit. People who clench their teeth know that the muscles around the jaw and face become sore and tired when they move or chew. The joint can become stiff as well. It is the same with the pelvic floor muscles. Lots of people (both men and women) clench their pelvic floor muscles and when they are stretched or touched there is a lot of pain, making penetration very painful or impossible. Some cannot even use a tampon.

Vaginas are all about the same size in most of us. If you make a circle with your thumb and index finger that is about the width of almost all vaginas. So why does it hurt so much for some? It is because the muscles at the entrance are tender and tight, and it feels like ripping and tearing when there is penetration of any kind. Arousal is nearly impossible in this scenario.

man and women not close
Vaginismus can limit enjoyment of intimacy, but Pelvic Therapy can help.

What we do in Pelvic Floor Physical Therapy is work on relaxation, very gentle stretches, movements that calm muscles, biofeedback, and other techniques; then little by little the muscles learn to relax. We have patients that have been married or with partners for years - 5, 10, even 20 years, and have not been able to have any type of penetration. There are others who are able to have penetration, but it is always painful, and others who only hurt some of the time. Some tough it out, and for others intercourse is impossible. But it does not have to be this way. Intimacy should be a wonderful part of a relationship and the best way to get pregnant if you would like to have a baby.

For so many of our patients making that first appointment is difficult. It is something that is very unusual and hard to discuss. Many of our patients have tried to talk to their gynecologist and sometimes the gynecologist does not understand the problem. Other times, the gynecologist will know exactly what the problem is and knows that Pelvic Floor Physical Therapy can help.

The Pelvic Floor Physical Therapist is used to working with these types of patients and will make you comfortable and reassured. If you are having pain with intercourse please talk to your doctor, find a PT and restore intimacy in your life. Vaginismus can be resolved.

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