Vaginismus Physical Therapy

Vaginismus Physical Therapy: Vaginismus Treatment & What To Expect

What Causes Vaginismus?

Vaginismus Physical Therapy is a treatment option for those suffering from the symptoms of vaginismus. Vaginismus, defined medically as genito-pelvic pain/penetration disorder, is characterized by the involuntary and instantaneous tightening of the muscles at the vaginal opening, which makes vaginal penetrations difficult or impossible. There are two types of vaginismus: primary vaginismus (always there) and secondary vaginismus (began after a life’s event). Vaginismus is often a lifelong condition unless promptly attended to. If you’re looking for more information on how to treat vaginismus using physical therapy, you’re in the right place.

It is essential to emphasize that vaginismus is not a structural problem but rather always an anxiety-based condition, a psychosomatic reaction to a conscious or subconscious worry or fear in anticipation of pain.

Vaginal penetrations include finger, insertable menstrual aids (tampons, cup, disk), vaginal applicator for inserting medication, pelvic gynecologic examination, vaginal ultrasound, sexual intercourse, or penetrative intercourse with a penis-like dildo.

Why is Pelvic Floor Physical Therapy Important for Vaginismus?

A Pelvic Floor Physical Therapist (pelvic floor physiotherapist) is a licensed healthcare professional who specializes in the evaluation and treatment of conditions related to the pelvic floor, which is the group of muscles located in the pelvis for the purpose of supporting organs, aiding in voiding, and contributing to sexual function.  It is no wonder, then, that such a professional is most suited for addressing vaginismus and your pelvic health.

Main Benefits of Physical Therapy for the Pelvic Floor Muscles

The main benefits of pelvic floor physical therapy for vaginismus include:

  • A professional and much-needed pelvic exam
  • A professional understanding of how the body works;
  • Knowledge to educate about pelvic floor muscle action, vaginal muscles, and functions;
  • Establish a progressive, guided desensitization training program using vaginal dilators;
  • Provide pelvic pain management tools;
  • Include patient education and support;
  • Tailor an individualized treatment process aimed at restoring all vaginal penetrations;
  • Establish a team cooperation with a suitable female mental health professional to comprehensively manage the psychosomatic nature of vaginismus.

Physical Therapy for Vaginismus & Pelvic Floor Treatment

Vaginismus pelvic floor physical therapy treatment process will begin with a thorough initial evaluation that also includes medical, sexual, and emotional histories, and followed by establishing treatment plan with goals and projected length of treatment.

Treatment modalities may include manual therapy, progressive dilator training, relaxation techniques, education and counseling, guidance for genital hygiene and other needs that may arise.

A female mental health professional with experience and expertise in managing psychosomatic disorders should be added to the team to provide counseling, tools for diffusing the anxiety, medication recommendation, sex counseling, and relationship therapy.

What to Expect During the First Vaginismus Physical Therapy Appointment

A woman with vaginismus is often nervous, apprehensive, feeling inadequate, and embarrassed about her ‘not being a real woman.’  As such, the treatment set up should be comforting and non-alarming, ideally in a nurturing atmosphere while maintaining professionalism.  Furthermore, women with vaginismus often insist on being seen by a female clinician only, which makes perfect sense as a male clinician may understand the anatomy but does not ‘feel’ the vagina nor ‘thinks’ like a vagina owner.  A female clinician knows what it is like to ‘be vaginally entered’ or to have a vaginal infection or vaginal pain, which lends to better understanding of the psychosomatic implications of vaginismus.

The content of this first appointment should include an in-depth evaluation of the woman’s needs as described above, answering her questions, and the design of a projective treatment plan. The partner will often join in for the conversation, which is a great opportunity to get a wider understanding of their relationship dynamics and her anxiety.  The mental health professional on the team may sit on this session as well, or have her own session scheduled as soon as possible.

Home Program & Coaching Treatment Option for Vaginismus

May women choose vaginismus self-treatment while others feel too overwhelmed or too nervous to even consider such an option and prefer a guided program by a professional.

Other factors in the decision to self-treat: cost, travel, lack of suitable resources near home, availability of dilator kits with instructions, Internet resources and advice, encouragement by healthcare providers, and embarrassment to admit there is a ‘vagina problem that makes me feel inadequate, not a whole woman.’  In our statistics, most vaginismus patients never tell anyone about their suffering with this condition, choosing to live in silence about it!

While a self-treatment can be successful in mild cases, you may want to watch this video to avoid frustration and disappointment should it not work for you: limitations to vaginismus home program.

A home program for vaginismus may include

  • A Dilator kit with instructions: there are many brands available for the choosing. Some countries ban them;
  • Relaxation techniques;
  • Self-education and resources: Internet search, books, podcasts, etc.;
  • Topical anesthetics: often prescribed by gynecologists;
  • Praying;
  • Trying finger insertion with partner;
  • Alcohol, Marijuana, and other substances;
  • Support groups, including our active group on Facebook, Private Pain.

Our Online (Virtual) Vaginismus Treatment Program

In addition to our in-person professional vaginismus treatment for which we’ve been known for over 30 years, we now offer another option for curing vaginismus, a Virtual Vaginismus Coach program.

With our goal of helping as many women with vaginismus as possible (already over 2000 at time of this publication), we utilized our extensive expertise and vast experience to create a successful virtual program for women who cannot travel to us for an in-person program.

Check out this option – there is no reason to live with vaginismus!

Contact Us to schedule an appointment.

About The Author

Dr. Ditza Katz

Ditza Katz, PT, Ph.D., is the founder of Women’s Therapy Center, a practice specializing in urogynecologic rehabilitation, treatment of female sexual dysfunction, breast & female cancer rehabilitation, and management of somatic disorders. Dr. Katz holds an undergraduate degree in Physical Therapy, a Master’s degree in Pastoral Psychology & Counseling, a doctorate in Clinical Sexology, and clinical training in manual therapy and urogynecology. Dr. Katz is a Diplomate with the American Board of Sexology, Professor at the American Academy of Clinical Sexology located in Orlando, Florida, and the only physical therapist in the USA who is a clinical sexologist.

Scroll to Top