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What is Vaginismus?

Vaginismus is where there is an involuntary contraction of the pelvic floor muscles causing painful vaginal penetration, making sex and inserting a tampon difficult or impossible to do. This condition is rarely spoken about and there can be a lot of misguided information out there making it difficult for a person to find the right help.

There are two types of vaginismus:

Primary vaginismus – where vaginal penetration has never been possible.

Secondary vaginismus – where vaginal penetration has been possible in the past but has become difficult and painful.

What causes it?

The exact causes of vaginismus are poorly understood however it is thought that contributing factors may include:

  • recurrent vulvovaginal conditions such as thrush

  • recurrent UTI/infections

  • some sexually transmitted infections

  • endometriosis

  • very high levels of stress and/or other mental health conditions

  • sexual abuse, assault, or violence

  • personal and/or religious beliefs about sexuality

  • fear of the recurrence of pain that has been previously experienced

  • no known cause

How is it treated?

It is important to seek help if you feel you may have vaginismus and that you speak with your health care provider (such as your GP or gynaecologist) to ensure there are no underlying conditions which may be contributing to your symptoms.

Seeing a pelvic floor physio who is experienced in treating vaginismus is a great place to start. They can provide you with individualised education, hands on treatment, a home management plan and offer referral suggestions as needed. These referral suggestions may be to your GP, a mental health professional, a gynaecologist, or a dietician.

Physiotherapy treatment options may include the use of dilators. These devices allow a progressive approach to gently stretch the pelvic floor muscles. Other ‘down-training’ techniques may be utilized including breathing exercises, body awareness and relaxation exercises. It is likely you will need appointments that are close together for the start of your treatment, but the aim is to reach a point where you are confidently self-treating at home and can decrease the frequency of your sessions in clinic.

The examination

A vaginal exam is an important aspect of the assessment and treatment of vaginismus, but our physiotherapists understand that this can be very daunting if you experience pain. With the exam, the process is fully explained, you are in complete control the whole time and we do not push you into doing something that you are not comfortable with. It is not uncommon for the first couple of assessments to be fully clothed and to get used to the treatment environment if this is what is needed.

A note for parents

These symptoms can first become apparent when a young woman attempts to use a tampon for the first time but is unsuccessful or when they first become sexually active. Parents can support their child by providing an empathetic ear and providing a supportive role taking them to their GP in the first instance and subsequent gynaecological or women’s health physiotherapist appointments.

Vaginismus is a condition that can get fantastic results with Physiotherapy. To book with one of our Women's Health Physiotherapists, click on the link below or call us on (02) 4384 3395.

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