Vaginismus is an involuntary spasm of vaginal pelvic floor muscles particularly around the vaginal opening. These muscles may cause pain (such as burning, stinging or tightness) during sex or may totally prevent a woman from engaging in sexual intercourse. Women may also be unable to insert a tampon or may have difficulty tolerating gynecologic exams such as a pap smear. This vaginal tightness is basically causing a “barrier” or is blocking penetration from occurring.
What are the symptoms of vaginismus?
Symptoms can vary as some women can tolerate tampon use but cannot tolerate sex. Vaginismus can be diagnosed by surface electromyography (sEMG) or with an examination of the pelvic floor muscles. A study, performed by Shafik and El-Sibai, looked at pelvic floor muscle activity and found increased EMG activity in the levator ani, puborectalis and bulbocavernosus in subjects with vaginismus. Women with this diagnosis many times will avoid sexual activity due to fear of pain and may experience involuntary pelvic muscle contraction due to anticipation of pain. There are two types of vaginismus that can occur, primary or secondary. Primary vaginismus is described as a woman who has always had pain when inserting tampons or who has never had pain-free intercourse. Vaginismus is considered secondary if a woman used to be able to engage in pain-free intercourse. Causes of secondary vaginismus include frequent yeast infections, thinning of the vaginal wall after menopause or trauma from childbirth.
How can physical therapy help?
Pelvic floor physical therapy can help decrease symptoms associated with vaginismus. A study performed by Reissing et al. suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus. This study found internal manual therapy techniques to be most effective in treatment. Physical therapy will work on “down-training” and teach you how to relax your pelvic floor muscles. Manual therapy techniques can work on trigger points and help to decrease muscle spasms and desensitize the area. Other techniques used include biofeedback and teaching patients how to use dilators at home to accompany treatment. Our pelvic floor physical therapists here at New Dimensions Physical Therapy are specialized in treating this diagnosis. Call us to make an appointment!
Lahaie, M., Boyer, S. C., Amsel, R., Khalifé, S., & Binik, Y. M. (2010). Vaginismus: A Review of the Literature on the Classification/Diagnosis, Etiology and Treatment. Womens Health, 6(5), 705-719. doi:10.2217/whe.10.46
Reissing, E. D., Armstrong, H. L., & Allen, C. (2013). Pelvic Floor Physical Therapy for Lifelong Vaginismus: A Retrospective Chart Review and Interview Study. Journal of Sex & Marital Therapy, 39(4), 306-320. doi:10.1080/0092623x.2012.697535
Shafik, A., & El-Sibai, O. (2002). Study of the pelvic floor muscles in vaginismus: A concept of pathogenesis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 105(1), 67-70. doi:10.1016/s0301-2115(02)00115-x
Symptoms of vaginismus. (n.d.). Retrieved April 15, 2019, from https://www.hse.ie/eng/health/az/v/vaginismus/symptoms-of-vaginismus.html
What is the difference between primary vaginismus and secondary vaginismus? (n.d.). Retrieved April 15, 2019, from https://vaginismus.com/faq/general-questions/primary-and-secondary-vaginismus-differences/