If penetration is painful, difficult, or sometimes feels impossible, you may have heard the word vaginismus. It can be a difficult thing to talk about, especially when you aren’t sure why your body is reacting this way. Still, understanding what’s happening can be the first step toward getting the right support and feeling more comfortable in your body.
Vaginismus is when the muscles around the vaginal opening tighten involuntarily in response to attempted or anticipated vaginal penetration. This can make sexual intercourse painful or, for some women, make it feel like there is a wall or blockage that prevents anything from going in. However, vaginismus does not only affect sexual function. Women may also notice the same difficulty or pain with using a tampon or with a pelvic exam by a gynecologist or other medical progressional. The pain can feel like an intense tightness around the vaginal opening, but also like burning, stinging, or a feeling similar to a wound or rawness, even when you’re not sure what is triggering the muscles to tighten
The most important thing to understand is that the pain or difficulty allowing insertion is not “all in your head.”
Your pelvic floor is made up of muscles that can both contract and relax, but what makes these muscles unique is they can also become very protective when your body expects pain. Once that happens, it can create a cycle where pain leads to tension, tension leads to more pain, and eventually your body starts anticipating the experience before it even happens.
There isn’t always one clear reason why vaginismus develops. It can be associated with previous painful experiences, pelvic pain, hormonal changes, injury, childbirth, or simply a cycle of pain and muscle tension that develops over time. Sometimes there isn’t an obvious starting point at all. You don’t have to know exactly why it started in order to work on it.
This is where pelvic floor physical therapy can help.
Treatment is not about forcing your muscles to relax or pushing through pain. Instead, the goal is to help you understand what your pelvic floor is doing and teach your body that it is safe to relax.
Your physical therapist may work with you on breathing and pelvic floor relaxation, since your breathing and pelvic floor muscles naturally work together. Depending on your symptoms and comfort level, treatment may also include gentle hands-on techniques to address muscle tension and sensitivity.
For some women, treatment may eventually include gradually getting comfortable with things that have previously caused pain, such as touch, tampons, pelvic exams, or vaginal penetration. This should never be rushed or forced. The pace should be based on your symptoms, your goals, and what feels comfortable for you.
One of the most important parts of treatment is understanding what your body is doing. When you understand that the muscles are tightening as a protective response, it can take away some of the fear and frustration that often comes with these symptoms.
If penetration is painful or difficult, you don’t have to simply accept that as your normal. Whether you’re struggling with sex, tampons, pelvic exams, or simply feeling disconnected from your body, pelvic floor physical therapy is one option that may help.
Your body isn’t “broken.” Sometimes it just needs some help learning that it doesn’t have to protect you quite so hard.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.