Managing Bacterial Vaginosis Pain with Pelvic Floor Therapy

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 11/29/2023

Managing BV Pain with PFPT


Bacterial vaginosis is a common vaginal infection caused by an imbalance of bacteria in the vagina. It can lead to symptoms such as abnormal discharge, itching, and a strong fishy odor.

Pelvic floor physical therapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. It is often used to treat conditions such as urinary incontinence, pelvic pain, and sexual dysfunction.

The purpose of this article is to explore the potential link between bacterial vaginosis and pain in the uterus, and how pelvic floor physical therapy may be used as a treatment option.

Explanation of Bacterial Vaginosis

Bacterial vaginosis occurs when there is an overgrowth of harmful bacteria in the vagina, disrupting the natural balance of bacteria. This can be caused by a variety of factors, including douching, using scented products, and having multiple sexual partners.

While bacterial vaginosis is not considered a sexually transmitted infection, it is more common in women who are sexually active. It is also more likely to occur in women who have recently changed sexual partners or have a new sexual partner.

Overview of Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a non-invasive treatment approach that focuses on strengthening and relaxing the muscles in the pelvic floor. This can be done through a variety of techniques, including exercises, manual therapy, and biofeedback.

The goal of pelvic floor physical therapy is to improve the function of the pelvic floor muscles, which can help alleviate symptoms such as pain, incontinence, and sexual dysfunction. It can also help improve overall pelvic health and prevent future issues.

What is Bacterial Vaginosis?

Symptoms and Risk Factors

The most common symptom of BV is a strong, fishy odor coming from the vagina. Other symptoms may include abnormal vaginal discharge, itching, and burning during urination. However, some women with BV may not experience any symptoms at all. Certain risk factors can increase the likelihood of developing BV, such as having unprotected sex, using an intrauterine device (IUD), and having a history of BV or other vaginal infections.

Diagnosis and Treatment Options

BV can be diagnosed through a physical examination and a sample of vaginal discharge. Your healthcare provider may also perform a pH test to determine the acidity level in the vagina, as BV can cause an increase in pH. Treatment for BV typically involves antibiotics, either in the form of oral medication or vaginal suppositories. It is important to complete the full course of treatment, even if symptoms improve, to prevent recurrence. In addition to medication, practicing good hygiene, avoiding douching, and using condoms during sex can help prevent BV.

Understanding Pelvic Floor Physical Therapy

Types of Pelvic Floor Physical Therapy

There are two main types of pelvic floor physical therapy: internal and external. Internal therapy involves the use of vaginal or rectal techniques to directly target the pelvic floor muscles. External therapy, on the other hand, uses exercises and techniques that can be done externally, such as through the abdomen or hips.

Benefits and Effectiveness

Pelvic floor physical therapy has been shown to be effective in treating a variety of conditions, including bacterial vaginosis. By strengthening the pelvic floor muscles, this therapy can help improve symptoms such as pain and discomfort in the uterus. It can also help with other issues such as urinary incontinence and pelvic organ prolapse. Additionally, pelvic floor physical therapy can have long-term benefits, as it teaches patients how to properly engage and relax their pelvic floor muscles to prevent future issues.

The Connection Between Bacterial Vaginosis and Pelvic Floor Pain

How Bacterial Vaginosis Affects the Pelvic Floor

Bacterial vaginosis is a common vaginal infection caused by an imbalance of bacteria in the vagina. This imbalance can lead to inflammation and irritation in the vaginal area, which can also affect the surrounding pelvic floor muscles. The pelvic floor muscles are responsible for supporting the bladder, uterus, and rectum, and any inflammation or infection in this area can cause pain and discomfort.

Common Symptoms of Pelvic Floor Pain Caused by Bacterial Vaginosis

One of the most common symptoms of pelvic floor pain caused by bacterial vaginosis is a feeling of pressure or heaviness in the pelvic area. This can be accompanied by pain or discomfort during sexual intercourse, urination, or bowel movements. Some individuals may also experience lower back pain or pain in the lower abdomen.

Other Potential Causes of Pelvic Floor Pain

While bacterial vaginosis is a common cause of pelvic floor pain, there are other potential causes that should also be considered. These include pelvic floor muscle tension or spasms, endometriosis, and pelvic inflammatory disease. It is important to consult with a healthcare provider to determine the underlying cause of pelvic floor pain and develop an appropriate treatment plan.

The Role of Pelvic Floor Physical Therapy in Treating Bacterial Vaginosis-Related Pain

How Pelvic Floor Physical Therapy Can Help with Bacterial Vaginosis

Pelvic floor physical therapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. It can be highly effective in treating bacterial vaginosis-related pain because it targets the root cause of the pain, rather than just masking the symptoms. By addressing the underlying issues in the pelvic floor, pelvic floor physical therapy can help to alleviate pain and discomfort caused by bacterial vaginosis.

Specific Techniques Used in Pelvic Floor Physical Therapy for Bacterial Vaginosis-Related Pain

There are several techniques that may be used in pelvic floor physical therapy to treat bacterial vaginosis-related pain. These may include pelvic floor muscle exercises, manual therapy, biofeedback, and relaxation techniques. Pelvic floor muscle exercises can help to strengthen and relax the muscles in the pelvic floor, while manual therapy can release tension and improve blood flow in the affected area. Biofeedback can also be used to help patients become more aware of their pelvic floor muscles and learn how to control them. Relaxation techniques, such as deep breathing and mindfulness, can also be beneficial in reducing pain and promoting overall relaxation in the pelvic floor.

Expected Outcomes and Success Rates

Studies have shown that pelvic floor physical therapy can be highly effective in treating bacterial vaginosis-related pain. Additionally, pelvic floor physical therapy has been found to have long-term benefits, with many patients experiencing continued improvement even after completing their therapy sessions. By addressing the root cause of the pain and providing targeted treatment, pelvic floor physical therapy can help to alleviate pain and improve overall quality of life for those suffering from bacterial vaginosis-related pain.

Other Considerations and Precautions

When to seek medical attention

If you are experiencing pain in your uterus or pelvic floor, it is important to seek medical attention to determine the underlying cause. This is especially important if you have been diagnosed with BV or have a history of recurrent BV.

Tips for preventing bacterial vaginosis and pelvic floor pain

While BV cannot always be prevented, there are some steps you can take to reduce your risk of developing it and experiencing pelvic floor pain:

  • Practice good hygiene, including washing your hands before and after using the bathroom and before and after sexual activity

  • Avoid douching, as it can disrupt the natural balance of bacteria in the vagina

  • Use condoms during sexual activity to reduce the risk of STIs

  • Wear cotton underwear and avoid tight-fitting clothing to allow for proper air circulation

  • Take probiotics or eat foods that contain probiotics, such as yogurt, to help maintain a healthy balance of bacteria in the vagina

It is also important to follow any treatment plans prescribed by your doctor or pelvic floor physical therapist to help prevent recurrent BV and manage any pelvic floor pain that may be present.

Reach Out to Us

If you are experiencing pelvic floor dysfunctions associated with the issues above, please 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

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