Vaginismus: A Patient Story - Legacy Physical Therapy
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Vaginismus: A Patient Story


We want to highlight a condition that we commonly see here called Vaginismus. This is a condition where there is involuntary muscle spasm of the pelvic floor muscles which prevents vaginal penetration. 

When a woman has vaginismus, her vaginal muscles start squeezing or spasming when something is trying to enter the vagina. 

This could be:

  • A tampon
  • The speculum during a gynecological exam
  • Penis insertion or other insertion with intercourse. 

The discomfort can range from being mildly uncomfortable, to being painful to being completely impossible to allow any insertion. Painful sex is often the first sign that someone is experiencing vaginismus. A majority of the time the only time discomfort will occur is regarding any type of penetration activity and it will typically go away after withdrawal, but not always. 

Our patients often described the pain as a tearing or ripping sensation or sharp knife-like pain or feeling like something’s hitting a wall & nothing can go further. 

We want to share a patient story, because many women are not aware that there is treatment for this condition. We are going to call her “Pam” for this patient story. 

Pam is a 38 year old teacher who attended one of our pelvic pain classes. She came and spoke to us after the class and told us she has been unable to have sex for the last 20 years because of pain. She has seen many providers, endured painful gynecological exams, but never received a diagnosis or any suggestions for treatment. It was actually her friends, who were sex and trauma therapists, who recommended that she try pelvic physical therapy. 

 We got her evaluation scheduled with us for the next day. After a thorough evaluation, we determined that Pam had involuntary spasming of the pelvic floor muscles with attempts at vaginal penetration. 

We started out by helping Pam learn how to relax the pelvic floor muscles. We used different techniques like visualization, deep breathing, and active movement of the pelvic floor muscles. Once she was able to locate and move the pelvic floor muscles and help them relax, we introduced something called vaginal dilators. 

Vaginal dilators are phallic shaped objects that can range in size so we can progressively go up in size from smaller to larger so that women can get a graded exposure to stretch the vaginal opening and the pelvic floor muscles. They can be an extremely helpful treatment option for women dealing with pain, fear and or anxiety associated with any type of touch at the vaginal opening or insertion. 

 Pam worked with us for several weeks and was able to successfully progress up in size with the dilators over time. And after about eight weeks, she came in for a PT appointment and just sat down in the chair and started to cry tears of joy, because she said that she was able to have pain free intercourse with her partner for the first time ever. 

Pam’s story is one of those that we hear unfortunately all too often here at Legacy, where she went years without knowing what was happening with her body and that there were options for treatments. If you are someone who is experiencing pain with vaginal penetration, please know that you are not alone, and there is help.

Give us a call at legacy physical therapy to talk to one of our pelvic floor physical therapists.