Physiotherapy Treatment for Vaginismus
Vaginismus is an involuntary contraction of muscles around the opening of vagina in women causing muscle spasms with no abnormalities in the genital organs.
- Primary Vaginismus -Pain with or an inability to tolerate insertion upon first attempts(usually a tampon or finger around puberty).
- Secondary Vaginismus -Pain or Spasm that is developed in later stages of life.It can also result fom menopause or gynecological cancers.
- Anxiety and fear of having sex
- Traumatic life events like rape
- A belief that sex is wrong
- Relation problems
- Painful medical conditions like Pelvic Surgery
- Dysparenia (pain during intercourse)
- Pain during tampon insertion
- Pain with bowel movements
- Pain during gynecological examination
- Muscle Spasm
- Based on Symptoms and Examination
- Education and Counseling
- Behavior therapy
Medical treatment -Drugs like Vaginal diazepam.
Goals of treatment
- To reduce involuntary tightening of pelvic floor muscles mainly pubococcygeus.
- To reduce fear of pain.
Exercise Protocol followed at Progressive Care :
In this condition there is usually significant pelvic floor dysfunction that needs to be addressed first.
- Relaxation techniques – Breathing Exercises and gentle touching exercises.
- For Chronic pain – Internal Pelvic floor Myofascial treatment.
A Randomized Clinical Trial was presented at International Pelvic Pain Society Conference and has been published in the Journal of Urology (2012) which demonstrated that this exercise was effective in 59% of patients compared to generalized massage therapy.
- Vaginal dilators.
- Pelvic floor strength training
- Pain education
- Biofeedback – To learn how to relax muscles , to minimize pain,to reduce anxiety.