Let’s talk about painful sex, baby! Vaginismus is the involuntary spasm or tightening of muscles around the vagina, which can make penetrative intercourse painful or impossible. Vaginismus can occur during the first time of vaginal penetration or begin after having prior pain-free experiences. It is important to understand the signs and symptoms and know that there are treatments to help! Read on for suggestions on decreasing your pelvic floor tightness.
On the first day of Vaginismus My PT gave to me….
Day 1: Happy Baby stretch
A good stretch for your pelvic floor and your hips! Lay on your back with your feet up in the air as if you are standing on the ceiling. Grab the inside of your feet and bring your knees to either side of your chest. Hold for 5 breaths.
Day 2: Child’s pose stretch
Another great stretch for your pelvic floor and your hips is child’s pose. Start on your hands and knees with your toes together and your knees wide apart, rock your hips back onto your heels. Hold for 5 breaths.
Day 3: Adductor rocking stretch
Tight inner thigh muscles can increase tightness in your pelvic floor. It is helpful to stretch surrounding muscles such as hips, groin, and lower back. For this stretch, start on your hands and knees. Place one leg straight out to the side and rock back onto your heel, feeling a stretch on your inner thigh. Perform 5x on each side.
Day 4: Deep squat stretch
One of the best positions for stretching your pelvic floor muscles is a deep squat stretch. You can get into this position by holding on to TRX straps, a counter, or a bedpost. With wide feet, squat down as far as you can. Hold for 5 breaths.
Day 5: Full body relaxation or mindfulness
Being able to relax your mind and reduce stress can help downregulate your nervous system, in turn reducing the tension in your pelvic floor. There are many helpful apps and YouTube channels to assist with mindfulness and meditation. A couple of apps I recommend are Calm and Headspace.
Day 6: Diaphragmatic breathing
A great start to a healthy pelvic floor is to practice diaphragmatic breathing. During a breath, your pelvic floor and your diaphragm should mirror each other. When you inhale your pelvic floor should lengthen and relax and when you exhale your pelvic floor muscles will return to a resting position. A good way to practice this is to start in a comfortable position, with one hand on your belly and one on your chest. Inhale through your nose and breathe deeply into your belly and pelvic floor, exhale slowly, and repeat.
Day 7: Pelvic Floor Massage
Pelvic floor massage is useful for stretching tight muscles. A trained pelvic floor physical therapist can stretch the pelvic floor muscles either internally or externally, to improve the flexibility of the tissues and to help desensitize the painful area.
Day 8: Vaginal wand
A vaginal wand is a tool used to assist with self-pelvic floor muscle stretching. A wand allows you to manage trigger points throughout your musculature. See the video below for more details.
How to use a vaginal wand:
Day 9: Dilator instruction
Dilators are another set of tools used to decrease pain and tightness in your pelvic floor musculature. They come as a set of different size dilators to assist with a prolonged stretch to improve vaginal flexibility. See the video below for more details on dilators.
How to use a dilator:
Day 10: Biofeedback
Biofeedback is another tool used to teach relaxation of pelvic floor musculature. A physical therapist will use biofeedback to give feedback for decreasing the tightness and tension in the pelvic floor.
Day 11: Lubricant samples
Vaginal dryness can contribute to pain during intercourse. The use of lubricants can decrease friction during vaginal penetration and decrease pain.
Day 12: Seeing a pelvic floor PT
A comprehensive pelvic floor assessment with a skilled PT can evaluate your specific needs. Your PT will come up with a tailored plan to assist with reducing pain during intercourse. See the video below explaining what a pelvic floor internal assessment consists of and schedule your appointment.
What is a Pelvic Exam?
If you are still experiencing painful intercourse, a pelvic floor physical therapist may have the solutions for you. Reach out to your local provider for assistance.