Sue's Vaginismus Made Intercourse Attempts Unsuccessful and Sex Impossible

Her primary complaint was that she had never been able to consummate her marriage after 39 years due to vaginal pain. With pain described as sharp, burning, and a solid wall her husband was not able to penetrate through, she underwent sex therapy for months. Her therapist finally determined that her problem was not psychologically rooted in her mind; rather, it was physically rooted in her pelvis. 

Sue, a 60-year-old woman, was referred into Sarton Physical Therapy with the diagnosis of vaginismus by her sex therapist.

Upon exam, Sue was found to have severe pelvic floor muscular spasm/vaginismus, making intercourse attempts unsuccessful and sex impossible. Specifically, Sue presented with significant and severe muscle hypertonicity/spasm of her superficial pelvic floor muscles, including her transverse perineal muscles, ischioavernosus, bulbocavernosus and pubococcygues muscles. All of these muscles were shortened with multiple trigger points, and too much muscle activity at rest was noted on both sides. Physical therapy did not have a positive Q-tip test which helped us rule out Vestibulodynia as a cause of her inability to have intercourse.

Sue's Vaginismus Treatment Plan

Sue underwent 6 months of intensive pelvic floor physical therapy, receiving external and internal advanced manual therapy to address her pelvic floor muscle spasm/vaginismus.

External dysfunction including panniculosis around the bony pelvis and a pelvic obliquity was treated and addressed. She was educated on pain science, had graded exposure to dilators and was taught a home program to use dilators.

A thorough lengthening and strengthening program of other muscles that influence the pelvic floor was instituted. A vaginal muscle relaxant suppository was recommended (20 mg of Baclofen), and Sue used this each night for 3 months before using her dilators to help break the pain-spasm cycle.

Physical therapy helped reduce her long standing muscle spasm by 75% with successful progression to the 3rd size dilator. In order for her to advance to the 4th dilator (which equates to the average size of a male penis), a referral was made to a Urogynecologist for botox to the pelvic floor muscles to address her remaining refractory muscle spasm.

Healing from Vaginismus

Once delivered, physical therapy was able to help reduce the remaining spasm and Sue was able to successfully consummate her marriage and routinely have intercourse with her husband.

Regardless of how long you have suffered with vaginismus, pelvic floor physical therapy can help resolve your symptoms. Our expert pelvic floor physical therapists are here to help guide the way to resolution of your vaginismus.

Learn more about vaginismus.