Vaginismus is a sexual dysfunction where women are unable to have vaginal penetration. This is because the muscles of the pelvic floor surrounding the vagina contract involuntarily resulting in the vagina clenching shut. This leads to pain on attempt of penetration and a lot of women opt to withdraw from having any type of sexual intercourse. Most women with vaginismus would also have problems to insert a tampon, have a vaginal exam or any other type of vaginal penetration.
Some women have never managed to have a successful penetration and opt to halt sex (primary vaginismus) whilst others develop vaginismus at a point in their life even if previously they would have had successful penetrations (secondary vaginismus).
Physical therapy is only a part of the possible treatment for vaginismus. The physiotherapist first takes a complete medical, psychological and sexual history and discusses the reason for seeking help and the goals and plan of treatment. This should always be done in conjunction with other therapies provided by qualified sexual therapists. The physiotherapist aims to guide the women with learn how to control the pelvic floor muscles to be able to consciously relax her muscles. This can be done through breathing techniques and relaxation exercises, pelvic floor control exercises and once the woman is ready through the use of vaginal dilators. Vaginal dilators come is sets of different sizes, with the woman starting her therapy with the smallest one gradually progressing the size until the woman is able to insert the largest dilator all the way into her vagina without pain, discomfort or muscle spasms. With the help of the sexual therapist a women could then progress to sexual intercourse and penetration.