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Explaining One Common Cause of Pelvic Pain - Vaginismus

Pelvic pain is such a vast topic, that it’s impossible for me to cover it all in one blog post. So, we’re going to start with something that is common, but on its own can be easy to treat – Vaginismus.


What is Vaginismus?

Basically, Vaginismus is when the muscles of the superficial pelvic floor (so the ones at the entrance), are too tight.

Too tight for what?

Inserting tampons, penetrative intercourse, or masturbation, or having the dreaded pap smear from the doctor. Basically, anything that needs to pass through the vaginal muscles feels tight, uncomfortable, or painful.

Now, I’m not talking about any other types of pain here, like when the entrance of the vagina or the clitoris is sore to touch, or deep abdominal pain with penetration, I’m talking about vaginal entrance pain with penetration exclusively.

Muscles of your Superficial Pelvic Floor

Pelvic Pain can exist for a variety of reasons (like we said – vast topic), but vaginismus is limited to the pain that is felt with penetration – from tampons to intercourse. When we look at the location of the muscles – this makes sense, right?

So how do we develop Vaginismus?

Some women seem to have tighter vaginal openings than others right off the bat, and struggle with intercourse or inserting tampons from when they’re a teenager. These women may genetically have tighter tissue and smaller vaginal openings. Some women, however, develop vaginismus over time.

So, what causes the muscles to tighten (or perhaps to not let go?)? Perhaps the muscles are tight because you’ve hard core exercised them, every day, because you love your Pilates classes (I also love my Pilates classes), but you then didn’t give them a chance to just relax and let go. So now your pelvic floor muscles are just on, all the time. It’s like walking around with your hand touching your shoulder for a week. When you try and straighten your arm after that, your bicep muscle is going to be stiff and sore, and you probably won’t be able to get your elbow straight right away.

Another cause might be suffering from prolapse, urine or faecal incontinence (leaking), or perhaps you’ve had really bad diarrhoea for a period of time because your guts are unhappy. If your pelvic floor is having to work non-stop to help you maintain your continence or keep your organs inside you, as best it can, that bad boy is never letter go. So, when you then ask it to relax and allow a tampon or a penis to enter, it’s telling you that it just can’t do that.

Finally, sometimes we are just stressed out. We know we clench our jaw when we’re stressed, our breathing patterns change as well. But did you now that we sometimes also clench our abs and our pelvic floor? Yep. So sometimes it has nothing to do with the pelvis at all, and more to do with the rest of your life.

Start to breathe deeply, daily.

Breathing is a great first step towards improving your pelvic floor function – do this for just 5 minutes every day and see whether it makes a difference!

So, what do we do?

I’d highly recommend seeing a Pelvic Health Physiotherapist to start with. Having a good assessment of you as a person and your pelvic floor will guide us to figure out why you’re struggling with penetration, and what might be the consequences, both good and bad, if we do convince your pelvic floor to relax and lengthen out.

The next thing I want you to do is start to breathe deeply, daily.

Lying on your back with the soles of your feet together and your knees flopped out to the sides (you can prop some pillows under your legs if you’re not very flexible!). Put one hand on your chest and one on your belly and breath gently, in through your nose, out through the nose or mouth, until you can get your belly hand to move and your chest hand to stay still. Once you’ve nailed this, start taking slightly bigger breaths and focus on feeling the air pushing your lower ribcage outwards, keeping your upper chest from rising.

Bring your mind to your pelvic floor and imagine that you’ve dropped a stone into a pond, and your watching the ripples of the rings that it made get bigger and bigger and stretch out. Now pretend your pelvic floor is doing that, dropping down and lengthening out, with every one of your big breaths.

Do this for 5 minutes every day and see whether it makes a difference.

Breathing is a great first step towards improving your pelvic floor function, but there are also plenty of other things that we can do in Physio to help reduce your pelvic pain. So, if this little breathing exercise hasn’t helped your pelvic floor relax or it’s helping but you need more, book in to see a Pelvic Health Physiotherapist today.

Feeling like you need an expert on your side?

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