Vaginismus physical therapy: how pelvic floor therapy and vaginal dilators can help

Vaginismus falls under genito-pelvic pain/penetration disorders , making vaginal penetration extremely difficult or even impossible due to involuntary contractions of the pelvic floor muscles. This can prevent sexual intercourse, tampon use, and even gynecological exams.

Types of Vaginismus

• Primary Vaginismus: When a woman has never been able to achieve comfortable vaginal penetration.

• Secondary Vaginismus: When a woman develops vaginismus after previously having pain-free penetration. This can be due to trauma, childbirth, or medical conditions such as endometriosis or infections.

Regardless of the cause, rehabilitation for vaginismus can help retrain the muscles and make penetration possible without pain.

Before my first vaginismus physical therapy appointment, I was nervous. Would it be like yoga? Would the therapist physically stretch my vagina? I had no idea what to expect, and the fear of the unknown was overwhelming.

But as soon as I met my physiotherapist treating vaginismus , my anxiety eased. She greeted me warmly and walked me through everything in a way that felt empowering rather than embarrassing.

The first session involved discussing my medical history, understanding the causes of my vaginal pain, and going over the treatment options. She reassured me that I wasn’t alone and that physical therapy for vaginismus is a well-established and effective treatment.

Pelvic floor physical therapy includes both external and internal techniques to help desensitize the muscles and gradually allow for penetration.

What to expect during vaginismus physiotherapy sessions

• External work: Stretching exercises, relaxation techniques, and posture correction to reduce tension in the pelvic region.

• Internal work: A trained pelvic floor therapist will use gentle techniques to help stretch and relax the vaginal muscles.

• Homework: Exercises to do at home, including vaginal dilator therapy, relaxation techniques, and mindfulness practices.

During sessions, my therapist would play relaxing music, provide heating pads, and make the process as comfortable as possible. It was far less intimidating than I had imagined, and for the first time, I felt in control of my body.

At-home therapy is an essential part of rehabilitation for vaginismus , and vaginal dilators are a major tool in the process. These are medical-grade devices that come in different sizes to help gradually train the vaginal muscles to relax and expand.

My Vaginal Dilator Routine:

1. Create a relaxing environment—Netflix, soft lighting, and a heating pad.

2. Use plenty of lubricant.

3. Start with the smallest dilator (about the size of a tampon) and progress to larger sizes over time.

4. Pair the process with deep breathing and relaxation techniques.

One tip: Watch something engaging while using the dilators. Your brain will associate the experience with relaxation instead of pain, making the process much easier.

Vaginismus physical therapy isn’t just a physical process—it’s an emotional one too. Many women, including myself, feel shame, frustration, or even hopelessness before starting treatment. But through physical therapy for vaginismus , I realized that I wasn’t broken. My body wasn’t betraying me—it just needed some guidance to relearn how to relax and function without pain.

This experience has also taught me how important it is to talk openly about sexual health. Too many women suffer in silence, believing that pain during sex is “normal” when it’s absolutely not. Physiotherapists treating vaginismus are out there, ready to help, and it’s time we bring these conversations into the mainstream.

If you’re struggling with painful sex or penetration difficulties, know that you’re not alone. Vaginismus physical therapy is a proven treatment that has helped many women, including me, overcome this condition.

There are multiple treatment options, including:

• Pelvic floor therapy with a trained specialist.

• Vaginal dilators to gradually train the muscles.

• Topical treatments to reduce discomfort.

• In some cases, surgical options if needed.

The most important thing is to seek help and start the journey toward pain-free intimacy. Rehabilitation for vaginismus is possible, and with the right support, you can regain control over your body and enjoy a pain-free sex life.

If you’re considering vaginismus physiotherapy , don’t wait—reach out to a specialist today. And remember, sex should never be painful. If it is, there’s help available!