Pain With Sex

Why You Can’t Just “Relax”: Treating Vaginismus

As a Pelvic Physical Therapist, my passion lies in helping individuals overcome pelvic floor disorders and conditions that affect their quality of life. One such condition that often goes undiscussed and misunderstood is vaginismus. Vaginismus is a condition characterized by involuntary muscle spasms in the pelvic floor muscles, making penetration painful or impossible. It’s not merely a matter of “relaxing” or “unwinding” with a glass of wine, as some may believe. Rather, treating vaginismus requires comprehensive treatment tailored to each individual’s needs. Let’s dive in and learn more!

Image of a couple that are disgruntled.

Understanding Vaginismus

Vaginismus can be caused by trauma to your body that happened many years ago and is showing now. 

Maybe you’ve had a tailbone injury or a fractured hip, and now it’s affecting your pelvic floor muscles. 

It can be a result of a difficult childbirth, yeast infection, hormones, or anything relating to your pelvic floor.

It’s common, and so many factors can contribute to this pain. We need to find the root cause of your specific problem to get you back to being healthy and enjoying sex again.

Diving Further In:

Vaginismus can be categorized into two types: primary and secondary. Primary vaginismus occurs when a person has never been able to have penetrative intercourse due to involuntary muscle contractions. Secondary vaginismus occurs when a person who was previously able to have penetrative intercourse experiences difficulty or pain later on.

As mentioned, the causes of vaginismus can be multifaceted. It may stem from psychological factors such as past trauma, anxiety, fear of pain, or negative sexual experiences. Additionally, physical factors such as pelvic floor muscle tension, infections, or hormonal imbalances can contribute to the condition. Even cultural, religious, and environmental factors can impact your pelvic floor, causing vaginismus.

Image of person holding a papaya at their waistline.

Treating Vaginismus

You may have tried some painkillers to ease your pain or even drank a glass of wine thinking it’d relax your muscles. Here’s the truth: it won’t help you, and it’s not a solution to your problem.

Maybe you’ve tried to have sex more gently or switch positions and that also failed. 

I know how awkward and difficult it is to acknowledge and speak to someone about your intimate health problems. However, unless you do it, you won’t be able to recover from your vaginismus that’s been keeping you in pain for so long. 

You need to reach out to an expert, like myself, to find out what’s really going on in your pelvic area and how we can treat it.

My Approach to Treating Vaginismus:

Pelvic floor physical therapy is all about treating your body using natural remedies. 

As a Pelvic Physical Therapist, my approach to treating vaginismus is holistic and patient-centered. It involves a combination of education, manual therapy, and pelvic floor exercises to address both the physical and psychological aspects of the condition.

Darshana demonstrated pelvic muscles on an anatomy model in a pelvic floor therapy session. Pelvic floor therapy is one approach for treating vaginismus.

Holistic Approach:

Our brain, body, and bottom parts are constantly talking to each other and they reflect each other’s behaviors. 

It’s a very well-researched phenomenon that when clinicians use a model to understand how your body and mind interact with the world, it helps us get a better understanding of how the body works. 

Painful sex is very difficult for women. Sometimes, it’s culturally inappropriate to talk about it even though it’s such a common issue among many women. 

A lot of the time women are getting these messages from their worlds, culture, religion, family, or a therapist and not ask for more.

This means that a lot of the time we need to look at the psychological aspect of your problem and your belief system before we dive into the physiological side of your condition. 

Because of this, I look at my patients from a holistic point of view and try to understand all the factors, not just the physical ones when I get to the root cause of your problem and treat it.


I firmly believe in educating women about what’s normal and what’s not when it comes to their bodies and health. 

Even in today’s age with all the resources like social media and different ways to gather knowledge, we still don’t have enough awareness and education on what’s normal and expected regarding female intimate health.

Educating women is so powerful and life-changing. If they know what is expected, what is “normal,” and even simply the anatomy of their vagina, they will be empowered to take control of their pelvic health. 

Sometimes women come to me with no words to describe what’s happening. I often hear that “it hurts down there” but I don’t know what “it” is. Is it the hood of your clitoris? Your vagina? What is it that’s hurting you?

If you can advocate for yourself, you get a better chance of getting more appropriate care for your problems. Education is a huge gap that needs filling when it comes to women’s intimate health. 

This is why I will not only treat your problem but also teach you about your body. You will have a better understanding of your pelvic health and how to take control of your healthy life, including having pain-free sex.

Pelvic floor muscle tension is a common underlying factor in vaginismus. I use manual therapy techniques such as myofascial release, trigger point release, and stretching to help relax and lengthen the pelvic floor muscles.

Focusing on Prevention:

Another strong belief that I have is that prevention is better than cure. 

This is why I am here to teach you about your pelvic health. 

As a Pelvic Floor Physical Therapist, I will treat your condition and help you recover fast and naturally, so you can return to being sexually active and fulfilled. I will also give you guidance on how to take care of your health, so you don’t have to see me in the future. 

You don’t deserve to be in lifelong pain – nobody does.

This is why I am dedicated to continuous research, training, and writing books and advice reports on women’s pelvic health. Women from everywhere have the right resources to learn about their pelvic health and know what to do to stay healthy. 

Your hole health is your whole health. You need to know how to care for your women-parts to feel empowered and confident in your body.

No “Band-Aid” Approach:

That’s right. In my clinic, we will never give you a band-aid solution to a problem that requires proper examination and a personalized treatment plan specific to you and your needs. 

We all want to get an instant fix, but there just isn’t anything like that. 

When you get a band-aid solution, you will feel amazing… for a few days. Then it’s back to square one and even more pain. 

We need to dig deeper into your issue until we find the root cause of what’s been causing you pain and discomfort. 

If we can get to the bottom of it, the chances of it coming back are smaller cause now we understand the problem a lot better. We know how to implement preventative tactics to keep you healthy in your body. 

We want to find out the real cause of your problem and get rid of it for good so we don’t have to see you week after week.

Getting What You’re Ready to Receive:

When it comes to treating vaginismus, some patients are ready to receive internal manual therapy. They’re okay with all the exams and aggressive treatment approach. 

However, other patients find it intimidating that they have to go to speak to a doctor about their sex lives, peeing in pants, or other pelvic problems that may feel awkward.

I appreciate and recognize how difficult it is for you to come to me and seek help. I appreciate your courage to share intimate details of your life to get better. 

My aim is to meet people where they are and give them the choice of treatments that will be comfortable for them. 

Sometimes, women come to me because they’re having pain during sex. They want to solve this so they can get pleasure from having sex again. Other times, women struggle with pain during sex and they want to get pregnant. 

It seems like these are the same things, but they’re not and they require different treatment approaches. 

I will give you a choice of treatment to get you to where you want to be and help you achieve your goals. 

I am an expert when it comes to treating painful sex. However, my patients are experts when it comes to their lives, schedules, and body priorities. I want to collaborate with them to meet them where they’re at and provide them with the best treatment for their specific needs. I will always include these pieces in my approach to treating vaginismus:

Pelvic Floor Exercises:

Pelvic floor muscle retraining plays a significant role in treating vaginismus. I teach my patients relaxation techniques, diaphragmatic breathing, and specific exercises to improve muscle coordination and control.

Gradual Exposure:

Gradual exposure to penetration is a fundamental aspect of treatment for vaginismus. I guide my patients through a step-by-step process of gradually increasing exposure to vaginal penetration using dilators or other appropriate tools, always prioritizing their comfort and autonomy.

Support and Follow-Up:

Treating vaginismus requires patience, persistence, and ongoing support. I provide my patients with compassionate care, regular follow-up appointments, and resources to help them navigate challenges and celebrate progress along their journey to recovery.

image of an anatomical model of the vagina. education about body parts is one approach for treating vaginismus.

Treating Vaginismus: TL;DR

Vaginismus is a complex and often challenging condition, but it is not insurmountable. As a Pelvic Physical Therapist, I am dedicated to providing comprehensive and compassionate care to individuals with vaginismus. I want to help them reclaim their sexual health and overall well-being. Treatment goes beyond simply “relaxing” with a glass of wine. It involves a holistic approach addressing both the physical and psychological aspects of the condition. With the right support, education, and therapeutic interventions, individuals with vaginismus can overcome their challenges and thrive.

Darshana sitting with a bony pelvic model

If you’re in the Seattle area, I can help! I know you might be nervous, and unsure whether pelvic floor physical therapy is right for you. That’s why I offer two FREE ways to speak to me, and my expert team in our Seattle clinic. You can either speak to us over the telephone or come into our clinic. You can get answers to your questions, get personalized advice, and learn about the safe, proven, and natural ways we can treat your problem fast and naturally!

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