What is vaginismus?
Vaginismus is a condition where the muscles around the vagina involuntarily contract, making it difficult or impossible to have vaginal penetration.
Do I have vaginismus?
If you answer yes to one or more of the following questions, you must book an appointment with a pelvic health physiotherapist to find out if you have vaginismus.
“Sex is so uncomfortable for me.”
“Why does it hurt to have sex? My doctor cannot find anything wrong with me.”
“Internal pelvic exams are a no for me – they are so painful.”
“My vagina feels like a fort that is impenetrable. I never realized it was vaginismus.”
“I used to have great sex, but now I close up—it burns and stings.”
“When my partner starts to move inside me, it hurts and we have to stop.”
“I don’t wear tampons because they don’t go in.”
What are the symptoms of vaginismus?
The symptoms may differ between younger and older women, emphasizing the significance of an accurate diagnosis and effective treatment for vaginismus.
The primary symptoms of vaginismus are:
- Sexual penetration seems physically impossible despite repeated attempts
- Difficulty inserting tampons from youth even after repeated attempts.
- Difficulty undergoing internal pelvic/gynecological exam
What are the causes of Vaginismus?
The exact causes of vaginismus can vary from person to person, and in many cases, the condition is multifactorial, meaning that multiple factors may contribute to its development. Here are some potential causes and contributing factors:
- Psychological factors: Emotional or psychological factors can play a significant role in vaginismus. Past traumatic experiences, such as sexual abuse, rape, or a history of painful intercourse, can contribute to the development of vaginismus. Anxiety, fear, guilt, or negative beliefs about sex can also trigger involuntary muscle contractions.
- Fear of pain or discomfort: Some individuals may develop vaginismus due to a fear of pain or discomfort during sexual intercourse. This fear can be based on previous painful experiences, cultural or religious beliefs, or misinformation about sex.
- Relationship issues: Difficulties in the relationship, such as poor communication, lack of trust, unresolved conflicts, or sexual problems, can contribute to the development or persistence of vaginismus. Emotional or physical distance between partners can create tension and anxiety during sexual activity.
- Cultural or religious factors: Cultural or religious beliefs and practices surrounding sex can influence a person’s perception of sexuality and contribute to the development of vaginismus. Upbringing that emphasizes guilt, shame, or negative attitudes towards sex can lead to involuntary muscle contractions during attempts at vaginal penetration.
- Lack of sexual education: Insufficient knowledge or understanding about sexual anatomy, arousal, and relaxation techniques can contribute to vaginismus. Inadequate sexual education may lead to misconceptions, anxiety, and fear surrounding sexual activity.
- Medical conditions or infections: Certain medical conditions, such as vaginal infections, urinary tract infections, endometriosis, or pelvic inflammatory disease, can cause pain during sex, leading to the development of vaginismus. Vaginal dryness or atrophy, often associated with menopause, can also contribute to discomfort and muscle tightness.
- Traumatic childbirth experiences: Some women may develop vaginismus after experiencing a traumatic childbirth, especially if they had a difficult or painful delivery. The association of vaginal penetration with the traumatic event can trigger involuntary muscle contractions.
What are the treatment options for vaginismus?
Pelvic health physiotherapy is a common treatment option for vaginismus. It involves a physical therapist working with the patient to help relax and strengthen the pelvic floor muscles.
Possible treatments include:
- Progressive pelvic floor muscle relaxation
- Biofeedback or muscle stimulation
- Yoga-based therapy
- Hip mobility work
- Lumbar spine mobility work
What can I expect during an assessment and treatment for vaginismus at Triangle Physiotherapy?
Assessment
The first step in pelvic health physiotherapy for vaginismus is usually an assessment of the patient’s pelvic floor muscles. This may involve an internal examination, but the therapist will always seek the patient’s consent and respect their comfort level.
Treatment
Once the assessment is complete, the therapist will develop a treatment plan tailored to the patient’s needs. This may involve exercises to strengthen the pelvic floor muscles or techniques to help the patient relax those muscles.
Techniques
One common technique used in pelvic health physiotherapy for vaginismus is called progressive muscle relaxation. This involves tensing and then releasing the pelvic floor muscles in a controlled way to help the patient become more aware of them and learn how to control them.
Another technique that may be used is biofeedback. This involves using sensors to monitor the activity of the pelvic floor muscles, which can help the patient learn to control them more effectively.
Overall, pelvic health physiotherapy can be an effective treatment for vaginismus, but it is important to work with a qualified physical therapist who has experience in this area. With patience, persistence, and the right guidance, many people with vaginismus can overcome their condition and enjoy fulfilling sexual relationships.
How do I find a pelvic health physiotherapist near me?
We have 8 locations with pelvic health physiotherapists to help you.
- Pelvic Health Physiotherapy Etobicoke – Triangle Physiotherapy Etobicoke
- Oakville Pelvic Health – Triangle Physiotherapy Oakville
- Pelvic Health Physiotherapy North York – Triangle Physiotherapy North York
- Mississauga Pelvic Health – Triangle Physiotherapy Mississauga
- Downtown Pelvic Health – Triangle Physiotherapy King West
- Uptown Toronto Pelvic Health – Triangle Physiotherapy Lawrence Park
- Pelvic Physiotherapy Downtown Toronto – Triangle Physiotherapy Queens Quay
- Mississauga Pelvic Health – Triangle Physiotherapy Erin Mills
Written by Roshni Ravi, Pelvic Health Physiotherapist.
Sexual health is an important aspect of overall health and well-being, but it’s not always an easy topic to talk about. Many women experience sexual health dysfunctions at some point in their lives, but they may feel embarrassed or ashamed to seek help by way of pelvic floor physiotherapy. There are currently large gaps in the sexual education provided at the elementary school level. Many sex ed classes are focused on birth control and how terrible periods are.
But there is not enough information, if any, on sexual health conditions and how to seek help. We’ve had a lot of conversations with patients about what they wish they had learned in sex-ed. In this blog post, we’ll explore some of the most commonly asked questions about sexual health dysfunctions in women and offer some tips for managing them.
What is pelvic floor physiotherapy?
Pelvic floor physiotherapy focuses on treating the muscles, ligaments, and connective tissues of the pelvic floor which is a group of muscles that form a supportive hammock-like structure at the base of the pelvis. They play a key role in maintaining continence, supporting the pelvic organs, and providing stability to the spine and hips.
Pelvic floor physiotherapy involves a range of exercises, manual therapy techniques, and education to help individuals with pelvic floor dysfunction. Common conditions that may benefit from pelvic floor physiotherapy include:
- urinary and fecal incontinence,
- pelvic pain,
- pelvic organ prolapse, and
- sexual dysfunction.
Why am I suffering from a low libido? Can pelvic floor physiotherapy help?
Many women experience a decrease in sexual desire at some point in their lives. This can be caused by a variety of factors, including stress, hormonal imbalances, and relationship issues. To manage low libido, it’s important to address any underlying issues and make self-care a priority. This can include:
- practicing stress-management techniques,
- getting enough sleep, and
- engaging in regular exercise.
Why does it hurt to have sex?
Painful intercourse, also known as dyspareunia, is a common sexual health dysfunction in women. It can be caused by a variety of factors, including vaginal dryness, infections, and hormonal imbalances. To manage painful intercourse, it’s important to work with a healthcare provider to identify the underlying cause and develop a treatment plan. This may include using:
- lubricants,
- treating infections,
- or using hormonal therapy.
I struggle to orgasm during sex, why does that happen?
Many women struggle to achieve orgasm during sexual activity which can be caused by a variety of factors, including, stress, relationship issues, and hormonal imbalances. To manage orgasmic dysfunction, it’s important to work with a healthcare provider or therapist to address any underlying issues and develop strategies for improving sexual function. This may include:
- practicing mindfulness or
- engaging in self-exploration techniques.
My vagina feels like a fort that is impenetrable. Why can I not have sexual intercourse?
Vaginismus is a condition in which the muscles of the vaginal wall contract involuntarily, making intercourse difficult or impossible. It can be caused by a variety of factors, including past trauma and anxiety. To manage vaginismus, it’s important to work with a healthcare provider or therapist to address any underlying issues and develop strategies for managing anxiety and relaxing the pelvic floor muscles.
What is vulvodynia? Do I need pelvic floor physiotherapy?
Vulvodynia is a chronic pain condition that affects the vulva, or external genitalia. It can cause burning, stinging, or itching sensations, and can make sexual activity painful or uncomfortable. To manage vulvodynia, it’s important to work with a healthcare provider to identify the underlying cause and develop a treatment plan. This may include:
- using topical creams or medications,
- practicing relaxation techniques, or
- seeing a pelvic health physiotherapist.
Help! I pee my pants!
Urinary incontinence is a common condition in which urine leaks from the bladder involuntarily. It can be caused by a variety of factors, including hormonal changes, pregnancy, and pelvic floor dysfunction. To manage urinary incontinence, it’s important to work with a healthcare provider or pelvic floor physiotherapist to develop a treatment plan. This may include:
- pelvic floor exercises,
- bladder training, or
- medications.
What are the signs of menopause?
Menopause can cause a variety of changes in sexual function, including vaginal dryness, decreased libido, and painful intercourse. To manage these changes, it’s important to work with a healthcare provider to develop a treatment plan. This may include:
- using hormonal therapy,
- vaginal moisturizers, or
- engaging in regular sexual activity to maintain pelvic floor health.
Where can I find a pelvic health physiotherapist near me?
We have 8 locations with pelvic health physiotherapists to help you.
- Pelvic Health Physiotherapy Etobicoke – Triangle Physiotherapy Etobicoke
- Oakville Pelvic Health – Triangle Physiotherapy Oakville
- Pelvic Health Physiotherapy North York – Triangle Physiotherapy North York
- Mississauga Pelvic Health – Triangle Physiotherapy Mississauga
- Downtown Pelvic Health – Triangle Physiotherapy King West
- Uptown Toronto Pelvic Health – Triangle Physiotherapy Lawrence Park
- Pelvic Physiotherapy Downtown Toronto – Triangle Physiotherapy Queens Quay
- Mississauga Pelvic Health – Triangle Physiotherapy Erin Mills
In conclusion…
Many women experience sexual health dysfunctions at some point in their lives, but they may feel embarrassed or ashamed to seek help. It’s important to remember that sexual health is an important aspect of overall health and well-being, and it’s important to prioritize it in your self-care routine. If you’re experiencing any issues related to sexual function, don’t hesitate to talk to your healthcare provider or a therapist about your options. Remember, there is help!
Click here to book your consultation with one of our knowledgeable and compassionate pelvic health physiotherapists.
Pelvic Floor Physiotherapy refers to a specific and advanced field within physiotherapy that deals with Pelvic Floor Dysfunction. Pelvic Floor Dysfunction can impact people of any age or gender and the term describes several conditions that may affect the urinary, reproductive, digestive, sexual, and/or stability systems in the pelvis.
Pelvic Health Physiotherapists have post-graduate training in pelvic health and can resolve many pelvic floor issues in people of all genders and ages.
What type of conditions can Pelvic Floor Physiotherapy help women with?
Pelvic Health physiotherapists at our clinics can help women with the following:
- Pelvic floor and abdominal weakness
- Bladder and bowel problems
- Pelvic pain (endometriosis, bowel, bladder pain)
- Pelvic organ prolapse (POP)
- Sexual dysfunction, vaginismus, painful intercourse
- Prenatal and postnatal care
- Diastasis Recti
- Labour and delivery prep
Can a pelvic health physiotherapist help men?
Pelvic Health physiotherapists at our clinics can help men with the following:
- Pelvic pain
- Bladder and bowel control problems
- Erectile dysfunction
- Pre and post prostatectomy
Can your pelvic health physiotherapists help transgender individuals?
Yes, our pelvic health physiotherapists can certainly help transgender individuals.
- Surgical preparation and recovery post-surgery
- Pelvic pain – Endometriosis or PCOS
- Intimacy pain, difficulty with penetration
- Pregnancy and postnatal care for Trans-parents
Pelvic Floor Assessment – what does it entail?
Your first appointment will last about an hour. Your pelvic health physiotherapist will discuss your medical history, do a thorough pelvic health assessment and propose a detailed individualized treatment plan to achieve your pelvic health goals. The assessment may include an internal examination, with your consent, of course, depending on your condition.
Triangle Physiotherapy and our pelvic health team are passionate about supporting our transgender and intersex community.
What should I bring to my appointment? What should I wear?
Make sure you have filled out the Health Questionnaire sent to you by our booking team. Bring any physician or specialist referrals to test results you may have. Please wear comfortable clothing, there are no specific requirements.
How many sessions will I need?
After your assessment, your physiotherapist will prepare a treatment plan for you and be able to indicate how many appointments you may need to achieve your pelvic health goals.
Can I attend my appointment if I have my period?
Your pelvic health physiotherapist can treat you while you have your period, as long as you are comfortable with it.
How do I book an appointment to see a pelvic health physiotherapist at Triangle Physiotherapy?
Triangle Physiotherapy has pelvic health physiotherapists at the following locations:
- Etobicoke Pelvic Health – Triangle Physiotherapy Etobicoke
- Mississauga Pelvic Health – Triangle Physiotherapy Mississauga, Triangle Physiotherapy Erin Mills
- North York Pelvic Health – Triangle Physiotherapy North York
- Toronto Pelvic Health – Triangle Physiotherapy King West, Triangle Physiotherapy Queens Quay, Triangle Physiotherapy Lawrence Park
- Oakville Pelvic Health – Triangle Physiotherapy Oakville
Pelvic organ prolapse (POP) is a condition in which there is a descent of the pelvic organs into or through the vaginal or anal canal. This can present as:
- a visible bulge in the above openings,
- pressure felt in the pelvic area,
- incomplete emptying of bladder or bowels,
- discomfort during intercourse.
The main reason for prolapse is increased pressure on the pelvic floor due to:
– Chronic constipation
– Bearing children
– Pelvic floor weakness due to hormonal imbalance
Conservative non-surgical management is the first line of treatment for POP.
Your pelvic floor physiotherapist will assess the severity of your symptoms, the strength of your pelvic floor and your ability to manage pressure and stresses to your pelvic floor. Treatment would include strengthening exercises for the core and pelvic floor muscles and coordination techniques for all the inner unit muscles.
The types of pelvic organ prolapse are:
- Anterior Wall Prolapse
- Posterior Wall Prolapse
- Rectal Prolapse
Depending on the grade and type of prolapse, you might be a candidate for a pessary fitting.
A pessary is a medical grade silicone device that is inserted into the vaginal canal in order to support the vaginal walls. If you are a candidate for a pessary, it must be fitted for you by a trained professional such as gynaecologists, nurses that have a certification in fittings or pelvic health physios that are specialized to do so.
We currently have 3 practitioners at Triangle Physiotherapy who are certified in pessary fittings.
Your pelvic floor deserves more than just kegels. Speak to a pelvic health physiotherapist today to get started!
Where can I find a pelvic health physiotherapist near me?
We have 8 locations with pelvic health physiotherapists to help you.
- Pelvic Health Physiotherapy Etobicoke – Triangle Physiotherapy Etobicoke
- Oakville Pelvic Health – Triangle Physiotherapy Oakville
- Pelvic Health Physiotherapy North York – Triangle Physiotherapy North York
- Mississauga Pelvic Health – Triangle Physiotherapy Mississauga
- Downtown Pelvic Health – Triangle Physiotherapy King West
- Uptown Toronto Pelvic Health – Triangle Physiotherapy Lawrence Park
- Pelvic Physiotherapy Downtown Toronto – Triangle Physiotherapy Queens Quay
- Mississauga Pelvic Health – Triangle Physiotherapy Erin Mills
Written by Roshni Ravi, Pelvic Health Physiotherapist
Stress incontinence is a type of urinary incontinence that occurs with physical activity or exertion. This can be from coughing, sneezing, laughing or exercise e.g. jumping. All of these actions can put pressure on the bladder thereby causing leaks. The pelvic floor is important in preventing this leaks and supporting the bladder.
Pelvic floor exercises such as a kegel are commonly recommended for leaks. However, a lot of time the pelvic floor is actually tight rather than weak. Reverse Kegels involve relaxing the pelvic floor muscles, allowing them to lengthen and release tension. This helps to prevent over-tightening and over-activity of the pelvic floor muscles, which can contribute to stress incontinence.
Hypertonic pelvic floor
Hypertonic pelvic floor refers to a condition where the pelvic floor muscles are in a state of excessive and persistent contraction. This can lead to a number of symptoms, including pelvic pain, urinary and fecal incontinence, and sexual dysfunction.
Hypertonic pelvic floor can be caused by a number of factors, including pregnancy, childbirth, surgery, chronic constipation, and chronic pelvic pain. It can also be a result of excessive or improper use of pelvic floor muscle exercises, such as Kegels.
Treatment for Hypertonic pelvic floor
Treatment for hypertonic pelvic floor typically involves a combination of physical therapy and relaxation techniques. Physical therapy may include manual therapy to release muscle tension, as well as exercises to stretch and relax the pelvic floor muscles. Relaxation techniques, such as deep breathing, progressive muscle relaxation, and biofeedback, can also be helpful in reducing muscle tension.
If you’re experiencing leaks, reach out to a pelvic floor therapist for an assessment or discovery call!
FAQ’s about Stress Incontinence
Q: What is stress incontinence?
A: Stress incontinence is a type of urinary incontinence that occurs when pressure is placed on the bladder, such as during coughing, sneezing, laughing, or exercising, and causes involuntary urine leakage.
Q: What causes stress incontinence?
A: Stress incontinence is typically caused by weakened pelvic floor muscles and/or a weakened urethral sphincter, which can occur due to aging, pregnancy and childbirth, menopause, obesity, chronic coughing, or certain medical conditions.
Q: Who is at risk for developing stress incontinence?
A: Women are more likely to develop stress incontinence than men, especially those who have gone through pregnancy and childbirth, menopause, or pelvic surgery. Other risk factors include obesity, chronic coughing, and certain medical conditions that affect the bladder or nervous system.
Q: How is stress incontinence diagnosed?
A: Stress incontinence can be diagnosed through a physical exam, a urine test, and other tests such as a bladder diary or urodynamic testing.
Q: What are the treatment options for stress incontinence?
A: Treatment options for stress incontinence may include:
- pelvic floor exercises,
- behavioral therapies,
- medications,
- medical devices such as pessaries, and in some cases,
- surgery.
Q: Can stress incontinence be prevented?
A: While stress incontinence may not be completely preventable, there are steps you can take to reduce your risk. Maintaining a healthy weight, doing regular pelvic floor exercises, and avoiding smoking and excessive caffeine consumption are some of these.
Q: Is stress incontinence a normal part of aging?
A: While stress incontinence is more common in older adults, it is not a normal part of aging and should not be ignored or accepted as an inevitable consequence of getting older. Treatment options are available, and seeking help from a healthcare provider is important.
A Diastasis Recti Abdominus is a separation in the 6-pack muscle, the rectus abdominis.
How does it occur?
It most often occurs during pregnancy. Sometimes it will spontaneously correct following birth, but it does not always.
It can also occur with overstretch of abdominal musculature.
Why is it a problem?
There is no pain with this condition.
However, the abdominal wall and the core will become weak. Your abdominals work with your pelvic floor, so a separation of your rectus abdominis muscles can make your pelvic floor less efficient and may result in prolapse and incontinence.Your abdominals also work with your lower back musculature, therefore it can lead to lower back pain.
How do I know if I have a Rectus Diastasis?
If you lift your head while lying on your back and the center of your belly protrudes out, you may have a rectus diastasis. It is measured by the number of fingers you can fit between the muscle when lying on your back and lifting your head. Normal is 1/2 a finger above and below the belly button, and one finger at the belly button.
How do I treat it?
If the abdominal separation is greater than 4 fingers, an abdominal binder is recommended. If you use an abdominal binder, it should be from your hip bones to your rib cage, you need to keep the binder on 24/7. You can only take the binder off when you do your correction exercise below, or when you take a shower. You should keep it on at bedtime.
To get your pelvic health assessed, schedule a consultation with a pelvic floor physiotherapist at Triangle Physiotherapy!
Written by: Kamand Zendeganidoost, Registered Physiotherapist