Does pelvic floor physiotherapy treat vaginismus?

Vaginismus involves involuntary tightening around the vaginal opening when penetration is attempted or anticipated. A pelvic floor clinician may assess breathing, guarding, hip and abdominal tension, and your ability to relax. Sessions can include education, gentle external work, breathing, movement and a gradual plan for touch or vaginal trainers when you consent. Nothing should be forced. Pain, fear, previous injury, skin conditions or relationship concerns may need additional support from a gynaecologist, pain clinician or mental health professional.

Choose a clinician who explains each step and agrees a stop signal with you. Practise slow breathing and relaxation only within a comfortable range. Do not push through sharp or escalating pain, and do not begin internal exercises without guidance if they increase fear or symptoms. Tell the clinician about pain with examinations, tampon use or sex so the plan addresses your actual triggers.

Seek medical review for new severe pelvic pain, bleeding unrelated to a period, unusual discharge, sores, fever or pain that persists after attempted penetration. Urgent care is appropriate for heavy bleeding, fainting, fever with worsening pelvic pain or a possible retained object. These symptoms can need assessment for causes other than muscle guarding.

Ask what may be contributing to the tightening, whether an examination can be adapted, how relaxation will be taught, and whether you would benefit from gynaecology, pain or psychological support alongside physiotherapy.