How long does pelvic floor physiotherapy take to work for vaginismus?

Vaginismus involves involuntary tightening around the vaginal opening when penetration or anticipated penetration causes pain, fear or discomfort. Assessment may focus on breathing, muscle guarding, hip and abdominal tension, pain triggers and your goals. An internal examination is not automatically required and should only happen with your consent.

Progress may first appear as less anticipatory tightening, easier relaxation, or greater control during self-directed exercises. Penetration is not the only measure of improvement, and a setback after pain, stress or an uncomfortable attempt does not mean the treatment has failed.

Use the breathing, relaxation and movement exercises taught by your therapist. If dilators or touch are part of the plan, use the smallest comfortable step and stop before sharp or escalating pain. Do not force penetration or treat pain as something you must push through.

Tell the therapist about fear, relationship concerns, past painful experiences or skin symptoms. Coordinated support from a gynaecologist or qualified counsellor may be useful when pain and anxiety reinforce each other.

Arrange a review if pain is new, persistent, burning, associated with discharge or bleeding, or present outside attempted penetration. Seek prompt care for severe pelvic pain, fever, heavy bleeding or a suspected injury.

Ask what pace is appropriate, whether an examination can be deferred, how to recognise useful relaxation, and which other causes of painful penetration should be checked.