What to expect from pelvic floor physiotherapy for vaginismus

Vaginismus involves involuntary tightening around the vaginal opening, which can make penetration, tampon use or examinations difficult. A physiotherapist may ask about pain, fears, previous experiences, bladder and bowel habits, and your goals. An external assessment may look at breathing, posture and movement. An internal examination is not automatic; it should happen only with your informed agreement, and you can pause or stop it.

Treatment can include breathing practice, pelvic floor relaxation, gentle touch or mobility work, and education about the muscles. Some people use graded exercises or trainers at a pace agreed with the therapist. The aim is comfort and control, not forcing penetration.

Wear clothing that allows comfortable movement and bring a clear description of what triggers symptoms. Tell the therapist about pregnancy, recent procedures, skin irritation or trauma history. At home, practise the breathing and release exercises you were shown; avoid pushing through sharp pain or panic. Progress may be reviewed by changes in muscle control, confidence and comfort rather than by a fixed timetable.

Contact a clinician if pain is new, worsening, associated with bleeding, unusual discharge, fever or sores, or if symptoms interfere with daily activities. Physiotherapy may be combined with assessment for infection, skin conditions, endometriosis or emotional distress when those concerns fit your symptoms.

Ask whether pelvic floor physiotherapy suits your symptoms, what an examination would involve, how consent is handled, and which other causes of pain should be checked.