What to expect from pelvic floor physiotherapy for vulvodynia

Vulvodynia is ongoing vulval pain that can feel burning, stinging, raw or sore, sometimes without an obvious visible cause. A physiotherapist may ask when pain appears, whether clothing, sitting, touch or sex changes it, and how symptoms affect sleep and movement. They may assess breathing, hip and pelvic movement, posture and muscle guarding. An internal assessment is optional and should be explained before consent is requested.

Sessions may use down-training rather than strengthening: slow breathing, pelvic floor release, gentle stretches, soft-tissue techniques and graded exposure to comfortable touch. The plan may also address habits that irritate the area, while another clinician checks for infection or skin conditions when appropriate.

Bring notes about triggers, menstrual changes, products and activities that alter pain. Follow the therapist’s home plan without forcing a stretch or touch exercise. Loose, breathable clothing and avoiding fragranced products may reduce irritation for some people. Keep follow-up appointments so the plan can change when pain, muscle tension or confidence changes.

Seek clinical review for new sores, marked swelling, unusual discharge, fever, bleeding, urinary difficulty or rapidly worsening pain. Ask for broader assessment if pain persists despite therapy, because vulval skin, bladder, nerve, hormonal and emotional factors can overlap.

Ask how vulvodynia was assessed, whether pelvic floor tension is present, whether an internal examination is useful, and which treatments can be combined with physiotherapy.