When is pelvic floor physiotherapy recommended for vaginismus?

Vaginismus can involve an automatic tightening response around the vaginal opening. A pelvic-health physiotherapist can assess muscle tone, tenderness, breathing, posture, and the anticipation of pain. Treatment may include education, relaxation, gentle external techniques, graded exposure, and coordination work. Internal assessment is not compulsory at the first visit and should only occur with your consent.

Choose a clinician who explains each step and agrees a pace you can tolerate. Tell them about pain, past procedures, trauma, skin symptoms, discharge, and goals for intimacy or examinations. Do not force penetration or use dilators through sharp pain. A broader plan may include gynaecological care, counselling, and treatment for dryness or infection when present.

Seek medical review for new severe pelvic pain, fever, foul-smelling discharge, unexplained bleeding, sores, or a possible retained tampon. Sudden pain after an injury or pain that prevents urination needs prompt assessment. These symptoms require evaluation rather than assuming muscle tightening is the only cause.

Ask what other causes of pain should be checked, whether a pelvic floor assessment is appropriate, and how consent will work during treatment. Ask what home exercises are safe, how to pause a programme, and whether another specialist should join your care.