Vaginismus is a condition involving involuntary contraction of the pelvic floor that prevents vaginal penetration or makes it painful and difficult.
People suffering from vaginismus often have trouble or pain using tampons, having a gynecological examination, or having penetrative intercourse.
Management of vaginismus can include treatment from a pelvic physical therapist, exercises to help train the pelvic floor muscles to relax, and use of vaginal dilators or a pelvic wand to address tightness in the vaginal canal and pelvic floor muscles themselves.
Exercises to help train co-ordination and control over the pelvic floor muscles is an important part of managing vaginismus. This control can take time to learn and develop, as new skills do.
The good news is that these exercises and stretches can be done daily in the privacy of the home and can easily be accommodated into a daily routine. The exercise and stretches below are helpful for treating vaginismus and use of breathing is helpful in this process.
Begin laying on your back with legs extended straight or propped up on 1-2 pillows if lying flat is bothersome. Bring your attention to your breathing pattern and focus on expanding your belly and rib cage.
Imagine that they are gently rising up and out like an umbrella opening during the inhale. On the exhale, gently allow the ribs and belly to return to their resting state.
Progressing With Each Exercise
To progress this exercise, continue with the breathing pattern and bring your attention to your pelvic floor. This group of muscles is the shape of a diamond and located between your tailbone and pubic bone from front to back, and between your sits bones right to left.
On your inhale, notice how the pelvic floor drops down, and then on the exhale, how it lifts back up. This movement is very subtle, and you might feel it more as a sensation of the tailbone dropping down toward the floor on the inhale and lifting off the floor on the exhale.
You can also do this exercise sitting on a firm chair. The chair can be helpful in providing feedback to provide more sensation to the pelvic floor during the exercise. Continue this gentle breathing pattern for two minutes.
This exercise is helpful to provide a gentle stretch and to improve overall mobility of the pelvic floor. This pelvic floor drop is a maneuver that is necessary to relax and open the pelvic floor during activities such as having a bowel movement, or during penetrative activity such as using a tampon or during sex.
To do this exercise lay on your back or sit with good posture in a firm chair. The breath pattern will be utilized to assist in this exercise. Inhale and gently bear down as if you were trying to pass gas, then exhale and allow the pelvic floor to return to a resting state.
If bearing down is challenging, it can be helpful to imagine that during the inhale you are trying to lay an egg or blow a bubble with bubble gum out of the vaginal opening.
Find the imagery that works best for you and use it to assist the exercise. Repeat this motion for 20-30 repetitions. It is helpful to practice this 1-2 times per day.
Begin laying on your back. Cross your right ankle over your left knee and press your right knee away from you. For an added stretch lift the left foot off the ground and draw the knee closer to your chest.
Repeat this stretch on the opposite leg. Hold this stretch for 30-60 seconds and then repeat on each side for three repetitions.
Begin kneeling and gently press your hips back towards your heels. Then, fold your trunk forward with arms overhead and breath into the back of your rib cage and your pelvic floor.
You can use a pillow in the front fold of your hips or the back fold of your knees for added support, or to change the sensation of the stretch. Remain in this position for 2-3 minutes.
Begin by laying on your back. Draw your knees toward your chest, and then reach for your big toes. Then gently extend your knees and press your feet toward the ceiling. If you have tightness in your hips or hamstrings, you can use a towel or yoga strap behind your knees to help extend your reach. Maintain this position and continue to breathe deeply and allow the pelvic floor to relax. Maintain this position for 2-3 minutes.
Begin standing near a sturdy and stable object to assist with balance. A kitchen counter or a banister is a perfect, a stable chair will also be suitable.
Holding onto the counter or chair back for balance, press your hips backward and sink into a deep squat. Breath deeply into your rib cage and imagine dropping the pelvic floor as in the previous exercises. Maintain this position for 1-2 minutes.
Vaginismus exercises are one component of overcoming this condition. Additional tools such as vaginal dilators or a vaginal wand are helpful.
It is also advisable to request an evaluation by a qualified pelvic physical therapist to help create a comprehensive and unique plan to help you reach your goals.