Vaginismus and Pelvic Pain Treatment

Vaginismus is a distressing condition that affects individuals of all ages and backgrounds. It is characterized by involuntary contractions or tightness of the pelvic floor muscles.  This can make being sexually active or even using a tampon painful or impossible. While vaginismus can be emotionally and physically challenging, the good news is that it can be treated. In this blog post, we will explore the diagnosis of vaginismus, its potential causes, and how we at DPPS take a comprehensive approach to treatment that includes three strategies: P-DTR® (Proprioceptive Deep Tendon Reflex®), hypnosis (Inner Freedom Technique®), and myofascial release and exercises.

Understanding Vaginismus

Vaginismus is often misunderstood, misdiagnosed, or overlooked, but it’s important to recognize its signs and symptoms. These may include:

  • Painful intercourse: Women with vaginismus typically experience pain, discomfort, or burning sensations during attempted vaginal penetration, such as intercourse or tampon insertion.
  • Involuntary muscle contractions: The hallmark of vaginismus is the involuntary tightening of the pelvic floor muscles. This reflexive response can make penetration painful or impossible.
  • Fear and anxiety: The anticipation of pain or discomfort during sexual activity can lead to increased anxiety and fear, further exacerbating the condition.

Diagnosing Vaginismus

Accurate diagnosis is the first step towards effective treatment. There are various approaches to diagnose vaginismus, including:

  • Medical Examination: A pelvic exam performed by a healthcare provider can help rule out any physical issues and confirm the presence of vaginismus.
  • Psychological Assessment: A psychologist or therapist may evaluate the emotional and psychological factors contributing to vaginismus, such as past trauma or anxiety.
  • Neurological Assessment: P-DTR® (Proprioceptive Deep Tendon Reflex®) is a neurological modality that can help determine if there are any neurological causes for pelvic pain or tightness. It can provide valuable insights into the condition.

Possible Causes of Vaginismus

Understanding the root causes of vaginismus is crucial for tailoring effective treatment plans. Vaginismus can be triggered by a combination of factors, including:

  • Physical Factors: Some women may have underlying physical conditions, such as infections, vestibulodynia, or endometriosis, that contribute to pelvic pain and muscle tension.
  • Psychological Factors: Emotional trauma, anxiety, and fear related to past experiences (e.g., sexual assault) or cultural upbringing can contribute to vaginismus.
  • Neurological Factors: Neurological issues, such as overactive pelvic floor muscles or nerve hypersensitivity, may also play a role in vaginismus.

Multifaceted Treatment for Vaginismus and DPPS

Effective treatment for vaginismus often involves a combination of approaches to address both physical and emotional aspects of the condition. Here are three key components of a comprehensive treatment plan at DPPS:

  • P-DTR® (Proprioceptive Deep Tendon Reflex): P-DTR® is a valuable tool for identifying and addressing neurological causes of pelvic pain and tightness. Through precise assessments and techniques, it can help restore proper neurological function in the pelvic area.
  • Inner Freedom Technique: Hypnosis strategies such as IFT can be used to address emotional causes of pelvic pain, such as trauma or anxiety. By helping individuals relax, release emotions, and reframe their thoughts and associations with sex, hypnosis can reduce fear and anxiety related to penetration and intimacy.
  • Myofascial Work and Exercises: Myofascial release techniques and targeted exercises can help relieve pelvic pain and reduce muscle tension. These approaches can be tailored to the individual’s specific needs and may include stretches, massage, and strengthening exercises.

Other strategies for working with pelvic pain can include:

  • Cognitive-Behavioral Therapy (CBT): CBT is a widely recognized and effective therapeutic approach for treating vaginismus. It focuses on changing negative thought patterns and behaviors related to sex and penetration. Through CBT, individuals can learn to identify and challenge their fears and anxieties, ultimately leading to more relaxed and positive associations with sexual activity.
  • Pelvic Floor Physical Therapy: Pelvic floor physical therapy, performed by a trained physical therapist, can help individuals address muscle tension and tightness in the pelvic floor muscles. Techniques such as biofeedback, manual therapy, and exercises can be used to relax and strengthen these muscles, making penetration more comfortable.
  • Graduated Exposure Therapy: Graduated exposure therapy involves a step-by-step approach to vaginal penetration. It starts with non-threatening activities like relaxation exercises and gradually progresses to more challenging steps, such as using dilators. This method helps individuals desensitize themselves to the fear of penetration.
  • Dilator Therapy: Vaginal dilators are medical devices designed to help individuals gradually stretch and relax the vaginal muscles. Dilator therapy is often used in conjunction with other treatments and can be an effective way to overcome physical barriers to penetration.
  • Medication: In some cases, healthcare providers may prescribe medications such as muscle relaxants or low-dose anxiolytics to help manage physical and emotional symptoms associated with vaginismus. However, medication alone is usually not a primary treatment but may be used in combination with other approaches.

Couples Therapy: If vaginismus is impacting a romantic relationship, couples therapy can be beneficial. It can provide a safe space for open communication, address relationship issues, and involve partners in the treatment process.

It’s essential to note that the success of treatment often depends on factors like the severity of vaginismus, the individual’s willingness to engage in therapy, and the expertise of the healthcare provider. A personalized treatment plan, developed in consultation with a qualified healthcare professional, is crucial. The key is to address both the physical and psychological aspects of the condition to achieve the best outcomes. Therefore, individuals should seek the guidance of a healthcare provider who is experienced in working with this condition and can tailor a treatment plan to their unique needs.


Vaginismus is a challenging condition, but with the right diagnosis and a multifaceted treatment approach, individuals can find relief and regain control over their sexual health. By addressing neurological, emotional, and physical aspects, healthcare providers can offer comprehensive care that empowers patients on their journey to recovery. If you or someone you know is struggling with vaginismus, please reach out to see if what we offer at DPPS might help you or your loved one.  You can contact us here: