How Pelvic Floor Physical Therapy Helped Me Recover From Vaginismus

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Last month, Sigourney shared Martha’s Success Story, told from her perspective as Martha’s pelvic floor physical therapist. This week, Martha was kid enough to share her experience, in her own words. We hope her story provides hope for the many, many other women suffering from primary vaginismus or other causes of painful sex. We are sharing many success stories this year, people need to know they can and will get better!

From Martha: 

I’ve never had sexual encounters for most of my adult life until I got married a few years ago. I was looking forward to deepening my marriage and my new relationship with sexual intimacy. All my life, I’ve heard that people experience pain the first time they have sex. I knew it would be the same for me but I was ready for the challenge because I knew everyone overcame it eventually. However, my initial experiences with sexual intimacy soon became disappointing, frustrating, confusing and just painful. Soon, my excitement and any positive feelings I had dissipated and slowly feelings of alienation, darkness, and undesirability overshadowed it. I felt rejected by my husband’s lack of interest in starting this new relationship with me. Then, I didn’t know he had some physical issues he was struggling with but I was kept in the dark for a while. My self-confidence soon plummeted, and I didn’t feel I was attractive enough to inspire sexual feelings in him. I didn’t feel desired by him the way I have heard most couples talk about their honeymoon period or the fact they couldn’t get enough of each other and was always hitting the sack. I felt so broken because I desire having a relationship with him through physical intimacy. But I couldn’t understand the situation I was in.

When I finally got to the bottom of his issue, I was already in a low position where I felt so broken about myself and my body. I remember when we finally decided to have sex, the pain was unbearable and it further made me feel hopeless of the situation I was in. I talked to family members whom I could trust. I told myself maybe the pain wasn’t that bad and I was just being wimpy and all I needed to do was push through the initial pain and overcome it. I tried and I failed and felt even more broken. I went to my primary care doctor and talked to her about my situation and she spoke about going to see a pelvic floor therapist to help me with my situation. I’ve never heard of a pelvic floor therapist and I kept researching to understand what they do and I also came across stories of women who had gone through what I have gone through.

 About a year later, I decided to give pelvic floor therapist a shot and found Pelvic Health and Rehabilitation Center. I made my first appointment and showed up. I remember meeting Sigourney for the first time  we talked about my history, my pain, why I was here and I remember feeling so comfortable sharing my issues and concerns with her. She was empathetic, kind and patient and reassured me that it is a common problem among many women and I don’t have to suffer in silence. She explained what was in my control and what I could do to help alleviate my pain. She also explained that it’s just a matter of exercising the muscles in the pelvic region since it’s never been used. She showed me some exercises that I could do daily to help relax the muscles around my pelvic region and we talked about using the 5 size dilator set as a daily practice to use the muscles in that area.

 I walked out of the office that day feeling hopeful, relieved and positive. Most importantly, I walked out of the office feeling HEARD and SEEN by another human being who could help me with overcoming the issue. I was so happy to know that the pain wasn’t “all in my head.” That it was real and I felt my experiences were validated.

 I went to see Sigourney religiously every week and outside of clinic hours, I tried religiously to keep up with my pelvic floor exercises. The treatment was instrumental in helping me work up the different dilator sizes, starting from 1 to 5. Also, the treatments made me feel confident about my body and made me feel I wasn’t broken. During the treatments, Sigourney would spend a lot of time explaining my anatomy and also she was very patient in answering my questions about the mind-body connection. She also helped me with providing suggestions on how to inspire sexual intimacy with my husband and gave me helpful recommendations such as speaking to a sex therapist, what I can do to help my husband deal with his physical issue.

 The turning point for me came when I was able to use dilator size 4 easily in my daily practice. I told Sigourney that I was ready to have sexual penetration with my husband on my trip to Hawaii. Sigourney was very encouraging and felt I was ready. She explained how I should prepare for the encounter to loosen up the muscles. The part of me that wanted an intimate relationship  felt like I have a chance at it. I was able to have sexual penetration with my husband pain-free and I just broke into tears of happiness when it happened. I never thought sexual penetration was possible for me. I never thought I’ll have a chance at experiencing sexual intimacy and a chance at starting a family.  

 Sigourney gave me a chance at reclaiming my body and even when I didn’t believe in myself, she never let me give up. The emotional side effects with dealing with this can be very real.  Finding a good treatment plan involving a pelvic floor therapist can be a daunting and an overwhelming search. However, I highly recommend women experiencing with pain to seek help so as not to feel isolated and alienated.

For more information on the different causes and treatments for painful sex check out our book, Pelvic Pain Explained and the Podcasts, YouTube Videos, and blogs on our Vulvodynia Resource List


What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

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