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The Femina Physical Therapy Blog

Featuring original articles by our staff about current events and trends

With emphasis on vaginismus, pregnancy and postpartum best practices, treatments for incontinence, and other topics related to the health of your pelvic floor.


Blog Posts by Topic

Featured From the Blog:

Vulvovaginal Moisturizers: Effective Hydration and Relief | Image Courtesy of Averie Woodward via Unsplash

Choosing the Right Vulvovaginal Moisturizer

Assuming you need one, make sure it's got the right ingredient list

There are many reasons why those born with female anatomy may require the use of a vulvovaginal moisturizer throughout their lifetime. As you age, the vaginal and vulvar tissues tend to become drier and less elastic. This change is typically seen around the time one goes through menopause due to the drop in estrogen that occurs. The vulvovaginal tissues are very sensitive to hormonal changes and estrogen is the hormone that controls vaginal lubrication, as well as tissue elasticity and thickness.

Read more: Vulvovaginal Moisturizers:...

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shockwave therapy for painful intercourse

Learn about low intensity shockwave therapy for painful intercourse (dyspareunia)

Our team at Femina Physical Therapy is committed to providing the highest level of evidence-based care. That is why we are conducting a research study to determine the effectiveness of low intensity shockwave therapy for painful intercourse, or dyspareunia as it is known clinically. We are searching for volunteers to participate in this high quality study. Those who qualify to participate will receive a reduced rate on all visits related to the study!

Read more: Participate in a High...

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Deep Infiltrating Endometriosis and Sexual Function

What is Endometriosis and Deep Infiltrating Endometriosis?

Endometriosis is a benign condition where endometrial tissue (the lining of the inside of the uterus) grows outside of the uterus.

About 5-10% of reproductive aged persons with female-associated genitalia have endometriosis. Symptoms can range from no symptoms to debilitating pelvic pain with dysmenorrhea, pain with periods, abdominal pain, genital pain, bladder dysfunction, bowel dysfunction and possibly other symptoms. In addition, endometriosis is known to also affect sexual quality of life. Pain with sex is called dyspareunia; while deep infiltrating endometriosis is a more severe form of endometriosis.

Read more: The Link Between Deep...

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effects of pelvic floor muscle strength on orgasm

Let's Look at the Effects of Pelvic Floor Muscle Strength on Orgasm

Hint: strong pelvic floor muscles = strong orgasm 

The world is learning more and more about the pelvic floor and the many ways that it can be treated. At Femina Physical Therapy, we have spoken about pelvic rehab for urinary, bowel, birth, pregnancy, bladder, erectile issues, and many more. But we all know the question that everyone wants answered: Does pelvic floor strength affect orgasm?

Well reader, you came to the right place.  

Read more: The Effects of Pelvic Floor...

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Endometriosis and Sexual Function | Image Courtesy of Anthony Tran via Unsplash

Endometriosis and Sexual Function Require a Specialized Approach

Endometriosis is a global disease affecting 5-15% of women during their reproductive years. It is characterized by the presence of endometrial-like tissue outside of the uterus which can trigger a local inflammatory response and can have a significant impact on patients’ quality of life.

One such domain of quality of life that is often affected is the correlation between endometriosis and sexual function. The DSM-V defines sexual dysfunction as a clinically significant disturbance in a person’s ability to respond sexually or to experience pleasure and includes pelvic pain, penetration disorders, lack of sexual interest, and/or arousal and orgasm disorders. Unfortunately, it is common, as approximately 40% of women with endometriosis and chronic pelvic pain suffer from sexual dysfunction. 

Read more: Endometriosis and Sexual...

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Sexual Function and Cancer | Image Courtesy of Priscilla Du Preez via Unsplash

Physical Therapy Can Mitigate the Effects of Cancer on Sexual Function

Sexuality can be a big part of who we are as individuals. Sexual function can be defined as “specific physical, physiological, neurological and emotional behaviors expressed by an individual response”.5 Sexual function and cancer can have an important and detrimental relationship.  There are certain cancers that can unfortunately affect our sexual health, including cervical, ovarian, bladder, kidney, colorectal and breast cancer to name a few.

Some cancer treatments can cause unwanted side effects that affect our sexual health such as decreased sexual arousal or desire, vaginal stenosis (narrowing of the vaginal canal), dyspareunia (painful sexual intercourse), and bladder/bowel dysfunction. This can affect our relationships with ourselves and with our partners, and reduce quality of life.

Read more: Sexual Function and Cancer:...

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contraceptives and sexual function | Image Courtesy of Reproductive Health Supplies Coalition via Unsplash

Contraceptives and Sexual Function Considered

As pelvic floor physical therapists, we work with a lot of women who have some type of female sexual dysfunction, whether it may be pain with initial penetration, pain with deep thrusting/deep penetration, pain with orgasms, or decreased sexual arousal, desire, libido. Unfortunately, about 30-50% of women may suffer from these symptoms.

We often see women with sexual impairments have the following conditions/scenarios:

  • Postpartum (regardless of delivery)
  • Vaginismus (involuntary spasms of the pelvic floor muscles)
  • Post-menopausal
  • Vulvodynia
  • Skin inflammatory conditions such as lichen sclerosus

Read more: What Do We Know About...

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** This information is for educational purposes only and is not intended to replace the advice of your doctor. **

Products Related to This Topic

When Sex Seems Impossible by Peter Pacik, MD

Have fear and pain stopped you from having intercourse?
Are you unable to use tampons, or feel like they won't fit?
Do you physically withdraw or panic during gynecological exams?

If you answered "yes" to any of these questions, you may be suffering from vaginismus, a condition that affects millions of women worldwide.

This book offers important medical information and first-person stories, including a new treatment option that has helped over ninety percent of my patients with severe vaginismus overcome this condition to go on to have pain-free, intimate relationships.

My treatment of vaginismus has put me in contact with patients from around the world and many different cultures. While each patient is unique, their stories evoke common themes-the shame of not being able to experience intercourse; guilt over lost relationships; a deep fear that their childbearing years will come and go. The stories shared by these women moved me deeply, and I felt their voices needed to be heard.

When Sex Seems Impossible: Stories of Vaginismus and How You Can Achieve Intimacy provides medical information about this condition and how it can be overcome. Equally important, the book shares the personal experiences of several of my vaginismus patients. These women volunteered to tell their stories in an effort to let their sister sufferers know that they are not alone, and do not need to suffer in silence. I admire them more than I can say.

Testimonials from Patients of Dr. Pacik for the Treatment of Vaginismus:

It has been three weeks and two days since my procedure. I was finally able to achieve intercourse tonight (full penetration)! I have learned so much about myself and my body since the procedure. I woulld highly recommend this treatment to anyone who suffers from vaginismus."

I feel like I have a real marriage now. I feel triumphant!"

Today we finally made love. It was actually incredible. I finally got to connect with him on this amazing level."

Beating Endo by Iris Kerin Orbuch, MD and Amy Stein, DPT

From two of the world’s leading experts in endometriosis comes an essential, first-of-its kind book that unwraps the mystery of the disease and gives women the tools they need to reclaim their lives from it. 

Approximately one out of every 10 women has endometriosis, an inflammatory disease that causes chronic pain, limits life’s activities, and may lead to infertility. Despite the disease’s  prevalence, the average woman may suffer for a decade or more before receiving an accurate diagnosis. Once she does, she’s often given little more than a prescription for pain killers and a referral for the wrong kind of surgery. Beating Endo arms women with what has long been missing—even within the medical community—namely, cutting-edge knowledge of how the disease works and what the endo sufferer can do to take charge of her fight against it.

Leading gynecologist and endometriosis specialist Dr. Iris Kerin Orbuch and world-renowned pelvic pain specialist and physical therapist Dr. Amy Stein have long partnered with each other and with other healthcare practitioners to address the disease’s host of co-existing conditions—which can include pelvic floor muscle dysfunction, gastrointestinal ailments, painful bladder syndrome, central nervous system sensitization—through a whole-mind/whole-body approach.

Now, Beating Endo formalizes the multimodal program they developed, offering readers an anti-inflammatory lifestyle protocol that incorporates physical therapy, nutrition, mindfulness, and environment to systematically addresses each of the disease’s co-conditions on an ongoing basis up to and following excision surgery. This is the program that has achieved successful outcomes for their patients; it is the program that works to restore health, vitality, and quality of life to women with endo.

No more “misdiagnosis roulette” and no more limits on women’s lives: Beating Endo puts the tools of renewed health in the hands of those whose health is at risk.

Heal Pelvic Pain by Amy Stein, MPT

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    • Testimonial by S.H., age 24

      I just wanted to thank you for everything you've done for me for the past 19 months. I literally could not have reached my goals without you and your practice. You gave me the courage to keep moving forth with my treatment no matter how afraid and anxious I was. You were always there to answer questions and made this whole process so much easier than I expected it to be. It's because of you that my marriage is on the right track, that I can get pregnant and that this part of my life is finally...

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    • Testimonial by A.B.

      Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the...

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