Alphabetical Index of Articles on Women's Sexual, Pelvic Floor, and Reproductive Health

Does Fear Create Vaginismus? Or Vice Versa?

I came across an article that came out last month and it brought up an old question I often muse over--Does Vaginismus create the fear and anxiety in women, or does an underlying fear or anxiety create Vaginismus? As we often say in physical therapy "It depends".

With some of my patients, there is a specific injury or infection that is at the root of their pain. The story is similar whether they were diagnosed with Vaginismus, Vulvodynia, Vestibulitis, Dyspareunia, or a host of many other diagnoses that lead to painful intercourse. For example, a young girl that always wore bathing suits and developed recurrent yeast infections, only to find out that over a decade later she had developed vaginismus. She had no fear or anxiety going in to first sexual encounter, yet she had severe pain. Now, she presents with what I perceive as fear and anxiety. Should she be treated for fear and anxiety? Or just the pain? Or both?

Heather Jeffcoat was once again the featured guest on the hugely popular podcast Girl Boner Radio with August McLaughlin! In this episode they discuss the pelvic floor, painful sex, and physical therapy after gender affirming surgery.

I was featured in New York Magazine's (@nymag) "The Strategist" column (@thestrategist) in an article on the best Kegel exercisers. But when they contacted me, I asked if they could include that Kegels may not be right for everyone, and I’m SO glad they did.

I LOVE Kegels, don’t get me wrong, but they simply are not the magical solution for every pelvic floor problem.

Some big signs you should STOP doing your Kegels (at least for now) are:

On Saturday May 19^th,Shelby Hadden, director and creator of Tightly Wound, came to Los Angeles to screen her short animated film on her experience with delayed diagnosis and eventual treatment of Vaginismus. Femina Physical Therapy in cooperation with Pelvic Health and Rehabilitation Center, Soul Source Dilators and Milli, hosted two events in Los Angeles to increase exposure for Shelby’s film, and in turn increase awareness of this distressing, yet very treatable, condition. You can read about the format and speakers of our morning event here. All attendees received a gift bag from our sponsors, and additional samples were provided by Uber Lube, Desert Harvest and Slippery Stuff.

Vaginismus Recovery is Possible

Is it painful to insert a tampon, get through a gynecological pelvic exam, or engage in intercourse? Have you always just thought maybe it’s just supposed to hurt and began to shy away from it all? You’re not alone. There are many women who have felt and thought the same things. What you are feeling is real and the culprit may be a condition called Vaginismus.

What is Vaginismus?

The definition of Vaginismus has been debated over the years and was first introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM), Third Edition in 1980. It was defined as a “recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse”.¹ And now in the DSM, Fifth Edition categorized as a disorder in which any form of vaginal penetration or insertion such as tampons, a digit, gynecological exams, vaginal dilators and intercourse is painful or impossible. Women have described it as “hitting a wall”. This disorder has been put under the umbrella of genito-pelvic pain/penetration disorder (GPPPD) in conjunction with dyspareunia (“recurrent or persistent genital pain associated with sexual intercourse”).²

Tightly Wound released on Iris!

Tightly Wound has been released, watch it today and share it with your loved ones and anyone else who may need more education on vaginismus and pain with sex.

Tightly Wound is a 15-minute animated short by Shelby Hadden. Our very own Heather Jeffcoat, DPT is one of the producers of film.

Have You Ever Asked "What's Up Down There, Doc?"

Pelvic floor physical therapy is one of the best kept secrets in medicine.

I was on a recent plane flight and sat next to two women that were very chatty with one another. They quickly swept me up into their conversation. Inevitably, in situations like this, everyone asks “So what do you do for a living?”. My answer used to be “I’m a physical therapist”. The past couple of years, my standard response is “I’m a physical therapist, but let me tell you about what kind of physical therapist I am”. Then I go into the diagnoses I treat related to bowel, bladder and sexual health and, in general, how I treat them. Across the board, their reaction is a mix of astonishment and genuine interest. The follow up dialogue is always eye-opening for them, and more often than not, they will report either knowing someone close to them as having one of these pelvic floor issues, or they have it themselves.

Should You Stop Doing Kegels?

Read on for the answer.

In my last post, “Why You Should Be Doing Kegels NOW”, I went over the specific diagnoses that tend to benefit most from doing pelvic floor muscle exercises. However, not all issues related to the pelvic floor are appropriate to prescribe pelvic floor muscle exercises for. In fact, doing Kegels can actually be harmful and counterproductive to your symptoms if you have certain diagnoses, and it may be best if you stop doing kegels depending on your diagnosis.

Why is having sex and inserting tampons painful for some?

Vaginismus explained

Vaginismus is one of our main areas of focus here at Femina Physical Therapy. Since the founding of Fusion Wellness and Femina PT we have seen great strides being made in the acceptance of a vaginismus diagnosis as something that is not only real, but treatable. So it's good to see a major internet presence like Yahoo! taking note of the subject and spreading the news to a wider audience.

The Yahoo! article defines vaginismus as "the involuntary tightening of the vaginal muscles that makes wanted penetration very painful or even impossible", and it then goes into some depth on some well known causes, myths, and treatments. Here are some snippets from the article interspersed with my own thoughts where needed.

A Conversation about Female Sexual Health & Pelvic Pain

with Screening of Animated Short Film "Tightly Wound"

Femina PT, the Pelvic Health and Rehabilitation Center, and the Milli, the first Expandable Dilator, are teaming up to bring Shelby Hadden and her animated short film about vaginismus, Tightly Wound, to Los Angeles on Saturday, May 19th! Many of you may know of Shelby and her past struggles with pelvic pain. Her journey getting diagnosed and treated combined with her skills as a filmmaker inspired her to create Tightly Wound to help raise awareness about vaginismus and pelvic pain, helping women get diagnosed and get the help they need.