Persistent genital arousal disorder (PGAD) is a condition that is poorly understood.

It is a rare disorder most commonly seen in those with female anatomy and is characterized persistent sensations of genital arousal in the absence of sexual desire or stimulation. These sensations typically stay after orgasm and are intrusive, unwanted, and can negatively affect quality of life.

The diagnosis itself is not well known among healthcare practitioners yet alone the general public. Those who experience its symptoms can be hesitant to talk about it with their healthcare practitioners even though it may be affecting their quality of life.

Manual Therapy Skills are an Often Overlooked Aspect of Physical Therapy

In is well documented in journals such as the International Urogynecology Journal and Harvard Medical School that patients see positive outcomes when they receive treatment with trained pelvic floor therapists. One of the most valued skills of a trained pelvic floor therapist is their manual therapy skills.

What is Manual Therapy?

Manual therapy is a clinical treatment approach using skilled, specific hands-on techniques to diagnose and treat soft tissues of the body. Manual therapy is used in a wide variety of rehabilitation settings, on all parts of the body.

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

Unlike other offices, your first visit at Femina Physical Therapy is a thorough 90 minute evaluation. Here's an outline of what to expect.

The goal of this initial evaluation is to understand all the different layers that could possibly be contributing to your condition. Once we understand the root causes of your issue, we will formulate a treatment plan to help you start feeling better, experiencing less pain, and getting back to the activities that you care about.

Orgasm Related Problems and Solutions

Anorgasmia and Dysorgasmia are clinical terms whose symptoms include complete lack of orgasm, diminished orgasms, and even painful orgasms. Causes can include physical, mental, and emotional factors. 

Dysorgasmia / Painful Orgasms

Dysorgasmia is defined as a painful orgasm, but without any prior pain during sexual intercourse. The pain often manifests as a cramping sensation in the pelvis, buttock(s) or abdomen. The duration of pain can last from seconds to minutes to several hours.

Endometriosis and Chronic Pelvic Pain

How Endometriosis can cause or contribute to chronic pelvic pain, and what pelvic floor therapy can do to help alleviate it

What is Endometriosis?

Endometriosis is a condition where endometrial-like tissue grows outside of the uterus(endometrial tissue is tissue that usually grows inside of the uterus and sheds each month). The most common area for it to grow is in the abdominal cavity, where it can implant on the surface of other structures including the ovaries, bladder, rectum, and along the walls of the abdomen and pelvis.

The true prevalence of endometriosis is unknown since it takes a laparoscopic procedure to confirm the diagnosis, and many women either have no symptoms or seek no treatment (Signorello, Harlow, Cramer, Spiegelman, & Hill, 1997). However, up to 78% of women undergoing laparoscopic investigation for infertility and up to 82% of women investigated for pelvic pain were found to have endometriosis in one study (Schenken, 1996; Wellbery).

Actress Lena Dunham has been vocal about her experiences with endometriosis, most recently publishing an essay in American Vogue on electing to have a total hysterectomy after years of chronic pain due to the condition.

Cervical Health Awareness Month:

Sexual Problems and Cancer Treatment

Sexual problems are a side effect of cancer treatment that oncologists don’t often talk about, but there are treatments to help, including the pelvic floor therapy that we do at Femina. Surgery, chemotherapy, radiation, hormonal therapy, stem cell transplantations, and other procedures can negatively affect quality of life, including sexual health and happiness. These side effects are not limited to cancers of the sexual organs either. Cancer treatment anywhere in the body (cervix, breast, throat, GI tract) can lead to changes in sexuality.

Up to 64% of women affected by cancer experience “altered sexuality”—their sex lives just feel different than they did before.  There are physical side effects like fatigue, nausea, dry, painful, itchy, and burning vaginal tissues, and hormonal changes which make sex unappealing and painful. Altered self-image, depression, and anxiety can make it hard to connect with others and feel intimacy. These effects can last years after cancer treatment. If you are currently experiencing these effects, you are not alone and there are treatments that can help.

Instruction in The IRAS Method is currently only available for individual instruction to patients. Qualified health care practitioners can be instructed in a group or individual setting, in your office or ours.

The IRAS Method is a unique combination of physical therapy, massage and neuromuscular techniques optimized to provide the quickest recovery of pelvic floor muscle spasm, hypertonicity and/or over-activity.