Gather ’round everyone, you’re about to hear a tale as old as time—about how everyone can (at an appropriate age and in a consensual way) just instantly have sex!
What a grand old time that would be! For some though, that is just not the case.
There are so many reasons why people with vulvas can’t have sex, despite wanting to, and a whole posse of professionals out there who can help you with this.
From sexual counsellors to sexologists, gynecologists, and women’s health-focused GPs; they all play their role. This, however, is a story about how a pelvic floor physio can help you.
Vaginismus, Vulvodynia, Vestibulodynia, oh my!
Wow—all the big scary words! Let’s break ‘em down:
Vaginismus: Tightness in the muscles and surrounding structures AROUND the vaginal canal (read: not the vagina itself, it is fine, it is just getting squished from the outside in).
Vaginismus makes life very hard to insert anything into the vagina (e.g. tampons, fingers, a penis, a speculum).
Vulvodynia: Pain in the general vulval area. This can be either constant or in response to a stimulus (e.g. tight clothing, cleaning yourself, sexual contact).
Vestibulodynia: Pain at the very inside of the labia minora/entrance to the vaginal canal. Often this is not felt unless penetration is attempted either with a penis/tampon/finger etc.
Nerve entrapments: Nerves supplying the clitoris/vagina/labia/anus getting squished (mostly by tight pelvic floor muscles) and NO ONE wants tingling and burning and numbness in those zones!
Endometriosis: Endometrium-like cells growing where they should not and causing chaos in the pelvis. Not all women with endo have pain with sex, but A LOT do.
At the moment these may be just a bunch of impossible to pronounce words (Like seriously who even came up with these names? Health needs a better marketing team I swear!) but who do they affect? Short answer: a lot of people.
It is estimated that 1 in 5 women will experience vaginismus at some point in their life. As with mostly everything in health though, there is a wide range of how bad (vaginismus for example) could be. Sometimes it is so bad that you can get absolutely nothing inside your vagina and at that point, well, what do we do?
So, what can be done?
Pelvic floor muscles (whilst they live very much on your insides) are actually very similar to the rest of the muscles on your outsides. If you had a tight crampy calf we may use massage, soft tissue stretching, muscle trigger pointing, mindfully relaxing the muscle etc.
If you were so unlucky as to have a tight calf with some grumpy nerves on top of it, we may also use a tens machine to calm them down—the same rules apply for misbehaving pelvises.
Chronic pelvic pain is no walk in the park, so we always, always need to make sure there are no other concurrent conditions happening that we can totally treat.
Things like thrush, UTIs, STIs, bacterial vaginosis, mental health flare-ups; none of these make thy yoni happy. Generally, with a bit of time, hard work (sometimes it’s not that hard, sometimes it can be quite easy) we can have you feeling much better.
So beautiful soul, please don’t suffer in silence. Intimacy is everyone’s birthright and there are health professionals out there, who are way cooler than your parents were, to chat all things “the birds and the bees”.
Pelvic Floor and Mastitis Physiotherapist