The Role of Pelvic Floor Therapy in Vulvar Pain Treatment

“In two retrospective reviews of physical therapy treatment of women with vulvodynia, one reported a 71% success rate of moderate or great improvement in vulvar pain, as well as decreased pain with intercourse, & increased intercourse frequency, desire, & arousal. And the other reported that 71% of those receiving physical therapy for vulvar pain reported decreased vulvar pain symptoms, & 62% reported improved sexual function” [1]

So What Exactly is Involved in Pelvic Floor Therapy?

As your Vulva Doctor will explain to you after they have reviewed your medical history, undertaken any necessary tests, and put you on a Holistic Personalised Treatment Plan: there are a number of important points in this proven method of pelvic floor therapeutics. These incorporate:

• Learning about the basic anatomy which sets the stage for your pain
• Understanding the principles of fundamental pain science, and thus integrating them into optimal functional living
• Biofeedback (traditional or manual)
• Being mindful of having the right thought processes which can drive success
• Participating in both external and internal manual therapy. (This includes:  (contracting and relaxing your pelvic muscles, and administering trigger-point pressures, such as myofascial release). Note: “Myo” refers to muscle and “fascial” means fascia. The latter is the white, thin connective tissue, which is wrapped around all our muscles
• Practising motor and muscle control of the muscles in the pelvic floor (relaxation whilst making a vaginal insertion)
• External work around the bony pelvis (which comprises connective tissue manipulation tapping into the somatovisceral reflex). Note: the latter reflex occurs when localised visceral  stimuli generate patterns of reflex activity in structures which are segmentally related
• Proven techniques including visceral mobilization integration and MFR
• Exercises recommended by your Vulva Doctor or Vulvodynia Physiotherapist, which can be done at home. These include lower body/hip exercises and stretches, PFM, stretching the vaginal tissue manually, and using a crystal wand or progressive vaginal dilators (in which you regularly upgrade to a larger size, in line with the progress you are achieving) [1]

Did You Know?

“Increased muscular tone causes a decrease in blood flow & oxygen to the muscles of the pelvic floor. This can lead to a build up of lactic acid. Symptoms of pelvic floor muscle hypertonicity include: generalized vulvar pain or burning, tenderness where the muscle insert in front of and behind (4, 6, and 8 o’clock) the vestibule which causes severe pain with sex, & more” [1]. Booking an consultation with a Vulva Specialist is the smart way to get an accurate diagnosis, & ameliorate your suffering as soon as possible

Reference

[1]. Sarton, J. (2020). “Treatment for vulvodynia: here’s why you need pelvic floor physical therapy.”