This is part 2 of my description of pelvic physiotherapy. If you missed part 1, it can be found here. And just so we’re all on the same page:
*DISCLAIMER* Pelvis physiotherapy was the single most life-altering treatment I received for my vaginismus. I truly believe that without my therapy, I would not have been able to beat this. That being said, I’m only documenting my personal experience. I do not know if the practices of all pelvic physiotherapists are the same, and I cannot guarantee that this will work for you as well. I can only hope that the information I provide here for you will be helpful to you, and, as always, feel free to email me with any additional questions you might have.
So, we’ve been through my first appointment at my pelvic physiotherapist. What happened next? Well, I won’t break it down appointment by appointment, as I had many. It takes different people a different amount of time to conquer their vaginismus through physiotherapy, and for me, it took about about a year. In that 12-month period, I saw my physiotherapist anywhere from once a week, to once a month, depending on schedules and how I felt I was progressing.
Each appointment was roughly the same in terms of the procedure. After my first appointment, my physiotherapist asked me to get my hands on a set of vaginal dilators that we would use during the appointments. I already had a set of 7 wax ones that a previous sex therapist had given me, but if you are looking for a similar set, they can be purchased online or in person here.
We would start each appointment by talking about how my “homework” had gone the previous week. Homework usually involved me working with the dilators at home by myself or with my husband. We would discuss any problems or successes that I had, and she would answer any lingering questions.
Then we moved on to the work with the dilators. Again, she would set up the massage tables with sheets and pillows and leave the room so I could strip from the waist down. Most often, she would begin the dilation work by just using her gloved finger (with lots of lube) to gently apply pressure to the outside of my vagina. Eventually, we moved on to the smallest dilator in the set. She would put a condom over the dilator (much more sanitary) and then apply lots of lube to it. When I was comfortable and relaxed, we would work together on inserting it.
For the most part, she controlled the insertion of the dilator itself. It was my job to relax my mind and my muscles so that the insertion was possible. My physiotherapist used lots of positive language and imagery to help me relax, and I found that it was really important to listen to her, and try to do what she said, even if it sounded corny or hippy-dippy. For example, if she said “imagine that your hip bones are falling apart from one another,” I really tried to visualize that – and it worked! If she said, “melt this muscle here, like butter,” I honestly tried to picture that muscle as butter melting. And somehow, by visualizing that image in my brain, my muscle would start to obey.
Once we were able to get to the point where a dilator was fully inserted, my physiotherapist would then work to stretch the muscles. She told me to imagine my vaginal opening like a peace sign, with the two arms of the peace sign stretching down to each buttocks. Then, with the dilator still inserted, she would apply pressure downwards on each arm of the peace sign, one side at a time. It was often uncomfortable at first, but if I kept breathing through it and using the imagery she provided, that muscle would eventually relax out of it’s spasm. The trick was that when she released the pressure, the muscle would often shock itself back to the spasm, so it often took a few tries. I had to really work to not be discouraged.
Eventually, over the course of 12 months, we were able to work our way through all 7 wax dilators, plus a more lifelike dildo that I had purchased. At no point did my pain level ever go above a 4 out of 10, but it was important to keep open communication with my physiotherapist in order to maintain this. My husband was also invited to come to an appointment and learn how to properly help me use the dilators and do the stretching (not all husbands would be able to stomach this, I believe, but it was a really positive experience for us!).
My progress was certainly much faster when I kept up with my homework of stretching and working with the dilators at home, in between appointments. At first, I was scared of doing “too much” homework, and it was often difficult to schedule time when we had houseguests or were traveling. But persistence was the key. Once I started dilating every one or two days, I really started to see progress. But I had to work through the mental and emotional blocks first before I could get there (a good counsellor or sex therapist can definitely help with that).
Again, if you have any questions about my experience with pelvic physiotherapy, please don’t hesitate to contact me.