Cured from Vaginismus but still have pain?

[Rglady]

I’ve been in treatment for Vaginismus with pelvic floor PT and dilators for about 6 months. My PT said I no longer have vaginismus, which is defined by the involuntary contraction of the muscles at penetration, but I still have trigger points and pain. She defined it as hypertonic pelvic floor dysfunction. Is there a different way to treat residual tightness/trigger points/pain, or just keep doing what I’m doing with dilating and PD? I’ve been on the largest size for months.

[Heather]

Hi Rglady!
Congratulations on your hard work!!! I kinda had the same problem when I became cured. And sometimes still feel pain but it’s not often. Are you having penile penetration? My biggest dilator would hurt me because it’s so stiff and it doesn’t move or bend to comfortably follow the curves of my vagina so I wonder if that may be what you’re experiencing. It could also be anxiety related as well. Vaginismus inflicts fear, because you know it can be painful and working on it can be painful. Vaginismus effects both mind and body and when your body is cured, your anxiety around it may not be. And it’s that anxiety that can still trigger muscle spasms. Maybe you could try some exercises that can help you get your mind and body on the same page! Talk to yourself out loud. Reassure yourself that you are safe and that your body is safe with you and you will never put yourself in a situation where you would intentionally hurt yourself. Also it’s a really good idea to say these things to yourself while you explore the inside of your vagina with a finger. Become familiar and show yourself there’s nothing to fear! It’s squishy! But a beautiful part of your body and womanhood and nothing to fear! 🙂 You could also try breathing techniques as well to bring yourself to a much deeper relaxed state of mind before dilating. As well as yoga stretches that helps stretch your pelvic floor muscles. All of these are great tools that helped me along my journey and I hope they help you! For breathing techniques and yoga stretches, you can find lots of different techniques on Google! There is also CBD infused lube too! CBD works wonders for anxiety and pain. I really hope I could be of help. Keep us updated and good luck! We’re always here for you 🙂

[Rglady]

Thanks for the reply! So I actually really don’t have an issue with my largest dilator, and I can sometimes have pain free PIV. I’ve never had the fear I’ve read about in other patients, I was always able to have intercourse it was just painful. Things have definitely calmed down, but I have all these painful spots that just don’t seem to be getting better with the dilator. PT has been helping a little especially in things not getting worse, but doesn’t really seem to be moving in a better direction.

I’m curious about Botox in someone like me, where I don’t have the fear or inability to penetrate, but maybe breaking the pain cycle in my brain could help my muscles learn to stay relaxed as a natural state? I just haven’t found similar experiences to mine so it’s hard to know what next steps I should explore.

[mazemelissa]

Hi Rglady,

Sounds like you have done really great work, and have come a long way. Being able to have painfree PIV as times is amazing.

Something to consider might be diazepam suppositories to help further relax the muscles. They are a prescription and you would need to get them from your gyn.

Botox injections can also be helpful, as that would paralyze the muscle and make your PT and dilation even more effective.

Trigger point injections with a pain management provider might also be helpful, if you can really target the spot that is painful, a skilled provider can do an injection in that specific muscle to help relieve the pain.

The diazepam suppositories might be the easiest way to go first, try that for a month or two with your dilation and PT and see if you have more improvment.

Melissa

[Rglady]

Thanks for the reply. I’ve been using diazepam suppositories for awhile and I do think they helped soften everything up. I took them every night for a month or so and now i take them every so often. They help but the effects don’t seem to last, which is why I’ve been exploring Botox. A couple of months with less pain sounds really attractive, and could help me convince my brain not to anticipate pain all the time.

[Helen Leff, LCSW]

Hi Rglady,
So glad you are on the forum! Exploring Botox injections sounds like a good plan. I really hear you when you write about needing to convince your brain not to anticipate pain – the more successful pain free experiences you have, will continue to reinforce that penetration isn’t painful and a virtuous cycle will begin. Also, Somatic Experiencing therapy may be helpful as well – it works on regulating the central nervous system when there’s been “trauma”. Let us know how you are doing and how we can continue to support you,
Helen