Hypertonic Floor – Dilators

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    I am 49-year-old perimenopausal woman who due to stress/anxiety and low hormones have developed vulvodynia and hypertonic pelvic floor. I also have birthed vaginally three babies with serious 3 and 4th degree tearing so scars exist. It hurts to have sex and inserting and moving anything in the vagina hurts. In addition, my vaginal muscle cause soreness, pain and burning most times. My pelvic pain specialist put me on compound hormone cream for the vestibule and vaginal estrogen. In addition, I have muscle relaxers for the hypertonic floor and will be starting pelvic floor therapy in four weeks. My doctor also prescribed vaginal valium to be used only during therapy so I haven’t tried it yet.
    In the meantime, I am doing Heal Pelvic Pain exercises and myofascial massage ball rolling and pressure on my muscles externally which does help. I really need to address the internal tightness as in my last exam she said it was very tight (especially on the left side.
    I tried using my thumbs with lubrication to push 3 to 5 o’clock and 7 to 9 o’clock in my vagina. It was uncomfortable but I was able to do five minutes. Afterwards, it burned when I peed (only once) and I was very sore. I am assuming this is due to stretching the muscle?
    My question is should I continue to use thumbs or would the dilation set I purchased to be better suited? Should I just insert the dilator or move it in any manner?
    Any advice would be appreciated as I know that being able to relax my pelvic muscles is the key to my recovery.


    Hi Soccermom!

    Sounds like you are doing great work already. I think incorporating more dilation will definitely help. There is a great book by Heather Jeffcoat, PT called Sex without Pain that has instructions on how to use your dilators more effectively to further stretch the muscles. Using the dilator to apply pressure to the left and right side, or to an area of increased tension can be helpful.

    I love that you are using the compounded estrogen for the vagina and vestibule. Really massage the cream into the entrance for 30 seconds, it will be more effective that way.

    As for the vaginal valium, you might get better benefit if you use it on a regular basis, every other night or every night, so the muscles are continually exposed to the muscle relaxing effects of the valium.

    I hope this helps. Melissa

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