Abstract
Background: Vaginismus is a condition characterized by involuntary pelvic floor muscle contractions, which can make vaginal penetration painful or impossible. This disorder has both physical and psychological components, often leading to significant emotional distress, anxiety, and relationship difficulties. Effective management requires a holistic, multidisciplinary approach, combining physical therapy with psychological support. This case report examines the treatment of a 29-year-old woman with grade 3 vaginismus, highlighting the role of Obstetrics & Gynaecology (OBG) physiotherapy in improving both physical symptoms and emotional well-being.
Case Presentation: A 29-year-old female presented with grade 3 vaginismus, with a history of severe pelvic floor tension and a complete inability to tolerate vaginal penetration. The patient experienced heightened anxiety, social isolation, and marital distress due to infertility concerns. After unsuccessful treatment with muscle relaxants prescribed by a gynaecologist, the patient sought physiotherapy through an awareness post on women's health. The treatment program was individualized and included a combination of relaxation therapy, myofascial release of the pelvic floor muscles, stretching exercises for the adductors, hip flexors, and glutes, as well as bibliotherapy for emotional support.
Outcome: After five sessions, the patient showed significant improvement, including reduced pelvic floor muscle tightness, the ability to tolerate 1.5 knuckles of vaginal insertion, and enhanced pelvic floor control. The patient also reported reduced anxiety, improved body awareness, and increased confidence in her ability to engage in intimate activities. These positive outcomes highlight the efficacy of a holistic approach to vaginismus treatment, where both physical and psychological factors are addressed.
Conclusion: This case demonstrates the effectiveness of a comprehensive physiotherapy-based approach to managing grade 3 vaginismus. By integrating physical therapy with relaxation techniques, stretching, myofascial release, bibliotherapy, and vaginal dilators, OBG physiotherapists can provide holistic, non-invasive care that significantly improves both physical symptoms and emotional well-being. This case underscores the critical role of physiotherapy in the multidisciplinary management of vaginismus and provides valuable insights for clinicians in this field.
Acknowledgements
I would like to extend my sincere gratitude to the patient for her cooperation, trust, and active participation throughout the course of treatment. Her dedication and openness were crucial in achieving the successful outcomes reported in this case. I would like to thank my colleagues for their invaluable guidance and assistance during the preparation of this case report.
Recommended Citation
Khan N. Holistic Approach to Managing Grade 3 Vaginismus: An OBG Physiotherapy Perspective. The Internet Journal of Allied Health Sciences and Practice. 2025 Aug 08;23(4), Article 5.
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Community Health and Preventive Medicine Commons, Development Studies Commons, Health and Physical Education Commons, Health Services Research Commons, Maternal and Child Health Commons, Movement and Mind-Body Therapies Commons, Other Rehabilitation and Therapy Commons, Physiotherapy Commons, Public Health Education and Promotion Commons, Women's Health Commons
