Tight pelvic floor vs vaginismus: What's the difference?
Experiencing discomfort or pain in your pelvic region can be concerning and confusing, especially when trying to understand the underlying cause. Many women face issues related to a tight pelvic floor or vaginismus, yet these terms and conditions are often misunderstood or used interchangeably. In this blog, we will demystify these conditions, highlighting their differences and guiding you towards effective solutions for your pelvic health.
What is a tight pelvic floor?
A tight pelvic floor, also known as a hypertonic pelvic floor, is a condition where the pelvic floor muscles are excessively tense or in a constant state of contraction. Many factors affect the female pelvic floor, with stress, physical trauma and over-exercising all potential causes of tightness.
A hypertonic pelvic floor is different to a hypotonic pelvic floor, which involves weakened pelvic floor muscles that lack sufficient tone. This can lead to issues such as incontinence and pelvic organ prolapse.
What is vaginismus?
Vaginismus is a complex condition involving involuntary muscle spasms in the muscles surrounding the vagina, making penetration painful or even impossible. These spasms are often triggered by the anticipation of vaginal penetration, whether it's during sexual intercourse or when inserting tampons.
Vaginismus can be both physically and emotionally distressing, impacting sexual relationships, self-esteem and overall quality of life. While the exact cause of vaginismus can vary from person to person, it is commonly associated with psychological factors such as fear, anxiety, past trauma or negative experiences related to sex.
Key differences between tight pelvic floor and vaginismus
While both involve pelvic floor issues, a tight pelvic floor primarily revolves around overly tense muscles, leading to discomfort and pain. On the other hand, vaginismus specifically entails involuntary muscle spasms around the vaginal opening, causing pain and difficulties with penetration.
How do you know if your pelvic floor is tight?
When it comes to how to tell if your pelvic floor is tight or weak, it’s all about paying attention to specific symptoms, and undergoing a pelvic floor examination with a pelvic floor physiotherapist. Common tight pelvic floor symptoms in females include:
Pelvic pain, including during menstruation or pelvic exams
Difficulty inserting tampons due to pelvic discomfort
Pelvic floor tenderness
Tightness or spasms in the pelvic region
Painful intercourse
Incomplete bladder emptying
Constipation, straining
Incomplete bowel movements
Lower back pain associated with pelvic floor issues
Painful coccyx/ tailbone
Weak or hypotonic pelvic floor symptoms are different. Signs to look for include leaking urine when you laugh or sneeze, feeling a heaviness in your pelvic area and struggling to control your bladder or bowel movements.
How do you reduce tone in a tight pelvic floor?
Various strategies and treatments exist to relieve tight pelvic floor muscles in females. Some effective pelvic floor treatment options include:
Pelvic floor physiotherapy: Engage in specialised exercises and techniques under the guidance of a pelvic floor physiotherapist to release muscle tension and improve flexibility. They’re your go-to for pelvic floor dysfunction and other conditions related to a tight pelvic floor.
Internal vaginal release Pelvic floor massage: Gentle massage techniques performed by a trained pelvic health physio massage therapist can help release tightness and increase blood flow to the pelvic floor to the pelvic area.
Dilators or pelvic wands are tools physios prescribe to help with self-release and stretch in the comfort of your home.
Breathing exercises: Practise deep breathing techniques to promote relaxation and reduce tension in the pelvic floor muscles.
Yoga and stretching: Incorporate yoga poses and stretching routines targeting the pelvic floor to increase flexibility and reduce muscle tightness.
Acupuncture: Consider acupuncture for a tight pelvic floor. Acupuncturists insert fine needles into specific points to help release tension and promote overall relaxation in the pelvic floor muscles.
Biofeedback therapy: Utilise biofeedback devices to gain awareness of pelvic floor muscle activity and learn to control and relax these muscles more effectively.
Mindfulness and meditation: Practise mindfulness techniques and meditation to reduce stress and anxiety, which can contribute to pelvic floor tension.
Warm baths and heat: Take warm baths or apply heat packs to the pelvic area to relax muscles and relieve tension.
Dietary changes: Make dietary modifications with the help of a women’s naturopath to reduce inflammation and improve pelvic floor health. This may involve increasing your water intake and consuming fibre-rich foods.
Stress management: Implement stress-reducing techniques such as mindfulness, relaxation exercises and seeking support from a therapist or support group.
How do you know if you have vaginismus?
Recognising the early signs of vaginismus will help you receive a proper diagnosis and explore treatment options tailored to your needs. Here are common vaginismus symptoms in female patients:
Finding it challenging or impossible to insert tampons, undergo a gynaecological exam or engage in sexual intercourse due to pain or discomfort.
Experiencing sharp or burning pain during any form of vaginal penetration, regardless of the size of the object.
Feeling anxious, fearful or tense at the thought of vaginal penetration, which may lead to avoiding sexual activity or gynaecological exams.
Experiencing involuntary muscle spasms or contractions in the pelvic floor muscles when attempting vaginal penetration.
Can vaginismus be cured?
With the right pelvic floor therapy for vaginismus, the condition can be cured. Vaginismus treatment typically involves a multidisciplinary approach, meaning finding the right integrated women’s health clinic is crucial. Here are some common vaginismus treatments:
Pelvic floor physiotherapy: Work with a pelvic health physiotherapist who can provide tailored exercises, therapy, and techniques to relax and optimise pelvic floor function
Dilator and pelvic wand: Gradually progress through a set of vaginal dilators under the guidance of your pelvic health physio to lengthen vaginal muscles.
Cognitive-Behavioral Therapy (CBT): Engage in therapy sessions with a mental health professional to address underlying psychological factors contributing to vaginismus, such as fear or anxiety.
Relaxation techniques: Practise relaxation exercises for vaginismus, such as deep breathing and mindfulness, to reduce muscle tension and promote relaxation during attempts at vaginal penetration.
Education and counselling: Receive education about vaginismus and counselling to address concerns, fears and misconceptions related to sexual activity and vaginal penetration. Involving your partner in therapy sessions and finding vaginismus support groups can support you on your healing journey.
Nurturing your pelvic health with holistic care
Whether you have a tight pelvic floor or vaginismus, seeking appropriate care is key. Pelvic floor physiotherapy and other tailored treatments can provide relief and support on your journey to improved pelvic health. Papaya Clinic is here to provide compassionate and personalised care to empower you on your path to wellness. If you're ready to take the next step towards understanding and managing your pelvic health, reach out to our experienced Sydney pelvic pain physiotherapists today.
