A 21 year old, newly married female with
complaints of dyspareunia. She presented to physical therapy with pelvic
floor pain and vaginismus. The patient is a nursing student with high
anxiety in her work day.
This patient had been married only a few months when she arrived to PT for her evaluation. Her chief complaint was an inability to tolerate intercourse at all. It had been almost 2 months since she had last had sexual intercourse with her husband. She reported an inability to tolerate penetration, therefore, could not engage in intercourse at all. Her report was "sharp” and on the left side, "Causing her to lose her breath”.
Treatment: Biofeedback to teach relaxation of pelvic floor muscles, education of positioning to better tolerate intercourse, a LE stretching program with down training of pelvic floor muscles, relaxation strategies, and manual therapy for internal trigger points
Progress: The patient was discharged on 04/05/12 after only four treatments. She was proficient with the use of dilators as a home program and could independently demonstrate her home exercise program. She reported very minimal pain (1/10) with initial insertion, but could complete the act of sexual intercourse pain free.
She was very pleased with her progress, and feels it greatly decreased the frustration not only she, but also her husband, was experiencing due to the pain. The primary goal was pain free intercourse, and this goal was met within one month of treatment, with only a single visit per week.
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