Holistic Approach to Managing Grade 3 Vaginismus: An OBG Physiotherapy Perspective

Internet Journal of Allied Health Sciences and Practice Volume 23 Number 4 Article 11 August 2025 Holistic Approach to Managing Grade 3 Vaginismus: An OBG Physiotherapy Perspective Nagma Khan Independent Researcher, Follow this and additional works at: https://nsuworks.nova.edu/ijahsp Part of the 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, and the Women's Health Commons 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 11. This Case Study is brought to you for free and open access by the Dr. Pallavi Patel College of Health Care Sciences at NSUWorks. It has been accepted for inclusion in Internet Journal of Allied Health Sciences and Practice by an authorized editor of NSUWorks. For more information, please contact . Holistic Approach to Managing Grade 3 Vaginismus: An OBG Physiotherapy Perspective 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, noninvasive 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. Author Bio(s) Dr. Nagma MPT, BPT, MIAP, COMT is a consultant physiotherapist specializing in obstetrics and gynecology (OBG) physiotherapy. With expertise in pelvic health, postpartum recovery, and sexual health rehabilitation, Dr. Nagma is committed to evidence-based practice and empowering women through physiotherapy. She is also dedicated to advancing the field through research and patient care. 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. This case study is available in Internet Journal of Allied Health Sciences and Practice: https://nsuworks.nova.edu/ijahsp/vol23/iss4/11 Dedicated to allied health professional practice and education Vol. 23 No. 4 ISSN 1540-580X Holistic Approach to Managing Grade 3 Vaginismus: An OBG Physiotherapy Case Study Nagma Khan Independent Researcher United States ABSTRACT Purpose: 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. Method: 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. Results: 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 dilator (...truncated)