It's actually called pelvic floor physical therapy, and it's a legit treatment for pain during sex and other conditions.

Jessica Migala
March 07, 2018

When Lena Dunham opened up recently about having a hysterectomy at age 31 following her struggle with endometriosis, she noted the various treatments she had tried in order to relieve her debilitating pelvic pain. Among them: “vaginal massage.”

“I go to pelvic-floor therapy, massage therapy, pain therapy, color therapy, acupuncture, yoga, and a brief yet horrifying foray into vaginal massage from a stranger,” she wrote in Vogue.

RELATED: What It's Really Like to Get a Hysterectomy

The term “vaginal massage” may not be legit—practitioners don’t like to use it—but the treatment is. In fact, it’s part of a well-rounded therapy regimen for pelvic floor physical therapy. Certified specialists in this field can help women who are dealing with pain during sex—something 75% of women experience at some point in life, according to research.

Pelvic floor physical therapy can also combat general pelvic pain, incontinence (both urinary and fecal), tailbone pain, and constipation, says Lauren Tadros, a physical therapist at NYU Langone’s Joan H. Tisch Center for Women’s Health.

Pain can emerge because of lifestyle factors and underlying medical problems. Sitting all day can affect the nerves in your saddle, which may translate into a burning pain in your vulva, explains Rhonda K. Kotarinos, DPT, a specialist in pelvic floor dysfunction in the Chicago area. The discomfort of chronic vaginal infections or holding urine all day long can also lead someone to “walk around with their pelvic floor clinched to their ears. It can make your pelvic floor very angry,” she says.

Finding help isn’t exactly easy, especially since women are often hesitant to bring them up. “My patients often express that doctors have told them that their pain is normal or that it’ll go away. Or various testing comes back inconclusive,” says Tadros. “They hit a dead end, and it sometimes takes women a year to get to us,” she adds.

RELATED: 5 Reasons Why Sex Can Feel Painful

Pelvic pain can be a huge drag on a woman’s quality of life. Pain during sex can be distressing and become a major strain on a relationship, explains Tadros. Some patients with general pelvic pain can’t wear tight pants without being uncomfortable. And standing for an extended time might hurt, making an impact on their social life. 

How pelvic floor physical therapy works

It’s highly unlikely that someone will head into a therapist’s office for a stand-alone “vaginal massage.” Why not? “It’s one small aspect of the whole therapy,” says Laura Y. Huang, MD, assistant professor of physical medicine and rehabilitation at the University of Miami Miller School of Medicine. She notes that pelvic floor muscle training, biofeedback, soft tissue release, and education are some of the many pelvic floor physical therapy treatments used to relieve pain or retrain muscles. Learning techniques and strategies to manage the condition at home is also part of treatment.

But while “vaginal massage” is a general, nonspecific term, it may be used to treat the musculoskeletal system of the pelvic floor, notes Dr. Huang. Sometimes this may be internally through the vagina or anus, though the target isn’t the vagina itself, but rather the muscles. “Some muscles, like hip rotator and pelvic floor muscles, are better accessed internally,” she says. (Imbalances in other muscles like those found in the abdominal wall or hip girdle are best treated from the outside.)

RELATED: Reasons Guys Should Do Kegels (Including Better Sex for Both of You)

If that’s part of your treatment protocol as determined by your therapist, she may use one finger to stretch and mobilize the pelvic floor muscles, explains Tadros. While it may seem like some patients would balk at this, “I find that patients are so desperate for help, they’re more than okay with having it done. We don’t use a speculum or stirrups. This isn’t invasive, it’s designed to keep someone as comfortable as possible,” she adds.

Finding help for your pain

If you’re dealing with pelvic pain, Kotarinos recommends researching the International Pelvic Pain Society or the American Physical Therapy Association to find a qualified pelvic floor physical therapist. (You can also see your PCP for a referral.) Dr. Huang also suggests focusing on your health holistically, with things like stress management, regular exercise, and a well-balanced diet. “We want to educate and empower women to be in control,” she says.

To get our best wellness tips delivered to you inbox, sign up for the Healthy Living newsletter

Remaining mum because you're embarrassed or don't think your condition is treatable may mean suffering in silence. Women shouldn’t be afraid to talk to each other or their doctors. “You’d be surprised at how many people deal with this pain. There is help out there,” adds Tadros.