Gynecology

The pelvic floor muscles can cause many sexual and genital symptoms. How can we cure these symptoms?

Women health
Gynecology

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Created 13 February 2025
Updated 18 March 2025

Here's how Prof. Graziottin answers this question from her patients:

When the muscles are very contracted, they squeeze the vaginal entrance and contribute to sexual pain.

So, your tightened pelvic floor is responsible for at least 50% of the pain you have in your vulva and during intercourse.

So, to relax this tightened pelvic floor, three major tools:

  1. First of all, I'll teach you how to breathe with your diaphragm, with your belly, so to speak, because this will help you to relax your pelvic floor muscles.
     
  2. Second, I recommend that you ask for help from a competent physiotherapist so that she will teach you how to relax the pelvic floor with biofeedback and with hands-on massage, so to speak, to stretch the muscle and relieve your pain.
     
  3. In selected cases, we can use also diazepam in the vagina. This drug is captured by the muscles and relaxes the pelvic floor in a very gentle, effective way. It is an off-label, we say, treatment, but with a very, very solid scientific evidence. It should be used for a short period of time, but it will accelerate, so to say, the improvement, so that really you can get rid of this pain and enjoy your sexual intercourse.

In this clinical situation it is key to teach the woman how the relax the pelvic floor muscles with:

  • First, appropriate diaphragmatic breathing, which I teach her simply in the office during the gynecological examination;
  • Second, “hands-on” relaxing physiotherapy;
  • Third vaginal diazepam (2,5-5 mg), to be inserted in the vagina before dinner, for a short period of treating time, to ease the muscle’s relaxation (off-label, but with good scientific evidence).

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    Gynecology