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Dr. Tim, MD
Dr. Tim, MD, Board Cert. OB/GYN
Category: OB GYN
Satisfied Customers: 950
Experience:  General OB/GYN, complicated obstetrics, complicated GYN
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Dear Dr, I'm 34 and have had a tight pelvic floor

Customer Question

Dear Dr,
I'm 34 and have had a tight pelvic floor for past few years due to stress and have received botox injections last year, which worked well and use a Valium suppository, which works but dislike how it makes me feel mentally. I have been fine for a year and just noticed the pain came back and tight muscles
I tried relaxing and embarrassed to admit, but tried gently masturbating to relax. However, I think I squeezed my muscles and worse
Should I be concerned? Would gentle masturbation weakeb the pelvic.floor muscles? They feel fatigued and tighter.
I'm going to see my Dr and use a suppository to help. But just can't stop thinking about why my muscles could easily get fatigued and feel awful. It could be mental too, because when I think of something stressful.I involuntarily squeeze my muscles. I have to be so saware
Thank you,liz
Submitted: 6 months ago.
Category: OB GYN
Expert:  Dr. Tim, MD replied 6 months ago.
Hello, I would be happy to help.You are clearly suffering from a condition called vaginismus, but you probably already knew that term. Here is an excerpt from a reputable source with some thoughts regarding treatment to start this discussion: Primary and secondary vaginismus may be treated initially with myofascial release of muscle tension in muscles of the pelvic floor, thighs, and abdomen, with or without biofeedback (you have tried this with botox). Desensitization techniques are then applied to give the woman control over muscle tonicity/relaxation. Activities include Kegel exercises, the pelvic floor drop technique (reverse Kegel), and use of dilators. Self-insertion of dilators of gradually increasing size in and out of the vagina teach the woman that control of introital musculature can be voluntary and painless. Desensitization is the goal of dilator therapy, not physical enlargement of the vaginal opening. A small amount of topical anesthetic should always be used on any object inserted intravaginally since desensitization will not occur without painless insertion.Other therapeutic approaches include sex therapy, progressive relaxation, sensate focus, electromyography, biofeedback, use of benzodiazepines, hypnotherapy, and Botulinum toxin type A injections. So, with regard to masturbation, I think that this might not be the right approach to learning desensitization techniques. No, gentle masturbation will not weaken the pelvic floor muscles, and, in fact, this is actually what you are trying to do. You obviously know the triggers involved in making things worse, and the feeling of 'fatigue' is related to the fact that the muscles are in a constant state of contraction. I have found with patients that the use of Physical Therapy is an excellent place to start. This involves intensive therapy to learn biofeedback techniques used to relax the muscles surrounding the vagina. I do not think that masturbation is bad, but it should not result in feeling worse afterwards. Dr. Tim
Customer: replied 6 months ago.
OK thank you, ***** ***** its new to me, my drs never used that term with me. But sounds like the same thing they've described as well. I did do PT for pelvic floor which helped a lotI just hate having to be so conscious of my muscles at all times. Its a lot of work. I worry very much about this problem all the time.Thank you again
Expert:  Dr. Tim, MD replied 6 months ago.
Now that you know the term, take some time to do a little reading / googling. You need to find people who are specifically familiar with this situation and diagnosis. You CAN solve the problem but it will take patience and time. If you are happy with my answer, PLEASE REMEMBER TO PROVIDE A POSITIVE RATING. Dr. Tim