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I tend to cramp after intercourse or a pelvic exam. The cramps feel like it’s within the vagina. Sometimes I’m achy for a day afterwards. Sometimes I feel like my vagina is being pulled downward in a weird sensation. My doctor suggested I look into pelvic physical therapy. Is this legitimate? Are there any other treatments?

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I tend to cramp after intercourse or a pelvic exam. Sometimes it’s hard to insert a tampon or anything. The cramps feel like it’s within the vagina. Sometimes I’m achy for a day afterwards. Sometimes I feel like my vagina is being pulled downward in a weird sensation. My doctor suggested I look into pelvic physical therapy. Is this legitimate? Are there any other treatments? It’s interfering with my relationship. I’m tired of being in pain after sex and frustrated by the suggestion that it’s in my head. Is “anxiety” the new female hysteria diagnosis?

I’m sorry to hear about the pain you are experiencing after sex. The description sounds like it could be related to vaginismus which is a spasm or contraction of the muscles around the vagina. There are two types of vaginismus: primary, which is when vaginal penetration has never been achieved; and secondary, which is when vaginal penetration has been achieved but is no longer possible.

A number of factors can trigger vaginismus, including sexual intercourse, pelvic exams and even inserting a tampon into the vagina. Possible underlying causes include sexual trauma, dryness and pelvic floor muscle issues. I do think seeing a pelvic pain specialist and a pelvic PT can be helpful if this is indeed what is going on. I definitely recommend speaking with your gynecologist or primary care physician to explore the reasons for your symptoms and possible treatment options.

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