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PHYS THER
Vol. 87, No. 7, July 2007, pp. 935-941
DOI: 10.2522/ptj.20060168

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Case Reports

Management of Dyspareunia and Associated Levator Ani Muscle Overactivity

Kimberly A Fisher

KA Fisher, PT, MPT, is Director, Pelvic Floor Rehabilitation Unit, OU Pelvic and Bladder Health Clinic, 825 NE 10th, Ste 3400, Oklahoma City, OK 73104 (USA); Clinical Instructor, Section of Female Pelvic Medicine and Reconstructive Surgery/Urogynecology, Department of Obstetrics and Gynecology; and Clinical Instructor, Department of Rehabilitation Sciences, University of Oklahoma Health Science Center, Oklahoma City, Okla

Address all correspondence to Ms Fisher at: Kimberly-A-Fisher{at}ouhsc.edu

Background and Purpose: Musculoskeletal dysfunction is a known cause of dyspareunia and a reason for referral for physical therapist management. The purpose of this case report is to describe the physical therapist management of a patient with dyspareunia and overactivity of the pelvic-floor muscles with a limited number of visits and a focus on self-management strategies.

Case Description: This case involved a 30-year-old married woman with levator ani muscle overactivity and dyspareunia that was 1 year in duration.

Intervention: The therapist explained the anatomy and function of the pelvic-floor muscles during intercourse, instructed the patient on how to control the levator ani muscles, and instructed her on vaginal self-dilation techniques.

Outcomes: The patient attended 3 physical therapy sessions over a period of 9 weeks. She performed vaginal self-dilation at home. She rated pain during intercourse as 0/10 on a verbal rating scale and had no remaining tenderness in the levator ani muscles at discharge.

Discussion: Some women with dyspareunia may improve with an intervention that emphasizes education and vaginal self-dilation techniques. Future research should compare home-based and clinic-based treatments.


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