Hypertonic Pelvic Floor Muscle Dysfunction
This condition, also called levator ani syndrome or (and previously called vaginismus) is a common cause of vestibulodynia (pain of the vestibule) and dyspareunia (painful sex). In this condition, the muscles that compose the floor of the pelvis and which come together in the back part of the vestibule (the pubococcygeus, puborectalis and transverse perineal muscles) become tight and tender. When these muscles are tight, less blood flows through them providing less oxygen to cells and resulting in a build up of lactic acid. The lactic acid causes the sensations of burning, rawness, throbbing, stabbing and aching so many women experience. In addition, it causes severe tenderness and redness of the vestibule near the perineum.
Women with pelvic floor dysfunction often also have urinary symptoms such as frequency, urgency and incomplete emptying of the bladder. In addition, constipation, hemorrhoids and rectal fissures (tears in the anal area) are common. Finally, women may also have low back and/or hip pain.
Treatments for pelvic floor dysfunction include pelvic floor physical therapy, biofeedback, pelvic floor relaxation exercises, vaginal dilators, rectal or vaginal Valium suppositories, trigger point injections, and Botox injections.