Dyspareunia is a common condition among nulliparous women, often leading to enxiety and reduced quality of life. This study evaluates the efficacy of a non-medical, but physiotherapeutic rehabilitation program focusing predominantly on coordinated pelvic floor relaxation, breathing techniques, and manual therapy.

The study included 20 nulliparous women aged 18 to 42 who complained about pain during sexual intercourse. Patients with a medical history of previous childbirth and ongoing pharmacological pain management were excluded. All women were examined with an assessment of pain intensity measured on the Visual Analog Scale (VAS) and manual palpation of pelvic floor muscles. All patients had regular appointments with me every 2-3 weeks, each lasting one hour, which included coordinated pelvic floor relaxation, breathing techniques, and manual therapy when necessary. Patients practiced voluntary pelvic floor relaxation, breathing exercises, and stretching daily at home for 15 minutes per session, with an average of 3-7 sessions per week. The rehabilitation was considered successful and stopped when a patient had pain reduction (VAS = 0) and palpable normalization of pelvic floor tension. Notably, some patients were seen more frequently, once a week, and achieved results after just 3 sessions.

40% of patients achieved symptom disappearance in 2 sessions. Another 40% were required to have 3 sessions, and only 20% needed 4 sessions. Patients who practiced at home on their own without supervision often achieved results in one session, with no recurrence at follow-up.

The study demonstrated a high success rate in treating dyspareunia with non-pharmacological rehabilitation. 80% of patients achieved full symptom relief in 2–3 sessions, while 20% required four.
Pain reduction to VAS = 0 correlated with muscle relaxation, confirming true neuromuscular recovery.
Patients who practiced at home improved faster, some after just one session.
Slower responses (20%) were linked to higher muscle tension, chronic symptoms, or psychosocial factors.
Manual assessment ensured that improvement was due to actual muscle relaxation, not compensatory patterns.
These results support pelvic floor therapy as an effective first-line treatment for dyspareunia.

A structured rehabilitation approach focusing on pelvic floor coordination and relaxation techniques is essential in managing dyspareunia in nulliparous women. Our study proved that all symptoms of dyspareunia can be managed in a short period with no further relapse if a healthcare specialist applies correct pelvic floor muscle techniques. Regular at-home exercises significantly enhance the effectiveness of the rehabilitation process. Further studies with larger participant groups are warranted.