This is the first retrospective study dedicated to investigating the full pelvic floor assessment and rehabilitation of patients with primary vaginismus, which is a condition characterized by involuntary muscle contractions of the pelvic floor muscles, specifically around the vaginal opening, whenever penetration is attempted, and affects approximately 3% to 6% of women.
Study aim: The goal of the research was to assess the efficacy of vaginal massage of pelvic floor muscles in treatment of patients with primary vaginismus.

The study included 40 women with the diagnosis of primary vaginismus with such symptoms as absence of vaginal intercourse throughout life, unbearable pain from attempts at penetration, fear of gynecological examination, constant tension in the pelvis, burning sensation when trying to penetrate. The average time duration of remaining symptoms varied from 2 to 19 years. The applied message technique included stretching and kneading predominantly bulbospongiosus muscles, teaching patients proper relaxation techniques (stomach breathing, leg spreading, buttock relaxation).

The average number of appointments needed to reach the full recovery varied from 5 to 7 each lasting up to 60 minutes. In most cases (85%) the main cause was bulbospongiosus muscles hypertonicity. First visits included mainly finger insertion into a patient’s vagina under constant monitoring of the patient's correct relaxation and maintenance of conversations at the time of performing this procedure. The 3rd and 4th visits were focused on vaginal dilators insertion of different diameters gradually, making sure patients were relaxed. During last appointments, patients were painlessly inserted with a maximum dilator. By the end of the treatment, patients were asked to have a sexual intercourse with their partners at home following all the recommendations for relaxation and calm penetration, and all of them did it successfully and painlessly. Four patients (10%) required help of physiotherapists, and tree of them (7.5%) were prescribed 25 mg of Amitriptyline daily. After successful recovery all patients completed a questionnaire were they were asked about why they achieved such a result by the end of the treatment: 90% responded that the doctor endeared herself and the patient was able to trust, relax and listen to instructions, and the remaining 10% admitted that the doctor took them from start to finish and did it in a short time, without taking long breaks between appointments.

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As primary vaginismus is a life-decreasing condition, it is essential to seek help from a specialist in sexual health once a patient declares its first symptoms. The key steps in treatment of patients with primary vaginismus include vaginal massage of the pelvic floor muscles (performed by a doctor), stretching and kneading of bulbospongiosus muscles, and teaching patients the correct relaxation technique during sexual intercourse. Thus, performing all these steps correctly by a qualified healthcare specialist is the most fundamental thing to reach a successful result and make patients happy.

to build a trusting relationship with patients with primary vaginismus. This is one of the fundamental points for obtaining the effect of therapy.
vaginal muscle massaging by a doctor accelerates getting results. Additionally, the patient feels in safe hands and believes in the result. Patients are often afraid to allow a partner to have a vaginal massage for fear of pain, and self-massage is often performed incorrectly and therefore ineffectively.
long intervals between appointments contribute to demotivation of patients