This remote continuing education course is for the pelvic health practitioner who is new to treating patients with vaginismus/vulvovaginal dyspareunia or to vaginal trainer(dilator) use or pelvic health rehabilitation; or for the experienced practitioner who has found that patients with vaginismus/vulvovaginal dyspareunia plateau with vaginal trainers or other treatments. In this course, pelvic health rehabilitation providers will learn about the different types of vaginismus and dyspareunia. Definitions and history of terminology will be explained related to pain with sexual activity and intercourse, including Genito-Pelvic Pain/Penetration Disorder, Lifelong or Primary Vaginismus, Acquired or Secondary Vaginismus, Dyspareunia, Vulvodynia, and others.

From a pain-science viewpoint, verbiage and terminology to reduce patient fear and anxiety will be discussed and incorporated throughout the course. Evidence for focalized dystonia as a component of lifelong vaginismus and how that impacts treatment will be reviewed. Causes for acquired vaginismus (such as postpartum healing or hormonal changes) will be addressed. Treatment approaches for reducing patient fear and anxiety, addressing medical and/or sexual trauma/abuse history, and promoting patient empowerment will be covered. The remote live portion of the course will also focus on rehabilitation treatments, including walking the participant through functional use of vaginal trainers (commonly known as dilators), and methods for progressing their use. Clinical cases will be provided to illustrate a variety of treatment approaches based on different patients’ treatment goals, history, examination findings, and sexual pain diagnosis.