issues & treatments

Pelvic Floor

Sexual Medicine

High tone pelvic floor dysfunction (HTPFD)

Some women and men with sexual health problems related in part to overactive, tight (hypertonic) pelvic floor.

This may occur in patients with primary or secondary provoked vestibulodynia, generalized vulvodynia, vulvo-vaginal atrophy, recurrent fissures in the posterior fourchette, extended use of oral contraceptives, and other hormone altering medications, dermatologic conditions such as lichen sclerosis, infections such as chronic candidiasis, and conditions such as desquamative inflammatory vaginitis (DIV).

Women and men with overactive, tight (hypertonic) pelvic floor may have sexual dysfunction and associated musculoskeletal abnormalities, postural/skeletal asymmetries, and/or soft tissue contractures, may have avoidance of direct touch to the genitals, and/or tightening of the muscles at the opening of the vagina.

Pelvic floor physical therapists may provide such treatments as manual therapy, massage, connective tissue and scar tissue release, visceral and urogenital manipulation pelvic floor surface electromyography (EMG) biofeedback, and low current transvaginal or external electrical stimulation.