Sexual Trauma and Pain: A Study of Women’s Experiences With Vaginal Dilators and Perineal Massage in Trauma-Informed Pelvic Floor Physical Therapy

Background: A history of sexual trauma may result in severe physical and emotional trauma in women, with repercussions regarding sexual complaints. Deploying targeted physical, therapeutic, and trauma-informed treatment is important to achieve optimal patient outcomes. Objectives: We explored the experiences of women with a history of sexual trauma and sexual pain who performed pelvic floor physical therapy (PFPT) for sexual pain. Methods: In this qualitative study, we used semi-structured interviews to explore the perceptions of women with a history of sexual trauma who performed PFPT for sexual pain treatment with perineal massage and dilator use. We transcribed the interviews verbatim and analyzed them with content analysis to identify 5 themes. Results: We interviewed 10 participants (mean age, 30.3 years; SD, 4.2 years). We identified 5 themes: pain-invalidation, rapport, sexual education and body awareness, perineal massage, and dilators. Discussion: This is the first study to evaluate the experiences of women with a history of sexual trauma regarding PFPT. The approach is very intimate and may trigger memories of sexual trauma; however, trauma-informed care may reduce traumatization in the office and help women to overcome their fears.