Experiencing Pain with Sex? How We Diagnose This + Other Vaginal Vestibule Issues

Sex shouldn’t hurt. Get help with pelvic floor physical therapy.

Sex shouldn’t hurt. Get help with pelvic floor physical therapy.

By: Julie Sarton, PT, DPT, WCS

Here’s What To Expect When Being Seen for Issues Related to the Vaginal Vestibule

As you prepare for your appointment, rest easy knowing what you can expect!

First Up: The Clinical Test⁣

(aka the q-tip test or the neurosensory test)⁣

To conduct this test, we strap on our handy head lamps, and gently use a Q-tip to go all the way “around the clock”, applying a bit of pressure at each point around the clock. As we tap, we observe patient reactions and see if there’s pain, and if so, on what scale. ⁣

As pelvic floor physical therapists, that lets us know essentially the “map” of the pain, a layout of painful areas which we can use to assess whether the pain is a hormonally-mediated pain, a neurological hypersensitivity, or from hypertonic muscles.

Next Up: The Medical Test⁣

(aka the vulvoscopy)⁣

Our friend Dr. Irwin Goldstein in San Diego at San Diego Sexual Medicine does a fabulous job with this test.⁣ With this test, we can see the vulvar/vestibular tissue at a level that the naked eye cannot detect. Cool, right? That lets us know the health of the bartholin glands that surround the vestibule and create lubrication for vaginal opening during intercourse, or in general to help clean the vagina and keep its pH at a consistently healthy level.⁣

If you need to get in touch with a sexual medicine doctor who can give you this test in conjunction with your pelvic floor physical therapy treatments, we would be more than happy to assist you. Please visit pelvichealing.com for more information, or give us a call at (714) 770-8222.


We want to encourage you to get evaluated by one of our outstanding physical therapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain—you name it—these conditions do not have to control your life. There is hope. Call us today to book an appointment for vestibulodynia treatment, or inquire about a virtual, online treatment session.

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