Vulvo-vaginal Pain & Sexual Dysfunction

Vulvo-vaginal pain can stem from a lot of different things. Sometimes, it’s a quick fix, like a simple bit of scar tissue or muscle tension that’s resolvable in one or two sessions; or, it can be a trauma-related, emotionally fraught challenge that needs a more long-term and multifaceted approach; other times, it’s something in between. We treat this whole spectrum on a daily basis, and see our clients improving all the time. So FYI, it’s unlikely that you’ll share something we haven’t heard before – it’s very likely we can help.

  • Pain with vaginal penetration

  • Clitoral pain or lack of sensation

  • Pain after sex or penetration of any kind (sexual / medical)

  • Pain from tight jeans, bike seat, sitting or anything else!

  • All types of diagnoses, like vestibulodynia, vulvodynia, vaginismus, endometriosis and other chronic pain conditions

What we treat

Our approach is highly variable depending on the person. While always true, this is particularly important with these issues, as they tend to be more emotive and sensitive. For some people, we spend lots of time helping them to be able to have an internal exam. For others, we might start with internal work, like dilators, or manual therapy right away.

We can help with: 

  • Treating the vulva sensitivity and giving strategies for the aggravating activities

  • Practical tips for staying sexual without flaring up pain

  • Graded exposure to build up to penetration / bike riding (insert goal here) 

  • Teaching you to control and relax your pelvic floor to allow penetration / pressure without pain

  • Using dilators to help improve sensitivity and work up to penetration goals (penis; sex toy; speculum – whatever it is). 


We also do hands-on manual therapy and pain education to help create shifts both in your body and in your understanding of what's happening. The most important aspect of our approach is that you feel empowered and in control.

  • "This is the most understood & supported I've ever felt in a medical office. The inclusive, compassionate & genuine care I was treated with by each & every staff member was incredible. Emily was a truly phenomenal practitioner; her questions, explanations, assessment & treatments were gentle, empathetic & effective. I've only had one appointment, but for the first time in years, the possibility of living without pain seems like a real possibility. I don't have the words to truly express how much that means to me. If you're searching for pelvic floor physio in Vancouver, look no further - these wonderful people are the best."

    Cheerful Client

  • "Devon, thank you so much for your help with my longstanding pelvic issues. Your gentle and effective therapy sessions have brought me relief and comfort that I hadn’t experienced in years. Your caring and professional approach has been a blessing and I would highly recommend your services to anyone in need of a gentle and skilled therapist!"

    Cheerful Client

  • "I really want to thank Lily for all of her help and support. It was hard to imagine being pain-free or believe there was nothing physiologically wrong with me, but Lily knew what was possible and gave me the tools to succeed, celebrating my little wins along the way. 🥳 She is the most supportive, non-judgmental person I’ve ever met, creating the safest space for these important discussions and exercises. Her experience, spot-on assessments, and clear instructions are critical for your success. If you’re looking for a pelvic floor PT, you’ve come to the right place. Thank you, Lily ❤️"

    Cheerful Client

  • "I’m truly so thankful that I found Cheerful Pelvis. It is such a welcoming and inclusive place, that has helped me understand and care for my body in a much healthier way, and has also helped me combat a lot of my internalized body shame."

    Cheerful Client

FAQ’s

  • Yes! From a physio perspective, we treat the physical concerns and your symptoms and struggles as we find them. A label doesn’t change this; approaches can be similar across diagnoses or differ for the same diagnosis because they’re so person-dependent. Having a formal diagnosis (or not) wouldn’t change your prognosis at all.

  • Yes! There are a few ways we can help: 

    • We can assess and treat your pelvic floor externally without going internal at all. 

    • Or we can teach you how to do internal work yourself. 

    • We can also use real-time ultrasound through your abdomen or perineum to assess. 

    • We can also find and treat the non-pelvic floor-related factors. 

    Sometimes people get fully better without ever having an internal exam. Sometimes, as people improve, they get comfortable and are happy to start internal work. 

    If internal physio is needed, and you’re not ready, it’s common to take a break and come back to physio when you are. Often, clients feel quite informed and empowered returning when they have already made a start with us.

  • Vulvo, vaginal and sexual pain is complex and can be highly related to what’s going on in your life and your nervous system at the time. Sometimes, timing is off, and we’ve had clients get stuck, then come back a year later and see a huge improvement because the timing was right and they were ready.

    We also know that it’s important to conduct a thorough full-body exam, because this type of pain can be influenced by factors far outside the pelvis. If you have only had a local pelvic floor assessment, it’s possible that something has been missed that could make a difference. We make sure to check all this thoroughly and work as a team between our physios for more complex cases to ensure we’re not missing anything.

I want a cheerful pelvis!

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