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Pain Management/Tight Urogenital Diaphragm


Hi, I have been told by my doctor that I have a tight urogenital diaphragm which is causing dyspareunia. I have had symptoms for 4 years but largely ignored them presuming that that was what it was like after childbirth (had 2 children 2006/2008 both as caesarians). I was wondering if you had come across this at all before and if you knew of any effective treatments?

Thank you for your help.

Hello, Melinda.

I'm going to answer your question and the offer a way for you to free your urogenital diaphragm, by yourself.

A tight urogenital diaphragm means you have muscles in contraction in the floor of your pelvis.  The usual causes are long-term anxiety (habituated Startle Reflex), habitual protection of the region by closing up (sexual avoidance), or an injury or painful event (Trauma Reflex).

I explain Trauma Reflex in this article. |
An explanation of startle reflex exists in the book, Somatics | ReAwakening the Mind's Control of Movement, Flexibility and Health, by Thomas Hanna.  
more on his method:

Somatic education exercises free tight muscles by bringing them back into your control.  Standard Kegel exercises address those muscles (do a web-search for Kegel exericses).  A more potent form of Kegel exercises exists in the program, titled, "The Five-Pointed Star", called, The Cadenced Breathing. |

You may try massage, but I think that the process would be rather painful, done that way.

By deliberately working those muscles in a slow way, you develop the needed control to free them.  

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Lawrence Gold


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In practice since 1990. Two years on staff at a hospital Wellness and Rehabilitation Center.

Townsend Letter for Doctors and Patients, American Journal of Pain Management, Somatics: Magazine-Journal of the Mind-Body Arts and Sciences. More complete listing at

Certifications: Hanna Somatic Education, the Dr. Ida P. Rolf method of Structural Integration (partial list)

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