An 80-year-old woman who had persistent cystitis symptoms despite a negative urine test. Her vaginal pH was 8.5, so we initiated laser treatment. Additionally, she had severe pain in the obturator internus muscle, to the point where even light touch would make her wince in pain. She had been diagnosed with chronic cystitis, and there seemed to be no effective treatment available.

However, after her first rehabilitation session (including fascial release via the vaginal approach), her cystitis symptoms disappeared, and we also observed improvements in her pelvic floor muscle function. She made comments to our specialist staff, such as, “Was that all I had to do to move my pelvic floor muscles?”, “I can’t believe the symptoms are gone after that,” and “I was worried I had a strange illness.”

Myofascial pelvic pain syndrome (MPPS) causes both sensory and motor dysfunction stemming from the myofascia. The fact that symptoms improved with fascial release via the vaginal approach has led it to refer to this condition as ‘vaginal stiffnesses’.

I believe it’s essential to address both GSM and MPPS in treatment. Although GSM and MPPS are still not widely known, I think they are more common than shoulder stiffness.

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