There is a quiet link most women are never told about: the way you breathe and the way your pelvic floor holds are connected. When you breathe high and fast in the chest — the way we all do when we’re anxious — the pelvic floor tends to grip along with you. When you let the breath drop low and slow, the same muscles soften. You can feel it if you pay attention.
This is why I ask every woman to begin with the breath, before anything else.
The rhythm: in for four, hold for two, out for six
It’s deliberately simple, because in a tense moment simple is all the mind can hold:
- Breathe in gently through the nose for a count of four — let the belly, not the chest, rise
- Pause softly for two
- Breathe out slowly through the mouth for a count of six
The long out-breath is the part that does the work. A slow exhale tells the nervous system the danger has passed, and the body answers by letting go. Three or four rounds is often enough to feel the shoulders drop and the floor ease.
When to use it
Before you practise, of course — a minute of this first sets the tone for everything that follows. But also before a smear test or an examination, in the waiting room, or any moment the old fear starts to climb. It costs nothing, no one can see you doing it, and it is always available.
Make it a habit, not a rescue
The breath works best when it isn’t saved only for hard moments. Practised a little each day, it becomes the body’s first response rather than panic — so that by the time you need it, it’s already familiar. In the app it’s built in as a guided four-two-six animation you can follow with your eyes closed, any time you need a calm minute.
Gentle next steps
When you’re ready, two quiet ways to begin
Understanding is the first step. The rest comes from gentle, steady practice — at your own pace, in private, with a companion by your side.
The Vaginismus Book
A gentle, science-based guide to understanding what’s happening and why. “Knowledge removes fear.” In English and German.
The TVZ App
Your private, step-by-step dilator companion. Follow a gentle 9-stage path, log each practice, and build confidence at your own pace. Everything stays on your phone.
A few quiet breaths first — everything else can wait until they’ve landed.
Warmly,
Dr Julia Reeve
Gynaecologist · Psychotherapist · Sexologist · Author of The Vaginismus Book
Dr Julia Reeve
Gynaecologist, psychotherapist and sexologist based in Amsterdam, with over thirty years working with women experiencing vaginismus. Author of The Vaginismus Book and creator of the TVZ dilator companion app.
This article is for general information and education. It is not a substitute for individual medical advice. If you have persistent pain or distress, please see a qualified healthcare professional.