What is Vaginismus? How is the treatment done?
What is Vaginismus?
For some women, the vaginal muscles contract voluntarily or involuntarily during vaginal sex. This is called vaginismus. Contractions can prevent sexual intercourse or make it very painful.
This can be:
- when attempting partner penetration
- when a woman inserts a tampon
- when touched near the vaginal area
Vaginismus does not prevent sexual arousal, but it can prevent penetration.
A gentle pelvic exam typically does not reveal the cause of the contractions. No physical abnormality contributes to this condition.
Sexual dysfunction can occur in both men and women and is usually treatable. It’s not your fault and it’s nothing to be ashamed of. However, these disorders can affect your relationships and quality of life.
Experts don’t know exactly how many women suffer from vaginismus, but the condition is thought to be rare.
types of vaginismus
Vaginismus is divided into two types:
- primary vaginismus: when vaginal penetration is never achieved
- secondary vaginismus: vaginal penetration once achieved but potentially not possible due to factors such as gynecological surgery, trauma or radiation
Some women develop vaginismus after menopause. When estrogen levels drop, the lack of vaginal lubrication and elasticity makes intercourse painful, stressful or impossible. This can cause vaginismus in some women.
Dyspareunia is the medical term for painful sexual intercourse. It is often confused with vaginismus, but dyspareunia may be due to cysts, pelvic inflammatory disease, or vaginal atrophy.
Causes of vaginismus
There is not always a reason for vaginismus. This condition has been associated with past sexual abuse or trauma, past painful relationships, and emotional factors. In some cases, no direct cause can be found.
To make a diagnosis, your doctor will do a physical exam and ask about your medical and sexual history. These dates can be helpful in providing clues as to the underlying cause of the contractions.
Involuntary tightening of the vaginal muscles is the primary symptom of vaginismus, but the severity of the condition varies among women. In any case, the narrowing of the vagina makes penetration difficult or impossible. If you have vaginismus, you cannot control or stop the contractions of your vaginal muscles.
Vaginismus may have additional symptoms such as fear of vaginal penetration and decreased sexual desire related to penetration. Women with vaginismus often report a burning or excruciating pain when something is inserted into the vagina.
If you have vaginismus, it does not mean that you will completely stop enjoying sexual activities. Women with the disease can feel sexual pleasure and have an orgasm, although it is annoying. Many sexual activities do not involve penetration, including oral sex, massage, and masturbation.
The diagnosis of vaginismus usually begins with describing your symptoms. Your doctor will likely ask when you first noticed a problem, how often it occurred, and what triggered it. Typically, your doctor will also ask about your sexual history, including questions about whether you have been sexually traumatized or abused. In general, the diagnosis and treatment of vaginismus requires a pelvic exam.
It’s common for women with vaginismus to worry or worry about pelvic exams. If your doctor recommends a pelvic exam, you can discuss ways to make the exam as comfortable as possible for you. Some women choose not to use stirrups and try different physical positions for the exam. You may feel more comfortable if you can use a mirror to see what your doctor is doing.
When a doctor suspects vaginismus, he or she will usually conduct the examination as gently as possible. You can help guide your hand or medical device into your vagina to facilitate the penetration process. You can ask your doctor to explain each step of the exam to you as you progress.
During the exam, your doctor will try to find any infection or scarring. There is no physical reason for the contraction of the vaginal muscles in vaginismus. This means that if you have vaginismus, your doctor can’t find any other cause for your symptoms.
Vaginismus treatment options
Vaginismus is a treatable disease. Treatment often includes education, counseling and exercises.
Sex therapy and counseling
Education typically includes learning about your anatomy and what happens during sexual arousal and intercourse. You will also learn about the muscles involved in vaginismus. This can help you understand how parts of the body work and how your body responds.
Counseling may involve you alone or with your partner. Working with a counselor who specializes in sexual disorders can be helpful. Relaxation techniques and hypnosis can also promote relaxation and help you feel more comfortable in a relationship.
Your doctor or counselor may suggest learning to use vaginal dilators under the supervision of a surrogate.
Insert the cone-shaped dilators into your vagina. Dilators will get bigger and bigger. This helps to stretch and flex the vaginal muscles. To increase intimacy, have your partner help you insert the dilators. After completing the course of treatment with a series of dilators, you and your partner can try to have intercourse again.
To perform Kegel exercises, repeatedly tighten and relax your pelvic floor muscles that control your vagina, rectum, and bladder.
You can find these muscles while urinating. Once you start urinating, stop the flow. You use your pelvic floor muscles to do this. You may feel them getting stuck and moving. These muscles act in groups, so they all contract and relax at the same time.
Practicing these exercises will help you control the contraction and relaxation of your muscles. Follow these steps:
- Empty your bladder.
- Contract your pelvic floor muscles and count to 10.
- Relax your muscles and count to 10.
- Repeat this cycle 10 times, three times a day.
To successfully strengthen your pelvic floor muscles, do not work the muscles of your abdomen, buttocks, or thighs while performing these exercises.
living with vaginismus
Sexual dysfunction can have an impact on relationships. Being proactive and getting treatment can be crucial in building a marriage or relationship.
It is important to remember that there is nothing to be ashamed of. Talking to your partner about your feelings and fears about your relationships can help you feel more comfortable. Your doctor or therapist can provide you with ways to overcome vaginismus. Many people recover and live happy sex lives.
Treatment with a sex therapist can be helpful. Lubrication or using certain sexual positions can help make intercourse more comfortable. Try and find out what works for you and your partner.
Last Update : 12.02.2021
Basson R. (nd). vaginismus.
Mayo Clinic Staff. (2015). Painful intercourse (dyspareunia): Causes.