Vaginismus is a tightness of the muscles around the vagina. Primary vaginismus can be caused by when they are trying to have intercourse for the first time, or they’re trying to use a tampon for the first time. It’s now like this trauma that is causing them to tighten up. We do evaluate them and try to figure out where is this coming from.
Secondary vaginismus is typically when patients who previously could have intercourse and previously could use tampons are now unable to do this. Other causes for vaginismus are postpartum changes in their hormones, recurrent yeast infections.
Vaginismus can be relieved by a multi-modal approach. Often we will prescribe patients with Valium suppositories to relax their pelvic floor muscles. They can use dilators under the supervision of a pelvic floor physical therapist. They can also be treated with hydrodissection nerve blocks and trigger point injections to their pelvic floor muscles.