What is Vaginismus?
While this doesn’t stop patients from becoming sexually aroused, the symptoms of vaginismus may cause anxiety about sex, making patients afraid of sex or any kind of vaginal penetration.
What Are The Causes of Vaginismus?
When a woman suffers from vaginismus, her pelvic floor muscles––the pubococcygeus (PC) muscle group, in particular––involuntary contract. This causes general muscle spasms and a temporary cessation of breathing. A woman with vaginismus may not be able to insert tampons or even undergo gynecologic exams.
Generally, vaginismus can be caused by physical and emotional triggers or both:
Below are some of the main emotional triggers of vaginismus:
- Fear, such as when a woman fears pain or pregnancy.
- Anxiety or guilt may trigger vaginismus.
- Issues in the relationship. If the woman has an abusive sexual partner or feels too vulnerable in their presence, for instance.
- Traumatic events, such as a history of sexual abuse or premature exposure to sexual imagery at a young age.
Some of the physical triggers of vaginismus are:
- Infections, such as a yeast infection or Urinary Tract Infection (UTI).
- Certain diseases, such as lichen sclerosis or cancer.
- Childbirth or pelvic surgery, which can be very traumatic.
- Menopause, which may induce hypersensitivity.
- Insufficient vaginal lubrication before intercourse.
Some medication may also have side effects that trigger vaginismus.
What Are The Symptoms of Vaginismus?
The symptoms of vaginismus vary from person to person. They may include:
- Painful sexual intercourse, such as stinging, burning or tightness.
- Penetration becomes difficult or even impossible.
- Long-term pain during intercourse.
- Short-term pain when inserting a tampon and during gynecological examination.
- General muscle spasms or difficulty breathing during intercourse.\
Types of Vaginismus
Vaginismus occurs in two types that can affect women of all ages, primary vaginismus, and secondary vaginismus:
This usually occurs when women have their first attempt at sex. Penetration is difficult and partner may feel like they are “hitting a wall” at the opening of the vagina. The woman may experience both pain and general muscle spasms. Breathing may also stop temporarily. When the attempt at vaginal entry stops the symptoms stop, too.
Apart from sex, primary vaginismus may also include tampon use and gynecological examinations.
This may be experienced at any stage in a woman’s life and can affect even those who have no history of vaginismus. Often, it results from specific events such as menopause, infection, traumatic events, relationship issues, childbirth, surgery, or medicinal side effects, among others.
Even when the underlying condition is treated, secondary vaginismus may persist. Because the body has been conditioned to respond negatively to penetration, a patient may feel pain at any attempt to do so.
Diagnosis and Treatment of Vaginismus
Diagnosing vaginismus is a complex process that may involve more than one specialist, including a gynecologist, sex therapist, physical therapist, counselor, and psychologist.
In a physical evaluation, the health specialist checks a patient’s medical history and performs a pelvic exam. Usually, the condition is diagnosed through elimination. The success of the diagnosis is determined when the underlying pain trigger is properly treated.
Vaginismus cannot be treated by surgery. In fact, this may end up worsening the condition. However, it’s 100% curable.
Just as the diagnosis may involve several professionals, treatment is achieved through a combination of tactics. These include:
Pelvic floor muscle strengthening exercises
Most commonly, a patient does Kegel exercises by repeatedly tightening and relaxing pelvic floor muscles. These are the muscles that control the vagina, bladder, and rectum.
The exercises help boost the control a patient has over contracting and relaxing pelvic muscles.
Insertion and dilation training
The healthcare provider may recommend supervised use of plastic vaginal dilators.
The patient inserts cone-shaped dilators into the vagina. The dilators get bigger to help easy stretching and flexibility of vaginal muscles.
This helps reduce the patient’s sensitivity to penetration.
Therapy and Counseling
The patient is educated about their anatomy and what happens inside her body during intercourse, including the muscles that are affected during vaginismus. Counseling may involve just the woman or both her and her sexual partner.
To combat the emotional triggers, the patient is taken through a series of exercises that help her identify and resolve emotional factors that could be contributing to the vaginismus.
Recovering From Vaginismus
The time for full recovery of vaginismus varies from person to person. If you have symptoms that suggest vaginismus, make an appointment and consult your doctor. If you’re diagnosed with the condition, remember that the better your participation, the quicker the treatment.
Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.
Walter Frontera, Julie Silver, Thomas Rizzo,Tayyaba Ahmed, Isabel Chan. Musculoskeletal Disorders, Pain, and Rehabilitation. Essentials of Physical Medicine and Rehabilitation. 2018 Nov; 4(107): 587-595. Link to Article.