Vaginismus refers to the involuntary tightening of vaginal muscles, which prevents penetration and interferes with sexual intercourse. It can manifest regardless of prior sexual experience. For some, even inserting a tampon or menstrual cup or having a pelvic exam can be painful.
Vaginismus is associated with a high level of distress for women, and it may have a profound impact on how they feel about themselves, their partner and their relationship.
Types of vaginismus
Vaginismus is categorised as primary and secondary. If one is unable to insert anything into the vagina or experiences pain every time something is inserted, such as, during penetrative sex or a pelvic exam, it is called primary vaginismus. If you have enjoyed pain-free intercourse or penetration earlier but experience tightness and discomfort now, it is known as secondary vaginismus.
Yeast infections, radiation, surgery, childbirth, or hormonal changes during menopause leading to the thinning of vaginal walls can result in secondary vaginismus. It can also be situational, which may allow certain types of penetration (like inserting a tampon) but not others (sex). If penetration of any kind is impossible, then it is classified as global vaginismus.
What causes it?
Currently, the exact cause of vaginismus remains unknown. Researchers suggest a combination of psychological and physical factors, traumatic experiences (like assault), cultural influences and fear of penetrative sex may result in an automatic response from the body. It is estimated that around 1% to 7% of the global population will be affected.
What are its symptoms?
The symptoms may vary amongst individuals. However, the most common ones are inability to have penetrative sex, painful sex (mild or severe) accompanied by tightness and a burning/stinging sensation, muscle spasms during intercourse, and experiencing pain when attempting tampon insertion or gynaecological examination without cause.
How is it diagnosed?
The doctor conducts a pelvic examination and asks you about your medical and sexual history and whether you experienced sexual trauma or abuse. A proper evaluation and diagnosis will help to differentiate whether you are suffering from vaginismus or dyspareunia and will aid in appropriate management.
Is it curable?
Vaginismus treatment is available, even if detected later in life. The primary line of treatment focuses on gradually reducing the automatic tightening of the vaginal muscles and removing the fear of pain. Therapists use a variety of techniques like breathing, relaxation, local tissue desensitisation, use of physical vaginal dilators, pelvic floor biofeedback and manual therapy techniques.
Other methods include taking medications to manage anxiety and a variety of psychological treatments with the help of sex therapists. The sexologists conduct an elaborate investigation of the couples’ marital and sexual history. Methods used for alleviating fear and anxiety associated with vaginismus include interactional sessions for relationship enhancement of the couple. Some severe cases may also demand hypnosis therapy.
Conclusion
Besides therapy, women with vaginismus can do Kegel exercises at home and learn to control and relax the muscles around their vagina while urinating.
