What you need to know about vaginismus
Vaginismus is a condition involving a muscle spasm in the pelvic floor muscles. It can make it painful, difficult, or impossible to have sexual intercourse, to undergo a gynecological exam, and to insert a tampon.
- Painful intercourse with tightness and pain that may be burning or stinging
- penetration being difficult or impossible
- long-term sexual pain with or without a known cause
- pain during tampon insertion
- pain during a gynecological examination
- generalized muscle spasm or breathing cessation during attempted intercourse
Pain can range from mild to severe in nature and from discomfort to burning in sensation.
Vaginismus does not prevent people from becoming sexually aroused, but they may become anxious about sexual intercourse, so that they try to avoid sex or vaginal penetration.
Vaginismus is a condition which can be caused by physical stressors, emotional stressors, or both. It can become anticipatory, so that it happens because the person expects it to happen.
The emotional triggers include;
- Fear, for example, of pain or pregnancy
- Anxiety, about performance or because of guilt
- Relationship problems, for example, having an abusive partner or feelings of vulnerability
- Traumatic life events, including rape or a history of abuse
- Childhood experiences, such as the portrayal of sex while growing up or exposure to sexual images
The physical triggers includes;
- infection, such as a urinary tract infection (UTI) or yeast infection
- health conditions, such as cancer or lichen sclerosis
- pelvic surgery
- inadequate foreplay
- insufficient vaginal lubrication
- medication side effects
Treatment usually includes a combination of:
Pelvic floor control exercises: These include muscle contraction and relaxation activities, or Kegel exercises, to improve control of the pelvic floor muscles.
Education and counseling: Providing information about the sexual anatomy and sexual response cycle can help the individual understand their pain and the processes their body is going through.
Emotional exercises: This can help the person identify, express, and resolve any emotional factors that may be contributing to their vaginismus.
Reducing sensitivity to insertion: A woman will be encouraged to touch the area as close as possible to the vaginal opening every day without causing pain, moving closer each day. When she is able to touch the area around the vagina, she will be encouraged to touch and open the vaginal lips, or labia. The next step will be to insert a finger.
Insertion/dilation training: Once a woman can do this without pain, she will learn to use a plastic dilator, or a cone-shaped insert. If she can insert this without pain, the next step will be to leave it in for 10 to 15 minutes, to let the muscles get used to the pressure. Next, she can use a larger insert, and then she can teach her partner how to apply the insert.
The time it takes for vaginismus to be successfully treated will depend on the individual.
Meanwhile, it is rare that vaginismus needs surgery.