Vaginismus is a type of female sexual dysfunction, where the vagina contracts by itself during sexual penetration, causing pain and discomfort. Apart from interfering with sexual life, vaginismus does not allow women to insert tampons or undergo pelvic examinations. The causes of vaginismus are varied and should be explored for treatment purposes. While annoying, embarrassing, and stressful, this condition is very treatable.
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Part 1 of 3: Identifying Vaginismus
Step 1. Don't underestimate pain during sexual intercourse
The first and most disturbing symptom of vaginismus is pain during sexual penetration. The pain experienced by every woman is different, some feel a burning, stinging, tightening, sore, or as if partner "hit a wall" sensation. In many cases, the pain and involuntary muscle contractions are severe enough to prevent complete penetration.
- Most women know this problem the first time they have sex. This is called primary vaginismus.
- Some only experience vaginismus years later, called secondary vaginismus. So you shouldn't ignore the key symptoms just because you haven't had any pain during intercourse.
Step 2. Watch for other vaginal penetration problems
In addition to pain during intercourse, women with vaginismus may have difficulty with other forms of penetration, such as inserting a tampon and a pelvic exam. Other symptoms are:
- Married, but not consummated by sexual intercourse
- Pain or discomfort that persists after childbirth, yeast/urinary infections, sexually transmitted infections, interstitial cystitis, hysterectomy, cancer and surgery, rape, or menopause
- Pain that persists during intercourse, but the cause is unknown
- Breath stops during sexual penetration attempts
Step 3. Watch for other muscle spasms
Vaginal muscle contractions and spasms are signs of vaginismus, but some women also experience spasms in the legs or lower back. Seizures occur most often during attempts at sexual penetration.
Step 4. Evaluate your reluctance to connect
Many women who suffer from vaginismus fall into a pattern of avoiding sexual situations. Avoiding sexual activity or love relationships because of pain or embarrassment about your symptoms are clear signs that you should seek medical attention.
Remember that your reluctance is not wrong, and is caused by the body's subconscious association between sex and pain
Step 5. See a doctor
Make an appointment with your GP or gynecologist to discuss the possibility of vaginismus. Describe the development and severity of your symptoms.
Step 6. Determine if any other conditions exist
The doctor should perform a pelvic exam and watch for any vaginal discomfort or contractions. In addition, your doctor may order additional tests to determine if your symptoms are caused by something else.
Vaginismus may have an obvious physical cause, such as infection, injury, or hypersensitive nerves at the vaginal opening (vulvodynia to touch)
Step 7. Get a diagnosis
If all other causes have been determined to be absent, your doctor may diagnose primary or secondary vaginismus. In addition, your doctor may describe your condition as global if it occurs in all situations where something must be included, or situational if it occurs only in certain situations (such as sexual penetration).
- Unfortunately, female sexuality and sexual dysfunction are not fully understood. You may encounter medical personnel who ignore your symptoms or fail to help you. In these cases, you should firmly ask for a diagnosis and treatment. If your doctor can't help, find another doctor with experience treating vaginismus and other types of female sexual dysfunction.
- Other possible diagnoses are apareunia, which is a term for the inability to have sexual intercourse (of which vaginismus is one type), and dyspareunia, which refers to overall pain during sexual intercourse.
- A diagnosis will take your treatment to an advanced stage and provide an opportunity to be treated by a team of experts.
Part 2 of 3: Understanding the Causes of Vaginismus
Step 1. Consider the role of anxiety
Many women can trace vaginismus back to anxiety, fear, and stress. The roots may be deeper or simply related to current life factors, such as lack of sleep and severe stress from work.
Step 2. Realize whether there are deep beliefs about sex and sexuality
Women who have vaginismus are more likely to have deep-rooted negativity about sex and sexuality. These feelings may begin in childhood or are related to certain traumatic events.
When negative beliefs about sex begin as a child, a potential component of vaginismus also comes into play, namely the absence of proper sexual education
Step 3. Understand the role of past experience
Women with vaginismus were estimated to be twice as likely to have a history of childhood sexual disorders as non-sufferers. Traumatic events contribute to moderate to severe trauma, and include:
- Sexual harassment by someone you know
- Sexual violence
- Pelvic trauma
- Domestic violence
- Very negative sexual experience at an early age with a consensual partner
Step 4. Recognize that relationship problems also contribute
If you have secondary and situational vaginismus, it may be at the root of a problem with your partner. These problems include lack of trust, fear of commitment, or concern that you will be easily hurt or open yourself up to pain and disappointment.
Step 5. Realize that medical conditions and medications may have a role
There are a variety of conditions that can trigger or intensify vaginismus symptoms. This is especially likely if vaginismus appears after a period of normal sexual function. Medical conditions that can potentially contribute to vaginismus are:
- Urinary tract infections and other urinary problems
- Sexually transmitted infections
- Cancer of the sexual or reproductive organs
- Endometriosis
- Pelvic inflammatory disease
- vulvodynia or vestibulodynia
Medical procedures involving the female reproductive organs, such as a hysterectomy, can also cause vaginismus
Step 6. Identify the potential role of reproductive outcomes
For many women, secondary vaginismus is related to childbirth. This may occur if delivery is very difficult or causes injury to the sexual organs. There are also some women who experience vaginismus due to hormonal changes and dryness that usually occurs during menopause.
Secondary vaginismus can also result from a fear of having children or giving birth
Step 7. Accept if there is no obvious cause
Some women never know why they have vaginismus. In this case, there is no known physical or nonphysical cause.
Some studies even suggest that vaginismus symptoms are part of a common defense mechanism that is triggered in threatening situations. This study considers that vaginismus is not always a primary sexual dysfunction
Part 3 of 3: Treating Vaginismus
Step 1. Try counseling
A therapist can help determine if your vaginismus is caused by an emotional or psychological problem. This is because awareness of the condition itself usually creates fear and anxiety before intercourse, forming a vicious cycle that exacerbates symptoms. Feelings of depression, isolation, and low self-esteem are also common effects of stigmatizing sexual dysfunction.
- Treatment outcomes will be much more positive when the woman and her partner are motivated, cooperative, and intent on reducing relationship conflict. So, psychological evaluation as a partner is a good start to treatment.
- If vaginismus is related to anxiety issues or past sexual trauma, a therapist can help you work through these issues so you can move forward.
- One particular type of therapy, cognitive behavioral therapy, can be of great help to some women. This therapy focuses on the relationship between thoughts and behavior, and a cognitive behavioral therapist can help you change thoughts and behaviors related to sexual aversion.
Step 2. Ask about exposure therapy
One of the treatments for vaginismus is exposure therapy, or exposure, and involves gradual penetration desensitization. Exposure to therapist-assisted penetration is an effective treatment, even for women with lifelong vaginismus. The exposure technique usually involves vaginal penetration exercises with dilator aids.
This is the same method used in self-care, with the addition of a guide who can help you proceed on your own with confidence and success
Step 3. Find a physical therapist
Ask your doctor to refer you to a physical therapist with experience with vaginismus and other types of female sexual dysfunction. Because the pelvic floor muscles play a large role in vaginismus, physical therapy is one of the best treatment options. Physical therapists can:
- teach breathing and relaxation techniques
- helps you learn pelvic floor muscle contractions to control pelvic floor muscles
Step 4. Do Kegel exercises
Kegel exercises are designed to help you control your pelvic floor muscles. To do a Kegel exercise, all you need to do is contract the muscle used to stop the flow of urine, hold it for a few seconds, then release. Do 20 contractions at a time, as many times a day as possible.
Some doctors recommend Kegel exercises are done by inserting one finger into the vagina (you can insert a maximum of three fingers). Your fingers allow you to feel muscle contractions to better control their movements
Step 5. Consider using a vaginal dilator at home
Your doctor may recommend a vaginal dilator for you to use at home. A dilator is a cone-shaped device that is inserted into the vagina. Inside, this tool will enlarge so that the vaginal muscles stretch and get used to penetration.
- To start, take a position like when you have a bowel movement. This helps enlarge the vaginal opening. Then, insert a finger (not a dilator) into the vagina, do not change the position of the body.
- While continuing with the dilator, let it sit for 10 to 15 minutes. Vaginal muscles will get used to the pressure.
- You can ask your partner to help insert the dilator.
Step 6. Have sex very slowly
Women with vaginismus should be patient and try treatment options before starting to have sex again. If you have an active relationship right away, you may experience pain or discomfort, and this will start a cycle of pain and anxiety that exacerbates vaginismus. Make sure that your partner is also patient and supportive.
- When having sex, go very slowly, use plenty of lubricant, and try different experiments to find the most comfortable position.
- Doctors usually advise women to hold the penetration object and insert it half or completely into the vagina after finishing with vaginal dilators. The objects of penetration in question are penises, dildos, and vibrators.
Tips
- Some women are so embarrassed by their condition that they don't seek treatment for vaginismus. If you feel this way, remember that vaginismus is not your fault and that this condition is very treatable. Find sympathetic doctors and good therapists, and work with them to lead a healthy sex life.
- Some doctors and websites may recommend medication, including local anesthesia, to treat vaginismus. However, in general this is not a great idea. Local anesthesia will numb the external pain, but will not solve the problem and may make it more difficult to manage.
