Vaginismus
Vaginismus is the involuntary tensing of the vagina…making sexual intercourse difficult or impossible.
For some women, the pelvic floor muscles, the pubococcygeus (PC) muscle group (the same muscle group used during a KEGEL exercise), involuntary or persistently contract when they attempt vaginal penetration.
This is called vaginismus.
The contractions constrict the vagina making sexual intercourse difficult or impossible.
This can happen:
- as the partner attempts penetration
- when a woman inserts a tampon
- when a woman is touched near the vaginal area
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.
Vaginismus can affect women of all ages.
There are two types of vaginismus.
PRIMARY 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 occur when placing a tampon or during a gynecological examination.
SECONDARY VAGINISMUS
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.
“If you experienced pain with intercourse, you anticipate having pain again. The natural response to pain is to tense up.”
Vaginismus is usually created by physical and emotional triggers or both.
Because the body has been conditioned to respond negatively to penetration, a patient may feel pain at any attempt to do so.
Emotional Triggers
- Fear, the fear of having sex, of having pain with sex, of
- 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.
Physical triggers
- 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.
Symptoms
The symptoms of vaginismus vary from person to person.
- 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.
DIAGNOSIS AND TREATMENT OF VAGINISMUS
Vaginismus is 100% curable.
Diagnosing vaginismus is a complex process that may involve more than one specialist, including a gynecologist, physical therapist, therapist and counselor or psychologist.
Pelvic floor muscle strengthening exercises.
First, do Kegel exercises by squeezing the same muscles you use to stop the flow when you’re peeing:
- Squeeze the muscles.
- Hold them for 2 to 10 seconds.
- Relax the muscles.
- Do about 20 Kegels at a time. You can do them as many times a day as you want to.
The exercises help boost the control a patient has over contracting and relaxing pelvic muscles.
Stretching the muscles that support the vagina
After a few days of understanding and performing Kegel excercises, insert one finger, up to about the first knuckle joint, inside your vagina while doing the exercises. You might want to clip your fingernails first and use a lubricating jelly, or do the exercises in a bathtub, where water is a natural lubricant.
Start with one finger and work your way up to three. You’ll feel your vagina’s muscles clenching around your finger, and you can always take your finger out if you’re not comfortable.
After a while, you’ll be able to put cone-shaped inserts into your vagina for 10 or 15 minutes to help your muscles get used to pressure.
Physical therapy
A physical therapist can factor in your unique circumstances and create a personalized treatment plan for your condition while keeping your comfort a priority. Your therapist may encourage you to perform a series of targeted pelvic floor exercises to learn how to strengthen those muscles, how to relax them, and how to eventually support your pelvic floor with your surrounding muscles.
Treatment options are aimed to relieve the underlying cause of painful intercourse. Treatments can range from simple medication and medical management to physical therapy or counseling.
At County OB/GYN, we will review your medical history and carry out a pelvic examination, to try to identify the cause of the pain.
If you are suffering from painful intercourse (dyspareunia) and want more information, please call our office for a consultation.