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Vaginismus is a medical condition found in women. Vaginismus symptoms are severe pain during sex and discomfort while penetrating a penis, tampon or medical instrument. Vaginismus causes are trauma, infection, and aging. Vaginismus treatments are kegel exercise and sex therapies to relax pelvic muscles.
Vaginismus refers to the pain a woman feels during sex. It is a situation where reflex action of the vagina's pelvic floor muscle occurs. In vaginismus, pelvic floor muscles contract preventing vaginal penetration, this results in severe pain in the vagina during sex attempts. Generally, the pain starts in the preliminary effort at the time of starting with sexual intercourse. (5) Vaginismus usually depends on unresolved psychosexual conflicts in childhood known as conversion disorder. Women with vaginismus disorder are classified into two types such as bonded (have an intense attachment to memory or something) or regressed (unconsciously thinking of childhood or a soothing memory).
This disorder is mostly recognized in women who have apprehension towards a past incident or to an imaginative negative experience (psycho-physiologic disorder). These events possibly possess a negative background with the penetration of an object in their vagina, either in real life or in an unconscious mind. One may additionally have a sensitivity to an organic pathology referring to neuro disorder or any other linked physical problems. Lack of sex education can also turn out to be one of the key vaginismus causes in women. (1) It is a common female psychosexual dysfunction and the number of women affected with this condition is under research. As per the records of some of the top sexual dysfunction clinics across the world, the rate of a woman with vaginismus is around 5 to 17 percent.
In simple terms, vaginismus is mentioned when pelvic floor muscles contract when an object like a penis, tampon or a diagnostic metal instrument (speculum) is inserted into the vagina. The vagina tightens itself to hamper the insertion. This automatic action may lead to short-term cessation or difficulty in breathing, pain and muscle spasm. During vaginismus, the pubococcygeus (PC) muscle group is usually affected. These muscles help in intercourse, urination bowl movement, orgasm, and aid in efficient childbirth. Vaginismus causes agony, distress, and frustration in a woman leading to a more fragile state. Fortunately, the treatment for vaginismus is absolutely available, but many women feel embarrassed to discuss this topic. (2)
The problem of vaginismus does not hamper sexual arousal, however, it prevents ease in penetration. On average, it is observed that the basic examination of pelvic muscles does not indicate any contractions present in this condition. In fact, there are no such abnormalities involved in this condition. Vaginismus symptoms represent a problem of sexual dysfunction. Sexual dysfunction might happen to both males and females. But one needs to know that vaginismus treatments are available. These problems may interfere in one's sexual life, and one should not feel uncomfortable about talking to a medical consultant to receive a permanent solution for the same. Sexual problems hamper the quality of life and increase continuous stress and pressure on the couple. This condition needs to be dealt in a better manner with awareness about sex education in a woman. In fact, obscuring this problem remains a prime factor in identifying the exact number of these cases. (3)
- What are the types of Vaginismus?
- Primary versus secondary vaginismus
- What are the symptoms of vaginismus?
- What are the different types of Vaginismus Treatments?
There are different reasons for the occurrence of vaginismus disorder like age, negative past experience or unconscious portrayal of sex in their minds. Below are the types of vaginismus, which may happen to any woman due to their psycho-physiologic disorder at any time in life:
- Primary vaginismus
- Secondary vaginismus
- Global vaginismus
- Situational vaginismus
Primary Vaginismus: This is a stressful type of disorder in a woman to restrict anything entering into their vagina. It is a lifetime condition, in which a woman feels constant pain while having sexual intercourse. The pain also generates at the time of inserting a tampon or any diagnostic instrument. In fact, the male partner also undergoes discomfort during sexual intercourse, and they might feel like 'hitting a wall' at the opening of a vagina. A woman usually experiences muscle spasm, pain and sometimes even stops breathing during the intimate course. Moreover, she becomes normal when the attempt is hindered and the vagina goes back into the usual condition.
Secondary Vaginismus: This problem develops lately in a woman, who has already performing intercourse. Vaginismus develops later in the life span. A woman usually has no experience of this pain before in their life. This may evolve because of menopause, infection, and traumatic events which occurred in the past. If a body has functioned naturally to respond in the same way then, even medication won't be able to relieve this pain.
Global Vaginismus: The condition is constant and always present in the woman's body and any potential object may trigger it.
Situational Vaginismus: Depending upon the situation this pain originates like it can occur while intimate intercourse but not in tampon insertion or diagnostic checkup.
Primary vaginismus refers to the constant pain and stiffness occurring while inserting any specific object or organ in the vagina whereas in secondary vaginismus pain develops due to certain conditions over time. (6)
There are several symptoms depending upon person to person. These vaginismus symptoms are observed when the pain goes unbearable for a long time. An uncontrollable tightening of pelvic floor muscle is the first vaginismus symptom. The severity of pain depends on the current health status of a particular woman. The contraction of the pelvic muscles makes penis insertion difficult or impossible. One having vagina constriction could not control or prevent these contractions. These contractions are involuntary because of the specific functioning of nerves, which passes a signal to the brain to not enter any object inside the vagina.
Vaginismus is a painful process, and a woman undergoes the feeling of excessive discomfort and pain while having sex. A woman gradually starts ignoring interest in having a sex life, decreasing sensual desire. Fear of penetration pain in the vagina leads to depression and exhilarates pressure on the woman to an unsuccessful sex life with her partner. A woman feels a stinging pain and a burning sensation when an object enters her body. A woman with vaginismus symptoms possessing intense sexual desires, may go through non-penetrative sexual activities and fulfill their orgasms. One may also involve massage, masturbation, and oral sex. (3)
We are summing up all the vaginismus symptoms below to identify vaginismus on time:
- Women feel stinging or burning sensations while having sexual intercourse.
- One has tightness and painful intercourse called dyspareunia.
- Unknown cause of long-term sexual pain.
- Severe pain during insertion of a tampon.
- A woman feels pain while having a basic gynecological examination
- While attempting the sexual intercourse one may feel general spasm and cessation of breathing
- Pain in the vagina feels from mild to severe in nature. There is also a burning sensation in the vagina, which discomforts a woman.
- People become anxious about their pain, but it does not prevent sexual arousal in them. Therefore, one starts avoiding to have sex and penis penetration into the vagina.
Vaginismus represents a condition, where a woman under psychological defunctioning has believed that the insertion of any object in her vagina is inappropriate. This condition is caused due to an emotional stressor, physical stressor or both. Subsequently, it becomes cautious by the body mechanism. There is a contraction, because unconsciously the mind of a woman expects this (contraction of muscles) to happen. Experts are currently researching evidence linked to different aspects of vaginismus. (3)
Dyspareunia: It does not cause vaginismus, but it is a medical term used for painful intimate intercourse. It is commonly confused with causes of dyspareunia. Dyspareunia occurs due to cyst, vaginal atrophy, or Pelvic Inflammatory Disease (PID).
Emotional trigger vaginismus causes:
- Apprehension or fear to have painful sex or pregnancy.
- Feeling guilty and anxious about performance during sex.
- Domestic violence by the co-life partner: Woman in an unfortunate relationship, who have a brutal husband feels vulnerable while sex and automatically generates pain in their vagina.
- A traumatic history of abuse like rape or sexual abuse in the past.
- Holding an influential notion of sex description and exposure to sexual images in their early childhood.
Physical trigger vaginismus causes:
A woman experiencing physical disorder or a health issue also experiences vaginal pains while sex. These situations are listed below:
- Vaginal Infection: Urinary Tract Infection (UTI) or yeast infection can generate pain and burning sensation during sex.
- Health issues: Lichen sclerosis or presence of cancer may lead to vaginismus.
- Pregnancy: Giving birth is a painful process leading to vaginal pain in some cases.
- Age of a woman: Woman after the age of 50, undergoes menopause which is one of the important female based events. In this case, sex hormones reduce and produce pain in the vagina during sex.
- Surgeries: If a woman has undergone a pelvic surgery, then she might suffer vaginismus.
- Indulging in less foreplay: Sometimes inadequate foreplay does not boost the necessary hormones and leading to painful sex.
- Deficient vaginal lubrication: A woman with less lubrication or dry vagina may experience vaginismus.
- Side effects of medication: Overdose or wrong intake of medicine can cause the pain in the vagina because of the adverse reaction.
The treatment is available for vaginismus and other sexual problems. These problems may affect both men and women. After identifying constant pain while sex, one should visit a doctor immediately, as this is not anyone's fault. Sexual problems are normal in many couples due to medical and lifestyle issues. In fact, One must feel unashamed about it and seek effective treatment to have a healthy sexual life.
Diagnosis of vaginismus: During consulting a doctor the patient has to describe all the symptoms. The doctor will most probably ask a few questions marked as below:
- When was the first time that this problem happened?
- How frequently does the pain occur?
- What are the patient's aspects of triggering such a problem?
- Was there any past experience or trauma in past life?
- Is there any childhood history of sexual abuse influencing sexual activity?
Typically, the doctor examines various aspects of the health in-depth of vaginismus treatments. Therefore, the patient should talk with ease about the problem with the doctor to find the best effective treatment to cure pain and related discomfort. Most of the times to find the reason behind vaginismus causes, an examination of the vagina is necessary.
Diagnosis of vaginismus:
It is common for a patient with vaginismus to feel nervous and fearful about the insertion of a medical instrument into the pelvic floor muscles to perform diagnosis of the condition. During the pelvic examination, it is the duty of the doctor to ask the patient about the most comfortable way he can perform the examination. The patient should also state her doubts and discomforts about the procedure. A pelvic examination should be as comfortable as it can. Using stirrups during the examination can also be avoided according to the woman's comfort zone. Different physical positions are also used for the efficient outcome of the diagnostic appointment. During vaginismus treatments, a patient can use a mirror to monitor the steps performed by the doctor during the diagnosis. The doctor will try to perform the procedure as gently as he can. He may also ask help from the patient to guide his hand or the medical instrument while inserting into the vagina. The patient can take knowledge of each and every step performed by the doctor before vaginismus treatments began.
While examining the vagina, the doctor will try suspecting any scarring or infection. If any such potential physical reason is not found of muscle contraction, then the doctor will confirm about required vaginismus treatments. This means the doctor has not found any other symptoms of pain and contraction. The procedure for examining pelvic involves below steps:
- The treatment will include other specialists depending upon the cause to diagnose the vaginismus. The general physician will study medical history and perform an examination of the respective woman.
- Before focusing on the vaginismus treatments, a doctor will observe symptoms of an infection. Curing the symptoms or infection first will provide the significance for vaginismus treatments.
- Vaginismus treatments aim at providing the most appropriate treatment to decrease the contraction of pelvic muscles and relieve the pain while penetration. The vaginismus treatments also focus on dealing with the fear of penetration, if other negative causes relate to it.
Vaginal dilator: The doctor or the concerned therapist will suggest the patient to learn to use a vaginal dilator in professional supervision. (7)
- A cone-shaped dilator is placed inside the woman's vagina. Progressively, the dilator will start creating space in the vagina. This way, the vaginal muscles will become flexible and stretch itself. Taking help from the partner will increase the intimacy between the couple. Afterward, the couple can try to practice regular sex and see if it helps.
- Vaginismus sometimes is mistaken for physical problems with the woman's vagina, which leads to needless surgery. In rare cases, surgeries are required in vaginismus treatments.
Vaginismus Treatments through therapy and exercise:
Here are some of the most effective exercises and treatments that will emphasis on woman's habit to accept penetration in the vagina:
- Prepares the vagina to become habitual for penetration. (4)
- The exercises controlling the pelvic floor muscle movement help in relieving the pain and developing a habit for muscles to relax while sexual intercourse.
- The exercise includes muscle relaxation and contraction.
The possible Vaginismus treatments through therapy and exercise and their details are mentioned below:
- Psychosexual therapy: This is a therapy of convincing the patient to become positive and understand their body and sex habits at a primitive level. In this procedure, the therapist talks to the patent in every session to change the patient's feeling about having sex.
- Pelvic floor exercises: To gain control over vaginal muscles, releasing and squeezing of pelvic floor muscle is exercised.
- Relaxation techniques: In this technique meditation, breathing and mindfulness are practiced. A gentle touching exercise for vaginal muscles is performed to learn relaxing.
- Sensate focus: Exercises for relaxation while performing sex and boosting woman's sex libido is taught to the patient.
- Vaginal trainers instruments and smooth tampons: Under this technique, several sizes of vaginal penetration instruments or smooth tampons are inserted into the vagina. This helps the vagina to develop a habit of penetration. Involving the partner in these therapies will increase the effectiveness and help the woman in practicing these exercises at home as well.
There is a known exercise called kegel exercise, proved to be one of the best exercises to control and improve pelvic floor muscle. Performing Kegel exercises repeatedly will tighten and relieve the pelvic floor muscle. Exercising will improve the functioning of pelvic muscles which controls the vagina, bladder, and rectum.
- Pelvic muscle is a group of several tiny muscles, which contract and relax altogether at the same time. The pelvic muscles play an important role in the urinating activity in women. While urinating to interrupt the stream in between pelvic muscles are used. One can feel the movement and tightening of these muscles while urination is interrupted.
- Practicing this exercise will assist women in controlling the contraction and relaxation of the muscles.
To practice kegel exercise one must follow the below steps:
- First of all, empty the bladder.
- Contract the pelvic floor muscles and count till one to ten.
- Flex the muscle and again count from one to ten.
- Practice this cycle threefold a day, with 10 sets each time.
One should not engage the abdomen, buttocks, or thighs while practicing the exercise. This will strengthen the pelvic floor muscle to a great extent.
Sex therapy and counseling:
A woman with vaginismus should thoroughly learn about her anatomy and focus on sexual arousal and intercourse. Sex education will help the patient in learning natural facts about sex and prepare her mind to behave positively with respect to the penetration of the penis during sex. This will provide information about the associated muscles as well. It also helps a woman in learning about the body, and the manner in which the muscles move in the response to penetrating action. Counseling involves the patient and her life partner. An expert working as a sexual disorder specialist will help in the case of vaginismus treatments. Relaxation techniques and hypnosis comfort the patient having sex and inserting a tampon. (3)
It is very important to have a healthy relationship with your partner. In order to avoid sexual dysfunction, getting a respective treatment is not only significant but must for a better life ahead. Sexual problems can destroy a relationship and endures pressure on a patient to fulfill sexual desires. Speaking out the pain and depression to your loved one or a therapist will give strength and motivation to have a normal sex life. It is important that without feeling guilty and ashamed of the pain, one must spread awareness and motivate others too with respect to sex education. Many patients, who had therapy or vaginismus treatments are now happily living their lives. Examining such a problem will help the couple and a doctor to find out, the reason behind the pain. Different treatments or ways of treatment may suggest a solution to have pleasant sex. A couple undergoing vaginismus should try lubricants and certain sexual positions along with required treatments which will help in having comfortable sex without any pain.
SOURCES AND REFERENCES:
- ^ Successful Management of Vaginismus Ncbi.nlm.nih.gov, 21 May 2019
- ^ Know About Vaginismus - Medical News Today Medicalnewstoday.com, 21 May 2019
- ^ What Is Vaginismus - Health Line Healthline.com, 21 May 2019
- ^ Vaginismus - NHS Nhs.uk, 21 May 2019
- ^ Vaginismus - Wikipedia En.wikipedia.org, 21 May 2019
- ^ Vaginismus - Issvd Issvd.org, 21 May 2019
- ^ What to Know About Vaginismus - MensHealth Menshealth.com, 21 May 2019
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