What is Vaginismus?
Vaginismus is a condition involving spasm in the muscles of the pelvic floor. Vaginismus makes sexual intercourse, vaginal examination and inserting a tampon extremely painful and difficult. It is an involuntary contraction seen in the pelvic muscles when an object is inserted which tightens it up. This, in turn, leads to muscle spasm, pain, and temporary cessation of breathing. The commonly affected muscle group in Vaginismus is the pubococcygeus group, the muscle which is responsible for urination, intercourse, orgasm, bowel movements, and childbirth.
Types of Vaginismus
There are different types of vaginismus which can affect women at different ages.
- Primary Vaginismus. This type of vaginismus is a lifelong condition and is always present. The female feels difficult to get examined and use a tampon. An attempt to intercourse is the time it is first experienced by the women. The male partner is unable to insert the penis; he may feel like hitting against a wall at the vaginal opening. There is pain which might obstruct the breathing in the woman. The symptoms reverse when vaginal entry is stopped.
- Secondary Vaginismus. This type of vaginismus occurs at any stage of life. It can also affect a female who has already experienced a normal sexual function. It can arise after a specific event such as infection, menopause, traumatic event, medical condition, stress, surgery, or childbirth. Even after correcting the underlying medical condition the pain continues as the body becomes conditioned to respond in that way.
- Global Vaginismus. This type of vaginismus is always present and any type of object can trigger the symptoms.
- Situational Vaginismus. This can occur only in certain situations. For example, in some, it might happen during sex and not during a vaginal examination or tampon insertion and vice versa.
What Causes Vaginismus?
The exact cause of vaginismus is not known, it can be linked with fear or anxiety of having sex.
Other problems such as infection, can lead to painful intercourse. It is important to consult a doctor to determine the exact cause, to go ahead with the treatment.
There are certain emotional and physical triggers which are thought to be causing vaginismus.
Emotional Triggers of Vaginismus Include.
- Fear of pain or pregnancy
- Anxiety about the performance
- Relationship problems
- Traumatic life events such as rape, or a history of abuse
Physical Triggers of Vaginismus Include.
- Urinary tract infection
- Health condition such as cancer or lichen sclerosis
- Pelvic surgery
- Insufficient vaginal lubrication
- Side effects of the medicine
Symptoms of Vaginismus
The symptoms associated with vaginismus include.
- Painful intercourse
- Difficult penetration
- Long term sexual pain
- Pain during gynecologist examination
- Pain on tampon insertion
- Generalized muscle spasm and breathing cessation during intercourse attempts
- The pain can be from mild to severe and the discomfort to a burning sensation.
Vaginismus does not affect sexual arousal but the anxiety and fear of pain can make them avoid sex or vaginal penetration.
Treatment of Vaginismus
The sexual problem can affect both men and women, and one should not be ashamed if suffering from any.
The treatment of vaginismus may involve different therapist depending on the cause. For the diagnosis, the doctor takes a medical history and carries out the pelvic examination. The infection needs to be ruled out before starting the treatment for the condition.
The main aim of the treatment of vaginismus is to reduce the automatic tightening of the muscle and fear of pain.
The Treatment for Vaginismus Includes.
- Pelvic floor Exercises. Also known as kegel, this exercise involves relaxation and contraction of the pelvic muscles, to improve the control over them (1). Kegel helps in reducing the symptoms of vaginismus.
- Education and Counseling. Educate people suffering from vaginismus about sexual anatomy and help them understand their pain and the reason behind its occurrence.
- Emotional Exercise. Help the person identify and resolve any factor contributing to vaginismus.
- Reducing Sensitivity to Insertion. It is important to make the female comfortable with the touch in the vagina. This can be done by asking her to touch the area around the vagina. When she is able to do that, she would be asked to open the lips of the labia and if comfortable with that to insert the finger. When she is comfortable with the insertion and can do it without pain she is asked to insert a plastic dilator or a cone-shaped insert. If this is done easily she is asked to keep it there for 10-15 minutes, to help muscles to get used to it. This makes the vagina comfortable and then she can allow the partner to easily insert the penis till it’s comfortable.
- Botox Injections. A study shows botox injections intravaginally and progressive dilatation cures vaginismus (2).
Depending on the individual the time taken in the treatment varies. In rare cases, surgery is required to treat vaginismus.