Vaginismus: What is it and how is it treated?

What is vaginismus?

Vaginismus is an involuntary contraction of the pelvic floor muscles surrounding the vagina. This makes penetration into the vagina impossible or only possible with pain. There are no known physical causes; the condition is psychological.

Many patients also suffer from vaginal cramps when they try to insert a tampon or during a gynaecological examination. In severe cases, even the thought of an intimate procedure is enough to trigger contractions of the vagina and pelvic floor. If the contractions are strong and persistent, they cause pain. When the contraction subsides, the muscles relax again and normalise.

Vaginismus can occur in different ways in women. Some are only present during sexual activity and cause no complications during examination or tampon insertion. Occasionally it rejects the insertion of objects. Some allow partial penetration of the penis but make sexual activity painful.

Vaginismus is characterised by feelings of anxiety and distress, and although the woman wants sexual contact, her fear of pain suppresses this desire. Vaginismus is a painful sexual disorder, not a disease.

What are the signs and symptoms of vaginismus?

The symptoms of vaginismus vary from woman to woman. Some conditions can cause moderate contractions. In “severe vaginismus“, cramping happens whenever the vagina is touched.

• Uncontrollable cramping
• Cramping of the pelvic floor and vaginal muscles.
• Avoidance of intercourse.
• Unable to insert penis, finger or tampon.
• In some circumstances, the mere thought of sexual intercourse may cause vaginal cramping.

Women with vaginismus often experience extreme emotional distress. They feel ashamed.

What are the different types of vaginismus?

There are two types of vaginismus: The type depends on when the vaginal spasm occurs. In primary vaginismus, the dysfunction is present at birth, but in secondary vaginismus, the dysfunction develops over time.

Primary vaginismus is a birth defect that most people notice during their first sexual experience.

Secondary vaginismus is caused by sexual abuse, trauma or birth trauma.

What causes vaginismus?

Vaginismus can be caused by a number of things, but the most common cause is psychological. Infections or inflammations of the vagina are not physical causes of vaginismus (such as endometriosis).

• Fear of pain
• Fear of pregnancy
• Sexual abuse,
• Connotations associated with being a woman
• Hyperactive, shy and anxious personality
• Insufficient sex education
• Strict family environment
• Traumas,
• Negative feelings about your partner.

How is vaginismus treated?

The aim of treatment is to reduce the reflex contractions of the vaginal and pelvic floor muscles. Slowly and gradually, the woman learns that sexual intimacy is possible without pain.
Psychotherapies include the study of past traumatic events, sexual history, relaxation exercises and specific routines to help overcome vaginismus. Individual and couples studies are sometimes possible.

What treatments are there for vaginismus?

Vaginal expander

Vaginal dilators are special plastic needles that come in different sizes. The woman inserts them vaginally. They help to enlarge the vagina and accustom the muscles to penile penetration, allowing the person to experience that penetration is possible without pain.

Psychotherapy and sexual therapy

Psychotherapy can help in many cases of vaginismus, especially if it is caused by traumatic events such as sexual abuse or problems with sexual relationships.

Pelvic floor exercises

Pelvic floor exercises teach a woman how to contract and relax her pelvic floor muscles.

Cat hump

Kneel on the floor and support yourself with your hands, keeping your spine straight. Inhale deeply and exhale through your mouth. Form a cat hump, rolling your back up and resting your head in your arms. Breathe in again and keep your spine straight.

Medication

In rare cases, the doctor may prescribe medication (called “muscle relaxants”) to help prevent possible spasms. Muscle relaxants can relieve the symptoms, at least temporarily.

How does vaginism affect relationships?

Vaginismus causes many individuals and couples problems throughout their lives. Individuals and couples feel ashamed of the condition and do not hide it. The opinions of others lead to feelings of inadequacy, embarrassment, anxiety and isolation. As a result, treatment is put off and a solution is delayed.

What is the importance of treating vaginismus?

People who have vaginismus can live much more comfortably, sometimes just with counselling and sometimes with the help of medication. Everyone should have a fulfilling sexual life. The support of your partner is very important at this time. Remember that your privacy is of the utmost importance while you are receiving help from a professional. Because of their expertise, specialists in this field are in a better position to help you from a professional point of view than anyone else.

References:

Jaime R. Herndon, . (2023). What Is Vaginismus?