Some women experience involuntary contraction and tightening of the vaginal muscles, causing them discomfort or pain. The condition is called vaginismus and affects many aspects of a woman’s life.
But what causes vaginismus? What are the symptoms? What are the available treatment options? Keep reading the next sections to find out!
What is Vaginismus?
Vaginismus is a condition characterized by spasms and involuntary contractions of the vaginal muscles. This is due to the uncontrolled tensing of the pelvic floor muscles, specifically the pubococcygeus group of muscles.
The pubococcygeus muscles play a role in vaginal intercourse, urination, orgasms, childbirth, and bowel movement.
Vaginismus can lead to sexual pain, discomfort, penetration problems, or inability to engage in sexual intercourse. The pain may vary from a mild discomfort to a severe burning, almost unbearable pain. Because of this, relationships and marriages stay unconsummated.
The condition can also affect women of all ages and stages of life. Some patients that suffer from vaginismus have even had previous pain-free sexual experiences.
Although it is fairly common to find intercourse uncomfortable or painful, persisting problems that could affect your mental health, relationships, and self-esteem should be properly diagnosed for accurate treatment.
Four types of vaginismus may affect women. These are:
1. Primary Vaginismus
This is a lifetime condition wherein the pain has always been experienced by the person. Usually, women experience this during their first time to attempt or engage in intercourse.
It can be described as a male partner’s inability to penetrate the vaginal canal because the muscles are so tight, it seems like there’s no opening at all. This affects a woman’s sexual life, as well as a woman’s gynecological exams and use of tampons.
On top of the pain, temporary loss of breath and general muscle spasms may also be experienced. These symptoms usually go away once the attempt to enter the vagina is stopped.
2. Secondary Vaginismus
Secondary vaginismus is the type that happens after previously being able to have a healthy sex life. It can occur at any life stage to those who have no previous history of experiencing vaginismus symptoms.
Often this is triggered or brought about by a particular event, a traumatic experience, menopause, an infection, childbirth, surgery, relationship issues, or because of the development of another medical condition.
Sadly, for secondary vaginismus, pain can persist even after the underlying medical condition is cured. This is due to your body being used to responding a certain way resulting in vaginismus symptoms.
3. Global Vaginismus
This type is when the pain occurs on all occasions without a certain object or circumstance.
4. Situational Vaginismus
Situational vaginismus is when pain is only experienced during certain situations. An example of this is being able to have normal sexual intercourse but experiences pain during gynecological exams or when inserting a tampon.
5 Signs that you have Vaginismus
Although the severity and the onset of the pain vary greatly among women, the following signs could indicate that you have vaginismus:
1. Breathing cessation and General Muscular spasms when attempting intercourse
Vaginismus can cause a person to experience apnea, the technical term for when a person temporarily stops breathing. Spasms in large muscle groups of the body such as the lower back or legs may also occur.
This is believed to be a woman’s protective and defense mechanism against pain. This can happen without your conscious control and is simply due to nerves signalling the muscles, especially that of the vagina, to constrict, guard, and brace against penetration.
Generally, when the attempt to penetrate the vagina ends, the muscles relax to normal. Because of this, no problems are noted by medical pelvic exams unless tightness occurs during the process.
2. Pain when inserting a tampon and undergoing gynaecological examination
This pain is still due to the uncontrolled tightness and contraction of the vaginal muscles due to the same reasons as the previous one. This can be a sign of vaginismus although not everyone with the condition experience it.
3. Difficulty during penetration
Although vaginismus usually does not interfere with your sexual arousal, it can prevent potential penetration due to the closing of the vaginal muscles and the blocking of the vaginal canal.
4. Dyspareunia or pain during sexual intercourse
Dyspareunia can be described as an unusual, strong tightness, stinging, or burning that can even lead to long-term sexual pain. The cause may be known or unknown.
This is common in women who develop vaginismus after menopause because during this menstrual stage, estrogen levels drop. This leads to a shortage or lack of natural vaginal lubrication and elasticity, making intercourse very stressful, painful, difficult, and even impossible, a sign or possible cause of vaginismus.
However, dyspareunia is different from vaginismus. Dyspareunia in itself can be because of vaginal atrophy, inflammatory disease, or cysts.
5. Sexual dysfunction
Sexual dysfunction can either be the failure to be aroused, lack of sexual interest, or inability to reach orgasm, which can arise from the pain, mental and emotional stress that accompanies vaginismus.
Causes of Vaginismus
Not all cases of vaginismus have identifiable or direct reasons. However, it can be linked to several possible factors classified into emotional and physical triggers, or a combination of both.
● Emotional Factors
○ Fear of pregnancy or pain
○ Anxiety or guilt regarding one’s sexual performance
○ An abusive sexual relationship
○ A feeling of vulnerability
○ Emotional and mental trauma from a past abuse, harassment, or rape
○ Negative experiences during childhood such as exposure to sexual things
● Physical Factors
○ Infections like yeast infection or UTI
○ Underlying disease or condition such as lichen sclerosis or cancer
○ Previous pelvic surgery
○ Insufficient foreplay
○ Low amounts of vaginal lubrication
○ Side effects of certain medications
Treatments for vaginismus
Fortunately, when diagnosed early, vaginismus can be easily and successfully treated under a sex therapist or specialist through any or a combination of the following:
● Dilation and insertion training
This is a series of supervised exercises that utilize vaginal dilators that help the patient become more accustomed to penetration.
● Sexual counseling and education
To develop a much deeper understanding of the condition, its symptoms and cure, one can be given lessons about the sexual response cycle and the anatomy of the reproductive system.
● Emotional therapy
These may involve consultation with a specialist that allows the patient to express, identify, and resolve emotional burdens that could be contributing to their pain and condition.
● Pelvic floor exercises
To develop control and strength of the muscles of the pelvic floor, it is advised for vaginismus patients to perform kegel exercises. Kegels are exercises that involve tightening and relaxing the muscles that control the bladder, rectum, and vagina.
You can do this by trying to stop the stream when urinating, without using your thigh, butt, or abdominal muscles. Do this in three sets of ten cycles each day.
Do not let your fear of judgement or rejection prevent you from seeking medical help for your condition. You can recover from vaginismus as long as treatments are explored and administered as soon as possible.