How Do I Know If I Have Vaginismus?

What is Vaginismus?

Vaginismus is the involuntary tensing or contracting of muscles around the vagina. These involuntary/unintentional muscle spasms happen when something attempts to penetrate the vaginal, for example; a penis, finger or medical instrument. The muscle spasm could be mildly uncomfortable or very painful.

Type of Vaginismus

There are two main types of vaginismus:

  1. Primary: This happens when a woman has had pain every time something entered her vaginal for example, having penetrative sex, or inserting a tampon or medical device during the examination. This may also be called lifelong vaginismus.
  2. Secondary: This happens when a woman has had sex without pain before, but suddenly notes that it has become difficult or impossible. This may also be called acquired vaginismus.

Symptoms for Vaginismus

Painful sex or dyspareunia is usually the first sign of vaginismus. The pain usually happens during penetration and goes away after withdrawal. Some women find out they have vaginismus when they feel uncomfortable inserting a tampon or having a pelvic exam by the doctor. 

The most common symptoms are:

  • Unable to have penetrative sex or insert a tampon
  • Fear of pain and leads to loss of sexual desire 

The involuntary tensing can’t be controlled by women. 

What are the causes of Vaginismus?

The exact causes of vaginismus are not clear. It can be due to physical, psychological and sexual issues. 

The factors that can contribute to vaginismus are:

  • Anxiety disorder
  • Childbirth injuries like vaginal tear
  • Fear of sex due to past sexual abuse, rape or trauma

How to diagnose Vaginismus?

Usually, doctors will start with history taking to find out more about patient’s symptoms and medical background. After history taking, the doctor will proceed with pelvic examination to confirm the presence of muscle spasm. Topical numbing cream will be applied outside the vaginal to make the examination process more comfortable for patients. 

What is the treatment for vaginismus?

Vaginismus treatment aims to reduce the reflex of muscles that cause them to tense up/ spasm. Below is the treatment available for vaginismus:

  1. Topical therapy: Topical anesthesia cream can be applied to the vaginal to help ease the pain due to vaginismus.
  2. Pelvic floor physical therapy/exercises:
  • Kegel exercises are recommended to help improve vaginismus
  • Squeeze the muscle that women use to stop urine during pee, contract the muscle and hold for 10 seconds each time then relax the muscle. Repeat about 20 times per cycle. 
  • After a few days, another attempt to insert one finger into the vagina while doing the exercises can be done. Start with one finger and work all the way up to three fingers. 
  1. Vaginal dilator therapy:  A vaginal dilator is a tube-shaped device that comes in various sizes. The purpose of using a vaginal dilator is to stretch the vaginal. Using a vaginal dilator, it will make you more comfortable and less sensitive to vaginal penetration.

Besides this, cognitive behavioral therapy (CBT) can help to address the anxiety and fear that contribute to vaginismus.

What are the complications of Vaginismus?

Vaginismus will affect someone’s sex life and relationship with partner. It may affect mental health due to anxiety. Vaginismus also will make conceiving more challenging and might need other methods in order to get conceived, for example through IVF.

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