Vaginismus is a problem in which the involuntary contraction of the pelvic floor muscles around the vaginal canal occurs as a response of penetration or attempted penetration of the vaginal canal, causing pain and discomfort. These painful pelvic muscle spasms are involuntary, and many women are utterly unaware that they are happening.

Vaginismus isn’t a permanent issue, and it’s also not unfixable.

Yes, it is an involuntary spasm of a set of muscles surrounding the vaginal opening; however, a woman can learn to control these muscles.

Around 10% of women in the world deal with vaginismus. Sexual intercourse and other activities such as getting a pelvic examination at a clinic may be difficult or impossible for women with vaginismus. The degree of vaginismus is a spectrum that varies from person to person. The majority of women who are impacted may also suffer fear and anxiety while thinking about penetration.

Vaginismus is a reasonably prevalent female sexual problem that is likely underdiagnosed and underreported. It can affect any woman. Women with vaginismus may feel alone or ashamed about their condition, and they may be hesitant to seek therapy because they are unaware that they have a treatable medical condition.

Does vaginismus only happen in those who never had sexual intercourse?

No, this isn’t correct. Vaginismus can even affect women who have never had a problem with sexual activity before.

Vaginismus can be classified into two categories:

  1. Primary vaginismus: vaginal penetration has never been achieved.
  2. Secondary vaginismus: when vaginal penetration was previously achievable but is no longer possible attributable to gynaecologic surgery, trauma, or radiation.

After menopause, some women develop vaginismus. When oestrogen levels diminish, intercourse becomes uncomfortable, stressful, or impossible due to lack of vaginal lubrication and flexibility.

Due to vaginismus, many marriages have been left unconsummated. Some women’s relationships with their partners or husbands have become strained, if not broken.

It’s unfortunate to say, yet many ladies suffer in silence from this illness. A small percentage of women have attempted to seek guidance from their gynaecologist in this regard. During these consultations, they are frequently advised to simply go home and practice with different dilators.

To be honest, saying it is easier than it seems.

Which woman would willingly put herself through more pain to solve this problem when the vaginal entrance itself is the problem, making vaginismus a more deeply rooted issue?

Vaginismus can take several forms, some of which are moderate and others which are more severe, where even the attempted insertion of a cotton bud can cause tremendous pain.

What causes vaginismus?

There is no known cause or explanation for vaginismus. When it comes to sexual intercourse, it is frequently associated with worry and fear. Some women may have experienced sexual abuse as a child or come from a more traditional family. Nonetheless, in many women with vaginismus, determining the underlying reason may be impossible.

Your doctor will perform a physical exam and inquire about your medical and sexual history in order to make a diagnosis. These accounts may provide insight into the underlying reason of the involuntary pelvic muscle contractions.

How to know if you have vaginismus?

The major symptom of vaginismus is involuntary tightening of the vaginal muscles, but the severity of the problem varies from woman to woman. Constriction of the vagina makes penetration difficult or impossible in all circumstances.

You can’t control or cease the contractions of your vaginal muscles if you have vaginismus.

During attempted intercourse, women with vaginismus may suffer pain or a burning sensation. Penetrative intercourse may be impossible to achieve depending on the severity of vaginismus.

Vaginismus can also show in a variety of ways, including the inability to insert a tampon or problems with pelvic examinations in the clinical setting, such as receiving a PAP smear, which requires the use of a vaginal speculum to open up the vaginal canal.

Additional symptoms of vaginismus include a phobia of vaginal penetration and a decrease in sexual desire related to penetration.

If you have vaginismus, it doesn’t mean you’ll never engage in sexual activity again. Women with the condition can still experience orgasms and enjoy sexual pleasure.

Is painful intercourse always caused by vaginismus?

Painful sexual intercourse is described as dyspareunia in the medical field. It’s often confused with vaginismus.

Painful intercourse (medically known as “dyspareunia”) can be caused by a variety of factors, one of which is vaginismus. Other factors that might cause painful intercourse include skin conditions, infections, vaginal atrophy, and a lack of lubrication.

How does the doctor diagnose vaginismus?

Vaginismus is primarily diagnosed clinically, which means that your doctor will speak with you and ask you to describe your symptoms in detail, followed by a complete physical examination. This is also to ensure that the discomfort you’re experiencing isn’t caused by some underlying medical problem.

Other medical diseases that are comparable to vaginismus may also present as vaginismus, although treatment will be completely different.

In general, a pelvic exam is required for the diagnosis and treatment of vaginismus. Women with vaginismus may experience anxiety or discomfort during pelvic exams. If your doctor advises a pelvic exam, you and your doctor can talk about how to make the procedure as painless as possible. Your doctor will search for any signs of infection or scarring during the examination.

Additional examinations, like as a pelvic ultrasound scan, may be necessary in some circumstances if your doctor suspects your symptoms are caused by something else.

What are the treatment options available for vaginismus?

Treatment for vaginismus is complex, addressing both the physical and emotional, psychosexual, and relational aspects of the condition. This is why treatment should be comprehensive and include both the woman and her partner (if there is one).

The physical element of vaginismus treatment focuses on reducing tension in the pelvic floor muscles. Desensitization procedures are used to teach the pelvic floor muscles to relax, allowing a woman to gain conscious control and override reflexive muscle spasms.

Sexual education and counselling

Typically, sexual education entails learning about your anatomy as well as what occurs during sexual arousal and intercourse. You’ll also learn about the muscles that are involved in vaginismus.

This might assist you in comprehending how the various bodily components function and how your body responds.

Counselling can be done individually or with your partner. It may be beneficial to work with a psychotherapist who specialises in sexual problems.

Hypnosis and relaxation techniques may also help you relax and feel more comfortable with intercourse.

Vaginal dilators

To help women with vaginismus become more comfortable with penetration, a set of tube-shaped dilators can be inserted into the vagina. Begin with the smallest and gradually increase to the larger ones. Partners are encouraged to participate in this process.

The use of anaesthetic numbing gels applied to the vaginal opening can help break the pain cycle. This alleviates a significant percentage of the discomfort.

The increase of confidence you experience after inserting the smallest size dilator is incredible. This self-assurance leads to increased pelvic relaxation, making successive larger insertions easier each time.

Using anaesthetic numbing gels is not considered cheating. In the meanwhile, you’ll need it. You’re utilizing the numbing gels to boost your confidence and alleviate your fears of vaginal penetration. You can progressively wean off the anaesthetic numbing gels until penetration of an average erected penis sized dilator is achieved.

Can vaginismus be cured and will I be able to have normal, pain free sexual intercourse?

Vaginismus is a self-perpetuating, involuntary condition that does not usually resolve on its own.

When a woman with vaginismus tries to have intercourse, the pain she feels increases her fear of being penetrated, which diminishes the chances of treating vaginismus.

Vaginismus, on the other hand, is completely treatable.

Every patient’s road to recovery is different, with its own set of obstacles and victories. Patients who are determined and do not have any severe complications can usually get rid of their sexual pain or penetration issues in a month.

It is critical to remember not to compare or push oneself to the point of feeling frustrated; your journey to overcome vaginismus is unique to you.

Vaginismus can be treated, and pain-free sexual interaction is possible.

If you are experiencing any of those symptoms, visit us at dtap clinic for a consultation and treatment.

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