Vaginismus

What Is Vaginismus? What Causes Vaginismus?

Vaginismus is an uncontrolled, involuntary spasm of the vagina muscles. These spasms cause sexual intercourse to be painful. It is a complex disorder because it is both a psychological and physical condition.

Vaginismus is uncommon, less than 2% of women in the United States are affected. It can cause severe physical and psychological pain. It seems likely that society's expectations of women's sexuality may particularly impact on these sufferers.

According to Medilexicon's medical dictionary:

Vaginismus is a painful spasm of the vagina preventing intercourse.

There are two forms of vaginismus, primary and secondary. Primary vaginismus is diagnosed in women who have never had successful sexual intercourse due to pain or its anticipation.

Primary vaginismus occurs when a woman has never been able to have penetrative sex or experience any kind of vaginal penetration without pain. It is commonly discovered in teenagers and women in their early twenties, as this is when many young women in the Western world will initially attempt to use tampons, have some form of penetrative sex, or undergo a Pap smear.

Women who have vaginismus may not be aware of their condition until they attempt vaginal penetration. It may be confusing for a woman to discover she has vaginismus. She may believe that vaginal penetration should naturally be easy, or she may be unaware of the reasons for her condition.

Secondary vaginismus occurs when a woman who has previously been able to achieve penetration develops vaginismus. This may be due to physical causes such as a yeast infection or trauma during childbirth, or it may be due to psychological causes.

What are the symptoms of Vaginismus?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Symptoms of vaginismus can range in severity. Women with this disorder are not able to have sexual intercourse without pain. Vaginal penetration during sex is difficult or impossible.

Some women may also experience pain during pelvic exams or while inserting a tampon.

If a woman suspects she has vaginismus, sexual penetration is likely to remain painful or truly impossible until her vaginismus is addressed. Women with vaginismus may be able to engage in a variety of other sexual activities, as long as penetration is avoided. There is currently no indication that vaginismus reduces the sexual drive or arousal of affected women.

It is likely that many vaginismic women wish to engage in penetrative sex to the same degree as unaffected women, but are deterred by the pain and emotional distress that comes with each attempt.

What are the causes of Vaginismus?

Vaginismus is considered a disorder of sexual dysfunction. It has several possible causes, including past sexual trauma or abuse, psychological factors, or a history of discomfort with sexual intercourse. Sometimes no cause can be found.
Women with varying degrees of vaginismus often develop anxiety regarding sexual intercourse. The condition causes penetration to be difficult and painful, or even impossible. However, this does not mean the woman cannot become sexually aroused. Many women may have orgasms when the clitoris is stimulated.

Diagnosing Vaginismus

A doctor will ask you about symptoms and medical history, as well as perform a physical exam. The doctor may be able to observe a vaginal spasm during the pelvic exam, and confirm the diagnosis of vaginismus.

The insertion of a speculum may be impossible and vaginal secretion may be minimal. In severe cases, local or general anesthesia may be used to perform an exam.

What are the treatment options for Vaginismus?

Treatment usually combines counseling, education, and muscle exercises.

Kegel exercises cause the repetitive contraction and relaxation of the pelvic muscles. The exercises can help improve control over the vaginal muscles.

Vaginal dilation exercises use the patient's own fingers or plastic instruments called dilators. The dilators are gradually increased in size and placed in the vagina over time. Women may be asked to practice Kegel exercises while the dilators are in the vagina.

Once patients have reached a certain tolerance, sexual intercourse is attempted. Patients may be asked to place the dilators themselves, but the program is supervised by a healthcare provider.

Fear of sex is a large part of this disorder, so educating women is an important part of treatment. Women are taught about sex organs and how they work. The sexual response cycle and common sex myths are also discussed.

Depending on the cause, psychological counseling is often central to the treatment of vaginismus, particularly primary vaginismus due to sexual abuse or trauma. When treated by a specialist in sex therapy, success rates are generally very high.

Preventing Vaginismus

If a woman finds intercourse painful, she should seek medical evaluation right away. When pain continues to be endured as part of sex, it increases the risk of conditioning a vaginismus response.