Vaginismus

Mental Health

Vaginismus is a condition caused by a spasm in the pelvic floor muscles in a female’s body. This involuntary contraction of muscles occurs around the opening of the vagina, often making it extremely difficult to tolerate insertion. It may happen just prior to intercourse, using a tampon, or a medical examination. This vaginal spasm can be very painful – even traumatizing -that those with vaginismus shy away from intercourse and pelvic examinations. The prevalence of this painful sexual dysfunction is estimated to be between 5% to 17% in the United States. However, many women may find it difficult to be open about the condition and there are many undiagnosed sufferers. Treatment is usually based on changing the response to touch with behavioral therapies, lubricants, and counseling if necessary. Counseling is especially helpful if the response is due to sexual trauma. This article will help you understand this condition and answer any questions you may be afraid to ask. It also gives helpful tips on how to deal with vaginismus.

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Symptoms

Vaginismus can affect women both physically and emotionally. The main symptoms include:

  • Muscle spasms at the vaginal entrance
  • Pain or stinging with insertion (i.e., a penis, finger, tampon)
  • Feelings of fear when vagina is touched
  • Fear of intercourse
  • Low libido, sexual desire
  • Complete inability to insert a penis, finger or tampon
  • Loss of ability to have an orgasm

Diagnosis

Physicians diagnose vaginismus with a physical examination involving a pelvic exam (done as gently as possible). Once a physician recognizes the uncontrolled spasm upon examination, a diagnosis is made. Your doctor will most likely ask you about your history of symptoms, any medications you are taking, and your sexual history. It is important to open up to your doctor about any history of abuse or sexual trauma so they can understand underlying causes.

The doctor will need to examine your vagina and pelvic area to check for signs of vaginal injury or possible infection. There is also a condition known as vulvodynia that can cause the nerves at the entrance to be unusually sensitive. If the examination makes you fearful or you feel pain, let your doctor know at once. Your doctor may try another time or allow you to relax a little more.If your doctor cannot find a cause, you may be sent to a specialist for further testing. You may also be referred to a counselor or sexual therapy program.

Treatments

The treatment for vaginismus is entirely up to you and your doctor what will work best for you. Some women need therapy and counseling prior to working on relaxing the vaginal muscles physically. Others can go straight into the exercises to help relax the pelvic floor and have positive results. A small number of women may need a minor surgery to enlarge the vaginal opening, but this is rarely needed with advances in non-invasive treatment.

Kegel Exercises. This involves squeezing the pelvic floor muscles and then releasing them. It is much like stopping and starting the urine flow. You can do this on the toilet when urinating at first to get used to the feeling of the exercise:

1. Sit on the toilet and start your urine flow.
2. Stop your urine flow and hold for 5 seconds.
3. Relax your muscles and allow yourself to finish going.

You can repeat the start/stop a few times when you feel comfortable. If this causes you pain, stop and try again another time. After you are able to start and stop the flow of urine a few times, try it when you are not urinating. You can do these anywhere and anytime without anyone even knowing.

Finger Insertion. After you are comfortable with Kegels, you can try finger inserting while doing the exercises. Draw yourself a warm bath. Lay back in the tub and begin to do your Kegel exercises. After relaxing the muscles, try inserting one finger in the vaginal opening. If you begin to tense up, remove the finger until you can relax again. If you can get your finger in, try doing a few Kegels while your finger is inside. This will help you regain control of the muscles with something inside. Work your way up to a few fingers to get the muscles used to the feeling of something larger.

Therapy. If you cannot get your muscles to relax manually, you may need to see a therapist for some “talk therapy” to see if you can get to the root cause of the issue. You may also be referred to a sex therapist for some helpful techniques that can relieve the tension, fear, and anxiety.

Alternative Treatments and Home Remedies

There are a few alternative healing remedies you can try to change the response in your pelvic floor muscles. These include:

Meditation and Mindfulness. You need to increase your mindfulness of the present. It helps you focus on your breathing, your thoughts, and your emotions. Try a simple meditation where you clear your mind of all thoughts and just tune in to your breaths. Then focus only on your body. Any thoughts that enter your mind from the past or even daily routine need to be sent away until you are only focusing on the rhythm of your body. After you are able to clear and connect with yourself, try relaxing your pelvic floor and seeing if you can insert something into your vagina without the spasms. Give yourself time and patience.

Yoga. Check with a yoga studio in your area to see if there is a sexual or tantric yoga class. They will teach you and your partner yoga positions that can help improve your connections as partners and ease lovemaking without stress and tension.

Acupuncture. Talk to a Chinese medicine practitioner about acupuncture for sexual dysfunction. This may help open up the flow of energy that affects the sexual organs.

Lifestyle Changes

Open up and talk about things. The intimate connection between you and your partner involves talking about how you are feeling. Let them know it isn’t them and that you need them to help you feel more relaxed. Tell them about your needs and what you like to make sex more pleasurable and comfortable.

Make healthy lifestyle choices. Alcohol can be numbing to sexual response. Try not to drink too much. Get exercise which can increase endorphins, the “feel good” chemicals that can make you feel sexy and in the mood.

Reduce stress. Find ways to lower your stress levels and tension. Practice meditation or get out of the house for a walk.

Invest in a lubricant. Moisture can increase comfort for insertion. It is helpful both for intercourse and tampon insertion. Sometimes, this is all it takes to relieve the condition. Many women develop vaginismus from painful insertion and then react to dryness that way every time. Lubricant can easily remedy this cause.

Clitoral stimulation. Stimulating the clitoris can relax the pelvic floor muscles and prepare them for penetration. This is helpful in a lot of women who have not been able to achieve an orgasm. Once the body knows the response of penetration will be a good one, the tension may go away.

References

Basson, R. M. (2015, September 6). Vaginismus. Retrieved from Merck Manual: https://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus

Health and Safety Executive. (2015, September 6). Vaginismus. Retrieved from Health and Safety Executive: https://www.hse.ie/eng/health/az/V/Vaginismus/Symptoms-of-vaginismus.html

Lahaie, M.A., Boyer, S. C., Amsel, R., Khalifé, S., &Binik, Y. M. (2010, 5). Vaginismus: A review of the literature on the classification/diagnosis, etiology and treatment. Retrieved from Medscape: https://www.medscape.com/viewarticle/730325_9

MedLine Plus. (2014, July 28). Vaginismus. Retrieved from U.S. National Library of Medicine: https://www.nlm.nih.gov/medlineplus/ency/article/001487.htm

NHS Health Choices. (2015, September 1). Vaginismus: Diagnosis. Retrieved from NHS: https://www.nhs.uk/Conditions/Vaginismus/Pages/Diagnosis.aspx

Simons, J. P. A. (2001, April 30). Prevalence of sexual dysfunctions.Archives of Sexual Behavior, 30(2), 177-219. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2426773/

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