Vaginismus

Written by Jaime Herndon | Published on August 7, 2012
Medically Reviewed by George Krucik, MD

What is Vaginismus?

Sexual dysfunction can occur in both males and females and can usually be treated. It is nothing to be ashamed about, and it is not your fault. Nevertheless, these disorders can interfere with your relationships and quality of life.

For example, some women have involuntary contractions of their vaginal muscles. It typically happens right before sexual intercourse. Some women also have these contractions other times, such as when trying to insert a tampon or when touched near the vaginal area. This is called vaginismus. The contractions can prevent sexual intercourse. They can also make intercourse very painful.

Vaginismus does not interfere with sexual arousal, but it can prevent penetration. A gentle pelvic exam typically shows no reason for the contractions. No physical abnormalities contribute to the condition.

Experts do not know exactly how many women suffer from vaginismus, but the condition is considered to be uncommon, states the National Institutes of Health (NIH).

Types of Vaginismus

Vaginismus can be classified into two types:

  • Primary vaginismus, when vaginal penetration has never been achieved.
  • Secondary vaginismus, when vaginal penetration is no longer possible. This may be due to factors such as gynecologic surgery or radiation.

According to the Women’s Therapy Center, some women develop vaginismus after menopause when estrogen levels drop. This causes a lack of vaginal lubrication and elasticity that makes intercourse painful and stressful or impossible. In some women, this can lead to vaginismus.

Dyspareunia

Dyspareunia is a term that describes painful intercourse. It may be confused with vaginismus. Dyspareunia encompasses sexual pain from a variety of sources. The pain could be due to cysts, pelvic inflammatory disease, or vaginal atrophy. Although vaginismus is one of the conditions that can contribute to dyspareunia, all dyspareunia is not necessarily vaginismus.

Causes of Vaginismus

There is not always a reason for vaginismus. The condition has been linked to past sexual abuse or trauma, past painful intercourse, and emotional factors. But in some cases, no direct cause can be found. To make a diagnosis, your doctor will typically take a medical and sexual history in addition to doing a physical exam. These histories can help give clues to the underlying cause of the contractions.

Treatment Options for Vaginismus

Vaginismus is a treatable disorder. Treatment is typically multifaceted, and will include education, counseling, and exercises.

Sexual Education

Education typically involves teaching you about your anatomy and what happens during sexual arousal and intercourse. Information about the muscles involved in vaginismus is also given. This can help demystify the parts of the body and provide concrete information about how your body is responding.

Counseling may involve you or both you and your partner. Working with a counselor who specializes in sexual disorders may be helpful. Relaxation techniques and hypnosis may also promote relaxation and help you feel more comfortable with intercourse.

Vaginal Dilators

Your doctor or counselor may recommend using vaginal dilators. You should not use dilators without supervision by a professional. In these exercises, cone-shaped dilators are placed in the vagina. The dilators get progressively bigger. This helps the vaginal muscles stretch and become flexible. Your partner can help insert the dilators. This can help increase intimacy. After completing the course of treatment with the set of dilators, you and your partner can try to have intercourse again.

Kegel Exercises

Kegel exercises are the repetitive tightening and relaxing of the pelvic floor muscles, which control your vagina, rectum, and bladder.

You can locate these muscles when you are urinating. After you begin going, stop the stream. You are using your pelvic floor muscles to do this. You may feel them tighten and move up. These muscles move as a group, so they all contract and relax at the same time.

Practicing these exercises helps you regain control of when your muscles contract and relax. Follow these steps:

  • Empty your bladder.
  • Contract your pelvic floor muscles, and count to 10.
  • Relax your muscles, and count to 10.
  • Repeat this cycle 10 times, three times a day.

To successfully strengthen your pelvic floor muscles, be sure not to engage the muscles of your abdomen, buttocks, or thighs when doing these exercises.

Outlook: Living With Vaginismus

Sexual dysfunction can take a toll on relationships. It’s important to remember that there is nothing to be ashamed about. Talking with your partner about your feelings and any fears about intercourse may help you feel more relaxed. Treatment with a sex therapist may be beneficial. Many doctors and therapists can provide you with ways to overcome vaginismus.

Using lubrication or certain sexual positions can help make sexual intercourse less uncomfortable. Experiment and find out what works for you and your partner. What works for one couple might not be right for another.

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