What Is Vaginismus?
Vaginismus is considered to be a sexual dysfunction disorder in which, during attempts at sexual intercourse, the vagina tightens involuntarily. This vaginal tightness is often caused by contractions in the muscles of the pelvic floor, and is not caused by anything a woman can control. Vaginismus is an involuntary response.
Read more about female sexual dysfunction.
A woman with vaginismus may not even realize that it is the muscle tightening of the pelvic floor that is causing problems with sexual penetration or vaginal tightness.
Like any other condition, the experience for a woman with vaginismus may vary wildly - some women may feel burning, stinging, or pain during intercourse, while still others may never be able to achieve sexual penetration.
It's estimated that about 1 in every 500 women may experience vaginismus during her lifetime, although that number may be skewed as many women do not want to report having this difficulty.
The pain of vaginismus ends when intercourse - or attempted sexual intercourse - ceases.
What Are The Types Of Vaginismus?
There are two types of vaginismus, which can be experienced by any woman at any age, or during any time in her life. The major classifications of vaginismus are Primary Vaginismus and Secondary Vaginismus, which are generally used by the medical community to indicate the time frame when vaginismus begins. It's important to note that the following classifications may not be directly applicable: some women are able to tolerate penetration for many years, the pain gradually increasing over time. Vaginismus may also occur intermittently, with periods of enjoyable sexual intercourse and followed by vaginismus.
Let's explore the differences between Primary and Secondary Vaginismus:
What Is Primary Vaginismus?
Primary Vaginismus occurs during one of the first attempts at sexual intercourse, and is discovered by a woman during this experience, when her partner is unable to achieve sexual penetration. Women who have primary vaginismus may also have problems using tampons or undergoing pelvic examination at the gynecologist.
What Is Secondary Vaginismus?
Secondary Vaginismus is diagnosed when a woman begins to experience vaginismus after a period of pain-free intercourse. This vaginal muscle response often follows temporary, pelvic pain problems. Once the pain-causing problem has been healed or successfully managed medically, the woman continues to experience vaginismus.
Sometimes the severity of Secondary Vaginismus is so unmanageable that sexual penetration becomes increasingly painful, challenging, or impossible. Secondary Vaginismus can also interfere with the ability of a woman to reach orgasm.
What Causes Vaginismus?
As is the case with many medical conditions, the causes for this condition can vary wildly and may be very confusing to both women and their partners. It's widely believed that the root cause of vaginismus is a combination of physical and non-physical triggers that results in an anticipatory pain response in the woman.
The cycle of pain for vaginismus may look like this:
- Woman's body anticipates pain - may have roots in anxiety or fear of pain.
- The woman's body involuntarily tightens the muscles of the vagina.
- This tightness makes sexual penetration very painful or impossible.
- The pain experienced by the woman reinforces and intensifies the pain reflex response.
- The woman's body reacts by bracing itself for pain on a more regular basis.
- Fear, lack of sexual desire or avoidance of intimacy develops for the woman.
Some examples for non-physical causes for vaginismus can include:
Anxiety: anxiety problems, pressure to perform in bed, prior unpleasant or traumatic sexual experiences, negative feelings about sex, guilt, emotional traumas.
Childhood Experiences: rigid parenting, teaching the religious belief that sex is a BAD thing, childhood exposure to shocking pornography, improper sexual education.
Fear: anticipation of pain upon penetration, fear of getting pregnant, fears that the woman has a real medical condition or is "broken" somehow.
Idiopathic - no cause identified.
While there are plenty of non-physical causes for vaginismus, there are a number of physical causes for this condition. Physical causes for vaginismus may include the following:
Age-Related Changes: vaginal dryness, menopause, hormonal changes, vaginal atrophy.
Childbirth: the pain and damage to the vaginal area during childbirth can cause vaginismus.
Medications: certain types of medications can cause vaginismus and pelvic pain.
Pelvic Trauma: pelvic surgeries, pelvic examinations or other pelvic traumas may cause vaginismus.
One of the most important things to remember about vaginismus is that it is NOT the fault of the woman - it is not an intentional reaction, it is not intended to "play hard to get" and it is not something a woman can control.
Do I Have Vaginismus?
While symptoms of vaginismus may appear on a spectrum - from manageable to intolerable - the following are an indicator that you may have vaginismus:
- Burning, stinging, or pain during sex
- Tightness of the vaginal muscles during sexual intercourse
- Difficult to impossible vaginal penetration
- Pain with sexual penetration
- Discomfort with penile insertion
- Sexual pain without an identifiable cause
- Spasms in other muscle groups (legs, for example), or difficulty breathing during any attempts at sexual intercourse
- Inability to insert tampons into the vagina
- Difficulty during pelvic examinations
How Is Vaginismus Diagnosed?
Many women, feeling ashamed and at fault for having vaginismus may be reluctant to tell their doctor about the difficulty she is having during sexual penetration. If she does speak to her doctor, he or she will take a complete medical history and perform a pelvic examination to make the proper diagnosis.
How Is Vaginismus Treated?
Vaginismus is treated through a variety of therapies. If a sex therapist is involved in the plan of treatment, vaginismus is often treated with a high success rate. These therapies can include the following:
Proper education about the cycle of pain and responses to pain, in addition to providing information about female sexual anatomy, common sexual myths, and the cycle of sexual response.
Reassurances that the woman is not at fault and is not "broken."
Therapy to treat any underlying emotional issues stemming from abuse or trauma.
Behavioral exercises such as kegal exercise, which involve pelvic floor muscle relaxation and contraction.
Vaginal Dilation Exercises may involve the use of plastic vaginal dilators under the supervision of a proper health care provider or sex therapist. Vaginal dilation are typically utilized with the partner so that the woman may begin to feel as though she is comfortable and safe with her partner during sex.
Additional Vaginismus Resources:
Vaginismus.com: Their mission is to bring help and information to women struggling with vaginismus.
NHS Choices: Information about vaginismus and the treatments that may be used to treat this disorder.