Although vaginismus shows itself in a physical way it is generally considered to be a psychological problem. Vaginismus can cause distress and relationship problems. It can also create problems when it comes to starting a family.
The vagina muscles go into spasm, usually in response the vagina or vulva being touched before sexual intercourse. It can also happen if penetration of the vagina by the penis (sexual intercourse) is attempted, or during a gynaecological examination. Some women find that they cannot use tampons when they have a period because of vaginismus.
It’s untrue that women who have vaginismus don’t like or want to have sex. In fact, many women with this condition enjoy closeness and share sexual pleasure with their partner. They are able to achieve orgasm during mutual masturbation, through foreplay and oral sex. It is only when sexual intercourse is suggested or attempted that the vagina tightens to prevent penetration.
Vaginismus can disrupt or completely stop your sex life and make gynaecological and pelvic examinations difficult or impossible. In some cases, a woman may need an anaesthetic before a doctor can perform an examination.
There are many factors that cause vaginismus. Some women have had the condition all their adult lives and may never have had sex because of it. With others, it may be due to other reasons, for example, a difficult childbirth or sexual trauma.
Vaginismus is not rare and it’s likely that a lot of women will experience it at some time in their life, even if they have had a previous sexual history of enjoyable and painless sex.
Symptoms
There are several symptoms of vaginismus including:
* involuntary (against your will) spasm of the muscles in the vagina
* fear of pain or real pain
* intense fear of penetration
* loss of sexual desire if penetration is attempted, and pain if penetrated by a tampon, finger or penis.
These symptoms are entirely involuntary - the woman can do nothing to stop it.
Causes
There are many different causes of vaginismus, although the reason depends on the individual person. It is not always fully understood why the condition happens. Some cases appear to have a physical cause such as an injury, inflammation of the vagina, pelvis or bladder. It may be because of persistent vaginal dryness or irritation due to spermicides or latex (rubber) in condoms. Even if the original physical cause has disappeared, vaginismus can still continue to happen.
Vaginismus has also been linked to fear or dislike of sex and may be related to difficult or painful sexual intercourse (known as
dyspareunia). It can also a side effect of alcohol, medication or drugs.
Other factors may be the fear that the vagina is too small for sexual intercourse. It could also be due to unpleasant sexual experiences at a young age or the first sexual experience.
Experiencing a past or recent trauma to the genital area or an incident linked to sexuality can make your body respond in a protective way to stop further hurt. A clumsy, painful sexual encounter or examination may be the root of the problem.
For some women, vaginismus may be the result of being sexually abused, assaulted or raped.
A very strict upbringing where sex was never discussed, or unhelpful messages leading to feelings of guilt and shame can be another cause.
Religious or cultural taboos or the fear of getting pregnant can also contribute to vaginismus. Relationship problems can also be a factor.
In some cases, vaginismus can occur after a vaginal infection, the after effects of childbirth, tiredness and depression. Inadequate sex education, being told sex is painful or sexual desire is wrong can cause fear and anxiety of sex.
Diagnosis
Diagnosis is based on the woman’s medical history, the symptoms and a physical examination, if possible.Any physical disorders that may be causing or contributing to vaginismus will need to be treated, for example, an injury or infection. However, if the cause of the condition is psychological, then counselling for the woman and her partner (if she is in a relationship) is needed.
Treatment
Treatment will depend on whether the root cause can be identified. If there is an obvious physical cause like an injury or infection, then this can be treated with appropriate medication.If the cause is less obvious, it may be a case of taking time to see if the problem sorts itself out with self help techniques (see our Self-help section). In this case, getting to know your own body, an understanding partner or the help of a health professional are the most important factors.
Self-help
There are a few different methods and self-help techniques that help treat vaginismus. The good news is, it can be cured.
You can be taught a technique to relax the muscle spasms in the vagina. This involves gradually widening (dilating) the vagina with a set of vaginal trainers. These are four smooth, penis shaped cones that gradually increase in size and length. Insert the smallest one first and use a lubricant to help if you want to. Go at your own pace and make sure you are relaxed before trying. Once you feel comfortable inserting the smallest one, move onto the second size, and so on. It doesn’t matter how long it takes you to do this, whether it’s a day, weeks or months. Just do whatever you feel comfortable with so you gain confidence and feel more in control of your own body.
When you get to the stage where you can tolerate the larger cones without feeling anxious or any pain, then you and your partner may want to try having sexual intercourse.
If you don’t think that the cone method is right for you, take the time and get to know your own body. Take a warm, relaxing bath and lie somewhere comfortable. When you feel ready, touch yourself around the vaginal area. If you feel yourself tensing up, stop and take a moment to slow your breathing down. Relax and try again. Do this for a few days before you move onto the next stage.
If you feel comfortable touching yourself, try to put your finger very gently inside your vagina. If you are ready, over the next few days, gently push your finger further inside and feel around. You will find that your vagina is very flexible and supple.
If you have reached this stage, try putting a tampon inside. Put some lubricant on the tampon so it will be easier to insert. If you have a supportive partner, ask them to help you with each stage. Spend time with your partner being sensual. Explore each other’s bodies through touch and massage.
When you are relaxed enough to attempt intercourse, make sure you are fully aroused before attempting penetration. Remember to take things slowly and gently.
If the problem doesn’t go away, go back and speak to your GP.
