Vaginismus: How Does it Happen?

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Published on 30/10/2020 . 4 mins read
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The vagina has the ability to stretch during sexual intercourse and childbirth. It is elastic, meaning that it can also go back to its natural shape afterward. However, some women suffer from vaginismus, which causes their vagina to tighten up. This makes sex and medical exams extremely painful. Let’s discuss what causes vaginismus and how to prevent it.

What is vaginismus?

Vaginismus is an involuntary contraction or spasm of the muscles in the vagina. This condition leads to both physical and psychological pain in women with no vaginal abnormalities.

Vaginismus often results in physical pain during sexual intercourse and pelvic exams where medical instruments are inserted into the vagina. It can also happen when using tampons and menstrual cups. The condition can be set off by psychological pain such as fear, anxiety, panic, and helplessness. There are still no surefire ways to prevent vaginismus.

What are the types of vaginismus?

The following are the four types of vaginismus you should know about:

Primary. This type of vaginismus is a lifelong condition wherein a woman finds it difficult to insert anything into her vagina. Pelvic or gynecologic exams can also be hard to deal with, as these tests require the insertion of medical tools inside the vagina. Most women notice this condition during their first attempt at penetrative sex. A woman with primary vaginismus has never achieved any kind of vaginal penetration successfully.

Secondary. This is when a woman experiences symptoms of vaginismus after having experienced vaginal penetration. The causes of this type of vaginismus can be traumatic childbirth, painful sexual history, or prior gynecologic surgery.

Global. Women who have global vaginismus have been experiencing vaginal tightness right from the start. But, what makes it different from other types is that global vaginismus makes a woman feel pain and discomfort whenever anything is about to enter her vagina. 

Situational. This refers to the condition wherein a woman feels vaginal pain only under certain circumstances. For example, a woman with situational vaginismus can comfortably undergo a pelvic test but is experiencing excruciating vaginal pain whenever she tries to use a tampon.

What Causes Painful Sexual Intercourse?

What are the symptoms of vaginismus?

The most common symptoms of vaginismus include:

  • Pain, discomfort, or burning sensations while engaging in vaginal sex. During these instances, penetration is often unsuccessful.
  • Vaginal pain or discomfort when undergoing pelvic or gynecological exams.
  • Difficulty, discomfort, or pain when inserting tampons or menstrual cups.
  • Uncontrollable spasms in the vaginal muscles.
  • Feeling anxious about the thought of sex and penetration.

Take note that vaginismus does not hinder a woman’s orgasm. Women with vaginismus can still reach orgasm through direct and indirect clitoral stimulation with or without the help of a sex partner.

What are the causes of vaginismus?

Vaginismus can stem from physical and psychological factors. Most of the time, a woman has no control over it. But in certain situations, anticipation can trigger the condition. Knowing the causes of vaginismus can sometimes help to prevent it.

The causes of vaginismus can be physical, such as:

  • Menopause
  • Insufficient foreplay
  • Lack of vaginal lubrication
  • Vaginal delivery (childbirth)
  • Medicinal side effects and/or past pelvic or gynecologic surgery
  • Infections in the reproductive tract such as vaginal yeast infection and urinary tract infection (UTI)

There are also psychological or mental factors, including:

  • Traumatic experiences in the past like sexual abuse, a history of painful intercourse, or having an abusive partner
  • Insecurity about the appearance of the vagina or loss of sexual self-esteem
  • Fear of experiencing pain, especially for those who are about to engage in penetrative sex for the first time
  • Fear of getting pregnant
  • Being unwillingly exposed to sexual acts or images at a young age

How do they diagnose vaginismus?

Your attending physician will most likely ask you about your symptoms, how long have you been dealing with the spasms, and your sexual history. These questions are needed to determine the causes of your vaginismus.

After a physical exam, you might have to undergo a pelvic exam so the doctor can see what’s happening inside your vagina. During the pelvic exam, your doctor may use a speculum to properly open up your vagina. To relieve discomfort or pain, doctors apply topical anesthesia. In severe cases, however, they can administer local or general anesthesia.

How do you treat and prevent vaginismus? 

Here are some of the treatments your healthcare provider might recommend:

Pelvic floor physical therapy (Kegel exercises). This treatment helps patients strengthen their pelvic floor muscles to address certain problems such as dysfunction, weakness, and pain.

Vaginal dilator therapy. Normally prescribed by doctors, vaginal dilators are instruments that come in different sizes to help stretch the vagina. The objective of the therapy is for patients to gradually increase the size of the dilator without feeling any pain or discomfort. To make things comfortable, patients can use a numbing topical cream for the first few tries.

Topical therapy. A therapy that uses topical medications to treat or alleviate pain triggered by vaginismus.

Cognitive-behavioral therapy. This therapy is advisable for patients whose condition results from traumatic experiences, anxiety, and/or depression.

Sex therapy. Couples can undergo sex therapy to learn how to improve their intimacy.

Can vaginismus be prevented? As of today, there are still no known ways to completely prevent vaginismus. Scheduling regular check-ups with your doctor is the only way to monitor your vaginal health.

Key takeaways

Vaginismus is a disorder that greatly affects a woman’s life. This condition can damage a woman’s confidence and her relationship with her partner. That is why, if you think you are experiencing symptoms, it is best to figure out the causes of your vaginismus. A lot of women have already recovered from this condition with professional help and proper treatment.

Learn more about Pelvic Related Issues, here.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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