Vaginismus is a condition where a woman experiences discomfort, burning and pain during attempted penetration of the vagina, often leading to a difficulty in having sexual intercourse.
What is the Cause of Vaginismus?
In vaginismus, any attempt at penetration causes involuntary tensing of the pelvic muscles, specifically, the pubococcygeus muscle, as well as painful muscle spasms.
This is not intentional and women are often unaware that this is happening. The extent of vaginismus may vary between individuals and can range from mild discomfort to severe burning pain.
Women with vaginismus may find themselves unable to insert tampons or undergo a vaginal examination, inserting of Intrauterine Device (IUD) or PAP smear in the clinic, and most troubling of all, they may find sexual intimacy extremely painful or even impossible.
Vaginismus is far more common than people think and can affect any woman, even if they have previously been able to have pain free penetrative intercourse.
Primary Vaginismus & Secondary Vaginismus
Primary vaginismus is when a woman has never been able to have pain free intercourse.
Secondary vaginismus occurs in women who were previously able to have comfortable penetrative sex and may be triggered by events such as childbirth, surgeries, infections, or menopause.
While vaginismus can be deeply troubling, it is important to remember that it is a very treatable condition. Full recovery and achievement of a pain-free and fulfilling sexual intercourse are definitely possible.
What You Should Know Before Treating Vaginismus?
Before treatment, it is important to ensure there are no other medical conditions such as infections, structural abnormalities, or inflammatory skin conditions which are contributing to pain during attempted penetration of the vagina.
Your doctor will perform a thorough physical examination during your first visit and advise you on other investigations that may sometimes be needed to rule out these other problems.
Treatment of Vaginismus
How then is vaginismus treated? Treatment of vaginismus is aimed at releasing the tension in the pelvic floor muscles.
Retraining of the pelvic floor muscles to teach them to relax can be achieved through desensitisation techniques as well as the use of biofeedback devices.
Desensitisation techniques allow a woman to take conscious control of the pelvic floor muscles. These include Kegel exercises, reverse Kegel exercises or pelvic floor drop exercises and the use of vaginal dilators.
A set of vaginal dilators comes in gradually increasing sizes. These dilators are not meant to enlarge or stretch the vaginal opening, but rather, to desensitise the pelvic floor muscles.
The self-insertion of vaginal dilators enables a woman to learn to consciously override involuntary pelvic muscle spasms that occur during penetration. As these pelvic floor muscles learn to relax more over time, you will be able to progress through using the various sized dilators in the set. These dilators are often used in conjunction with a topical numbing cream or anaesthetic cream to make insertion more comfortable.
The treatment of vaginismus is not achieved in a single visit to the doctor; it is an individualised journey that will take perseverance and time. Your doctor will work together with you, your partner, a physiotherapist in a stress-free and encouraging environment to ultimately achieve pain-free penetration and full sexual function.