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Health and Fitness

Vaginismus: Type, Symptoms, Causes, Diagnosis & Treatment

Vaginismus is a condition in which the muscles of the vagina involuntarily spasm, making any form of vaginal penetration, including sexual intercourse, extremely painful or even impossible. It is a type of sexual dysfunction that can cause significant distress and difficulty in relationships. Vaginismus is believed to be caused by a combination of physical and psychological factors. Physically, it can be caused by muscle spasms in the pelvic floor, which can be triggered by a variety of things such as infection, injury, or a reaction to a medical procedure. Psychologically, it can be caused by fear, anxiety, or traumatic experiences. It can also be the result of cultural or religious beliefs that discourage sexual activity.

Types of vaginismus

There are two types of vaginismus: primary vaginismus and secondary vaginismus. 

Primary vaginismus is an involuntary tightening of the muscles surrounding the vagina that occurs before any attempt is made at penetration. This type of vaginismus is usually caused by fear or anxiety about the act of penetration itself. Often, women with primary vaginismus have never had any experience with penetration, and their body responds with fear and tension when penetration is attempted. 

Secondary vaginismus is an involuntary tightening of the muscles surrounding the vagina that occurs after some attempts at penetration have already been made. This type of vaginismus is usually caused by a physical or psychological trauma, such as a past sexual assault or a difficult childbirth. Women with secondary vaginismus often experience pain or discomfort when penetration is attempted, and they may also experience flashbacks or other psychological symptoms associated with the trauma. 

Vaginismus treatment usually involves a combination of psychotherapy, pelvic floor physical therapy, and the use of dilators. 

Symptoms of vaginismus

The most common symptom of vaginismus is the inability to engage in any form of vaginal penetration. This can include intercourse, insertion of tampons, and even the insertion of a speculum during a pelvic exam. Other symptoms of vaginismus may include burning, stinging, or aching pain in the vagina during attempted penetration, as well as fear or anxiety about penetration.

In some cases, the involuntary muscle spasms associated with vaginismus can be so severe that even touching the vulva or attempting to insert a finger can be painful. Additionally, some women with vaginismus may experience tightness in their pelvic floor muscles even when not attempting penetration. This can lead to difficulty urinating, sitting for long periods of time, and even walking.

Causes of vaginismus

The exact cause of vaginismus is not known, but there are several potential causes that can be considered.

One of the most common causes of vaginismus is psychological. Women who have experienced physical or sexual abuse, or those who have had negative experiences with intercourse, may be more likely to experience vaginismus. Anxiety and fear of pain or of being judged can also be contributing factors. Additionally, cultural norms and beliefs can play a role, as some women may feel that intercourse is a taboo or shameful act.

Hormonal imbalances can also be a potential cause of vaginismus. Low estrogen levels can cause the vaginal walls to become thin, dry, and less elastic, leading to pain during intercourse.

Physical causes can also be a factor in vaginismus. Injury or trauma to the pelvic floor muscles can lead to involuntary muscle spasms, as can conditions like endometriosis, pelvic inflammatory disease, and interstitial cystitis.

Diagnosis of vaginismus

Diagnosis of vaginismus can be done through a physical examination and a review of medical history. The physical examination may include an internal exam to check the pelvic floor muscles for tightness or spasm. If the doctor suspects vaginismus, they may recommend further testing such as a pelvic ultrasound or an MRI to look for any anatomical abnormalities. The doctor may also ask questions about the patient’s sexual history and any previous attempts at intercourse.

In addition to the physical examination, the doctor may also ask the patient to fill out a questionnaire about their symptoms and medical history. This questionnaire can help the doctor determine the best course of treatment. Treatment for vaginismus may include psychotherapy, pelvic floor therapy, medications, or a combination of these approaches. Psychotherapy can help the patient understand and address the underlying causes of the condition, while pelvic floor therapy can help relax the muscles of the pelvic floor. Medications may be prescribed to help relax the muscles and reduce the pain associated with vaginismus.

The most important step in treating vaginismus is to have a thorough evaluation by a qualified doctor. This will help to determine the underlying cause of the condition, which can vary from physical to psychological. Once the cause has been identified, the provider will be able to recommend the most appropriate treatment plan.

Treatments of vaginismus

Physical treatments for vaginismus include relaxation techniques, such as deep breathing and progressive muscle relaxation, as well as pelvic floor muscle exercises. These exercises are designed to help the patient gain greater control over her pelvic floor muscles, which can help to reduce the involuntary muscle spasms. Additionally, the use of dilators can be helpful in desensitizing the vaginal muscles and allowing the patient to become comfortable with penetration.

Psychological treatment for vaginismus can include cognitive-behavioral therapy, hypnosis, and psychotherapy. These treatments are designed to help the patient address any psychological issues that may be contributing to the condition, such as feelings of guilt or shame, fear of pain, or anxiety.

Conclusion 

Vaginismus is a condition that can cause a great deal of distress and frustration for those affected. It is important to remember that this is a condition that can be treated and that there is hope for those who suffer from it. There are many treatments available, such as psychotherapy, medications, and pelvic floor exercises, that can help to reduce the symptoms of vaginismus. It is important to talk to a doctor to discuss the best treatment options for you. The best gynecologist in India at Queen’s Gynecology treats the condition in the best possible way. The cost of vaginismus treatment depends upon many factors, and you can visit the clinic to know all about it. 

FAQs

  • How do you know if you have vaginismus?

Symptoms of vaginismus include difficulty or pain with inserting anything into the vagina, such as a tampon or penis, and/or tightness of the muscles of the pelvic floor. Other symptoms may include fear or anxiety about penetration, pain during intercourse, and/or difficulty with using a speculum during a gynecological exam.

  • How common is vaginismus?

Vaginismus is a relatively rare condition, affecting an estimated 5-17% of women. It is more common in younger women and in those who have had a traumatic sexual experience.

  • Can vaginismus be treated with exercises?

Yes, vaginismus can be treated with exercises. Exercises such as progressive muscle relaxation, breathing exercises, and pelvic floor exercises can help to relax the muscles in the pelvic floor and reduce the pain associated with vaginismus. Additionally, a therapist can provide guidance on how to properly perform the exercises and help to create a treatment plan that is tailored to the individual’s needs.

  • Can vaginismus be cured?

Yes, vaginismus can be cured with the help of physical therapy, counseling, and other treatments like cognitive-behavioral therapy, pelvic floor muscle exercises, relaxation techniques, and dilator therapy.

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