Vaginismus can be treated totally today. Moreover, the treatment takes only a few days not months or years as it used to be.
Vagina is the female sexual organ.
Vaginismus is when vaginal muscles (especially Pubococcocygeus (PC) muscles) contract involuntarily causing spasms in the vaginal area during intercourse, which prevents sexual penetration or makes it too difficult.
You’re not alone!
Vaginismus is a common sexual problem world-wide known to gynaecologists and mental health specialists. In our country, every 2 out of 10 women experience problems regarding sexual intercourse with their partners.
How do involuntary spasms occur?
Vaginismus patients do not only have spasms around the entrance of the vagina but also in other muscles of the body such as the ones in the abdomen, back, waist and legs. Thus, these people may experience strong muscle pain the following day of the intercourse. The wider the range of muscle pain, the stronger the condition of vaginismus.
In some patients, spasms occur only in the vagina not on other parts of the body and this makes sexual intercourse impossible. Moreover, these spasms, usually, are not noticed by the patient herself but her partner. Partners encountering such spasms, see these as “a wall blocking the entrance into the vagina”.
One specific feature of these spasms both around the body and the vagina is that these occur totally involuntarily. These spasms all around the body in addition to the vagina can create fear and anxiety much like a “panic attack”. Eventually, the woman refuses to have an intercourse, closes her legs tight, pushes her partner away and ends the intercourse.
Symptoms of Vaginismus
Many vaginismus patients are still virgins although they have been married for months and even years. Most of the time during intercourse it feels like there is going to be pain instead of feeling the pain in real.
When it’s time for penetration during intercourse, people feel like there is going to be a tear, they’ll hurt a lot, there is going to be massive bleeding even they feel like they will die, and, with such instincts they contract in reflex.
Vaginismus isn’t revealed only through spasms during sexual intercourse or not being able to have intercourse at all. There are other common symptoms.
Actually, all procedures on the vagina are felt as repulsive and unamiable.
- Having painful and hurtful sexual intercourse (disparonia). Although it is possible to have intercourse despite involuntary vaginal muscular spasms, it may hurt and be painful. One very important aim of sexual intercourse is to have pleasure and having sex entails satisfaction for both the male and the female. Pain during intercourse might be due to other genital reasons not just vaginismus; thus, proper diagnosis is required initially and then a suitable treatment should be started.
- Not being able to have gynaecological examination. While the gynaecological examination chair might feel repulsive to many women, contractions during examination can also be symptoms of vaginismus.
- Not being able to use vaginal tampons.
- Not being able to use vaginal suppositories.
- Not being able to put a finger into the vagina; not being able to look at the genital area using a mirror.
All of these can be symptoms of vaginismus.
In other words, vaginal penetration is impossible for people with vaginismus and all types of penetration trial is seriously inconvenient or impossible.
Why can’t people with vaginismus have sexual intercourse; hence, penetration?
The common response people show against sudden fear is to contract their muscles due to protective instincts. Women with vaginismus, which is a sexual phobia, get contractions involuntarily during sexual intercourse.
Negative messages in the subconscious from the past of a person related to sexual intercourse can lead to muscle involuntary contractions in different parts of the body in addition to vaginal muscles in women with vaginismus.
Normally, when faced with a sudden fear, our body contracting its muscles is to protect itself from the outside effect, however, in sexual intercourse this works the other way around. That is, a woman with the expectation of pain contracts her muscles and this makes it harder for the penis to penetrate into the vagina; thus, causing pain unnecessarily.
Moreover, every painful try strengthens the above mentioned memory. When that happens, no matter how genuine the woman feels that she wants to have sexual intercourse with her partner, every trial feels like having hit on the a wall for men and having lost control entirely over her body for the women.
In advanced vaginismus cases, the woman doesn’t allow her partner to get close; by pushing him away she closes her legs and prevents intercourse while crying. Because of that, the patient cannot even go as far as to feel pain during intercourse.
About the vagina
Vagina (sometimes referred to as sheath) is an organ just like other bodily organs which have their specific functions and it is a passage reaching to the uterus.
In medicine it is called vagina, the genital canal and sheath.
PC muscles which work voluntarily (it’s movements can be controlled) play a key role in the reproduction and the urinary systems.
The vagina has four major roles for women: 1- It is the genital canal where sexual intercourse (penetration) takes place, 2- birth takes place through the vagina, 3- it is the canal for menstrual blood flow, 4- it is the canal in which urethra is placed (urinary tube).
* Vaginismus treatments aim at controlling the reaction of these muscles during intercourse and restructure the memory related to these muscles properly.
Causes of Vaginismus
90% of the causes of vaginismus are related to psychological factors, and, 10% are related to organic (structural) reasons.
Organic (structural) reasons frequently include high and thick sides of the hymen, other anomalies regarding the hymen (a septate or cribriform hymen), vaginal septum, bartholin abscess, vulvar vestibulitis syndrome, PID (pelvic inflammatory disorders) and vaginitis.
Because of all these mentioned above, it is important that a gynaecological examination be done before starting with the right treatment.
In most cases, vaginismus is a sub-conscious related condition!
Yes…! Usually, the reasons behind vaginismus lies within past, bad sexual experiences or over exaggerated fear in the subconscious.
Psychological factors affecting vaginismus:
- Messages and fears from childhood related to keeping the hymen intact (virginity)
- Too much internal/domestic discipline, over protective family structure
- Sexual trauma (abuse, rape, incest, physical abuse, repulsion from watching pornographic movies, seeing parents having sexual intercourse etc.)
- Fear from pregnancy (abortion or birth is like a nightmare for such women)
- Living in an over conservative society with strict moral values and taboos
- Seeing sexuality as a guilt, sin and immoral activity; conservative/traditional family structure
- Authoritarian/oppressive behaviour of one of the parents
- Wrong, over exaggerated and lacking knowledge about the first night (intercourse) (images of an first experience that is painful, hurtful and very bloody)
- Fear of shutting down bodily functions during intercourse and losing face
- Fear of the vagina being too narrow and small for the penis to penetrate.
Women who have been taught since childhood that the hymen is much valuable like a jewel they have to protect and those who have encountered obsessive reactions and behaviour regarding this topic are at risk of vaginismus.
Besides, negative experiences and memories during childhood (abuse or rape, domestic violence, strict parenting) can lead to vaginismus.
It can also develop in women who have never had the problem due to negative experiences such as birth, miscarriage, abortion or an exhaustive and rough gynaecological examination.
And sometimes lack of knowledge of both partners, misinformation and prejudice about the first night and first intercourse may cause fear and panic which in turn may lead to vaginismus.
Then again, such problems might re-occur in patients who have undergone treatment.
As stated earlier, most of the time, deep down in the subconscious, there lie fears and anxiety of sexuality and sexual intercourse and the contractions of the PC muscle works like a defence mechanism for the woman who feels this way.
In order to overcome such unnecessary fears both male and female partners should be comforted, relaxed and psychological counselling should be provided to create a spiritual atmosphere to help them overcome their anxiety and fear.
In some women, vaginismus can occur due to an unknown reason where none of the above causes are valid.
However, it is not a must to find the reasons for vaginismus. The important part is to manage to “restore muscle memory”.
Who are under the risk of vaginismus?
The risk group consists of especially young girls who are childish, addicted to their families and those who haven’t completed their mental development properly. Within this group, specifically, those who have a higher socio-economic status are more likely to have the condition.
It is easier for those who have had childhood fears to experience the condition. The most noticeable fear among women is the fear of having pain or a tear in the genital area due to a large penis which has been over exaggerated symbolically in their mind. Such misbelief is called “sex myths”. These types of wrong and exaggerated beliefs create the base for vaginismus in the future in the subconscious.
The good girl syndrome: Young girls, who have been raised with a total lack of sexual knowledge, whose family has shown sexuality as bad and told her that the hymen was a very important genital area to be protected, are prone to experiencing vaginismus, lack of sexual drive, sexual repulsiveness and not being able to have orgasm (unorgasmic) in their future life.
This issue seen in young girls who have been raised in traditional families and a conservative cultural society is called “the good girl syndrome” and it is very common in the Turkish society.
Women with “the good girl syndrome” see sexual intercourse as a duty and it is for their partners only; thus, it is seen as a duty to please the husband rather than an activity to have pleasure as well. Besides such women are highly strict and meticulous in their private life; workaholics who have a perfectionist character.
Family structure; children who have an oppressive and strict father, a submissive mother are also under the risk of having vaginismus in the future.
Additionally, fear of getting pregnant, over conservative view of the society and strict religious ideas to be followed are other risk factors.
Do anatomical shapes of genital organs cause vaginismus?
Prejudice and irrelevant taboos can cause vaginismus. Vaginismus is not related to the anatomical shape and structure of the genital organs.
Actually, there is hardly an occasion in which the statement “My vagina is too small (too narrow or tight), so I cannot have sexual intercourse.” is true since the vagina is very flexible and during labour a baby that is 3500-4000 grams and 50-52 cm in length with a head of about 10 cm in diameter is born by passing comfortably through this flexible canal. However, it is quite natural that such women can feel this way although they do not have any physical/structural anomalies.
First, a gynaecological visual evaluation is necessary!…
Yes. Not only vaginismus but also other reasons such as vulvar vestibulitis, high and thick sides of the hymen, PID and vaginitis (vaginal inflammations) may prevent sexual intercourse or may cause painful intercourse.
Thus, before starting a vaginismus treatment, it is important that a gynaecological examination be done to come up with a correct diagnosis. This would be best way to decide on the proper treatment.
What are the types of vaginismus?
Primary Vaginismus:
There has never been a vaginal penetration.
Secondary Vaginismus:
Although there had been a healthy sex life previously, after a sexual or genital trauma (a problematic birth, miscarriage, abortion or an exhaustive and rough gynaecological examination, abuse or rape etc.), vaginismus may prevail.
Apareunia:
Not being able to have sex (penetration) due to some physical reasons. Vaginismus is a type of apareunia.
Dyspareunia:
Having a painful, stingy, burning or irritation feeling during sexual intercourse. Sometimes dyspareunia can be the reason behind secondary vaginismus.
If you feel pain, stinginess, burn or irritation during sexual intercourse (penetration), the reason doesn’t have to be vaginismus. Dyspareunia can be treated 100%.
Vulvar Vestibulitis Syndrome: Also known as “vulvar vestibulitis” or “vulvodynia”, VVS is syndrome related to vaginismus, dyspareunia, being unorgasmic (not being able to have orgasm) and lack of sexual desire due to over sensibility on the lower part of the hymen.
In VVS diagnosis can be reached easily upon the statement of the patient (painful intercourse or no intercourse at all), via a gynaecological examination by evaluating the sensibility of the area by touch and observing a rash. The exact cause is unknown.
The treatment of VVS involves a simple surgical operation by which the area (vestibulum) is excised (removed); thus, the issue can be solved permanently.
What is the difference between vaginismus and sexual frigidity?
In sexual frigidity the ideas of amorality, filth and sin play an important role in that the problem arises due to not having pleasure of sexual intercourse. However, in vaginismus there is no hesitation about having sex, but, the feeling of getting hurt during intercourse is in the forefront.
A woman with the diagnosis of vaginismus can have sexual desire and vaginal wetness, however, although it is desired, intercourse cannot take place.
Many vaginismus patients have never had a sexual relationship that is they are still virgins. Moreover, although some women have had successful sexual relationships before, later on it is possible that they might not be able to have any sexual intercourse.
