Vaginismus is a condition involving involuntary muscle spasms in the pelvic floor that surround the vagina, causing discomfort or pain during sexual intercourse or tampon insertion. Symptoms include: intense vaginal spasm when penetration is attempted, difficulty with penetration, feelings of faintness, and intense fear or anxiety about sexual activity.
Causes can be multifaceted, including psychological factors such as trauma, anxiety or relationship issues, as well as physical factors like infections or skin conditions.
Treatment options are:
1. Therapy: Counseling with a therapist experienced in sexual health can help address anxiety or relationship issues contributing to vaginismus.
2. Education: Providing information about sexual health can help alleviate fears about sex.
3. Kegel exercises: Strengthening pelvic floor muscles can improve control and reduce spasms.
4. Gradual desensitization: Using dilators can help stretch the vagina gently and reduce spasming.
5. Medications: Some cases may benefit from pharmaceutical treatment including antidepressants, muscle relaxants, or topical estrogen.
6. Communication: Open dialogue with partners about the condition and progress is imperative.
7. Support groups: Joining communities for shared experiences and advice can be beneficial.
Maintaining patience and consistent efforts are key for successful management and overcoming vaginismus. Consulting a healthcare professional with a specialist in female pelvic medicine and reconstructive surgery or a gynecologist can provide personalized treatment plans.
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What is
We speak of vaginismus when we are faced with a situation in which, despite the woman’s will, there is persistent difficulty in introducing vaginal a finger, an intimate tampon or allow penetration of the penis. It is present with a prevalence ranging from about 0.5 to 6 percent of the female population, represents the leading female cause of unconsummated marriages and is found in 5-7% of infertile couples.
Vaginismus is a difficulty that undermines femininity in a major way: women who suffer from it often report not feeling like women, feeling inadequate, depressed, and anxious. The difficulty in fully enjoying the sexual experience over time can lead the woman who is not already in a couple to pull away and avoid the relationship precisely in an attempt to avoid the discomfort, frustration and shame associated with the inability to experience penetrative sexuality.
Symptoms
Very often women come to consultation with a diagnosis that they have already made for themselves or otherwise suspect since they cannot have penetrative intercourse, some times they cannot even get a finger or an internal tampon to penetrate for intimate protection; this situation can create considerable discomfort and sense of inadequacy.
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Penetration phobia is an important element, often related to negative and catastrophic thoughts with respect to the penetrative experience. These thoughts activate a attitude of supercontrol over what happens during penetration or attempted penetration so physical sensations are amplified. Associated with this may be the actually painful experience related to the contracture of the pelvic floor muscles, that is, of those muscles that support and regulate the opening of the vagina, anus and bladder-urethra. When the muscles are tight, closed, the vagina although elastic and stretchable, cannot accommodate anything inside because there is no room to stretch. Phobia can have varying degrees of intensity and in the most severe forms can be associated with a neurovegetative response with hyperventilation, tachycardia, sweating, and tremors. The difficulty occurs not only during sexual intercourse but also for example during a gynecological examination which is therefore also an important time for diagnostic confirmation.
Causes
The underlying causes of vaginismus can be many and involve Social, educational, psychological and cultural aspects And it is difficult to single out just one factor. Much more often we are faced with a combination of different aspects that have laid the foundation for vaginismus and maintain it over time. Precisely because the etiology of vaginismus is multifactorial, the treatment must be as well, i.e., one must take care of all aspects, the psychological, educational, sexual and rehabilitative.
Care
The first thing is have a correct diagnosis in order to distinguish vaginismus from other causes of penetrative pain and also to rule out the possibility that the inability to penetrate is related to, for example, an abnormality in the shape or consistency of the hymen, this is to avoid doing exclusively psychological work in the presence of an anatomical obstacle instead.
Precisely because of the particularity of the symptoms, women often present for help having already a clear idea of their difficulties and can refer them to a psychotherapist to a sexologist or gynecologist. The best way to arrive at an accurate diagnosis from which to start targeted treatment is a integrated approach in both diagnostic and therapeutic phases.
In the initial stages of therapy, a course of sex education during which anatomical and functional information about the sexual apparatus is provided; this is because very often women with vaginismus do not know their own bodies and mindfulness is naturally a good ally in overcoming phobia and erasing negative thoughts about penetration. The goal is to replace any dysfunctional thoughts about sex and penetration, experience the possibility of penetration by going through the use of the finger, internal pads, and dilators to the penis. We refer to this process as desensitization through progressive exposure to the situation that triggers the phobia itself.
In parallel, work is done on aspects of the woman’s internal life and on relational aspects. This course is also often associated with pelvic floor reeducation to facilitate body awareness and reduce when present the associated muscle difficulty. Vaginismus has an excellent prognosis, especially when addressed with a integrated approach, with a group of professionals working as a team each of whom can collaborate in the treatment process by bringing their professionalism to bear on the therapeutic project.
