Vaginismus

Vaginismus (also known as vaginal penetration disorder) is the difficulty of performing intercourse, due to the contraction involuntary of the muscles of the lower third of the vaginal. It is an uncommon condition and women who suffer from vaginismus can enjoy sexual play and achieve orgasm since this dysfunction is not related to sexual response.

Most of the causes of vaginismus are psychic. Lack of sexual information or lack of communication, leading to fear or fear; traumatic experiences, fear of pregnancy, fear of contracting sexually transmitted diseases, painful experiences in visiting the gynecologist, sexual abuse, etc.

The primary muscle group involved is the pubococcygeus, or the PC muscle group. Vaginal spasms interfere with sexual intercourse leading to a broad range of psychological fear induced resistances that perpetuate the issue further.

Types of vaginismus

Primary Vaginismus: Occurs when a woman has never been able to have sex or achieve any type of penetration. It is commonly found in teenagers and women in their twenties, because it is when the woman tries to use tampons, have sex or when she goes to the doctor to have a Pap test . A woman can have vaginismus and not realize that she has it until the moment she tries to have a sexual intercourse with vaginal penetration. You may probably think that penetration should be naturally simple or you may ignore it because of your condition, or it may be due to other causes such as sex aversion.

Secondary vaginismus: Occurs when a woman who has previously been able to achieve vaginal penetration normally suddenly feels unable to do so. This may be physical causes vaginal -Infections, trauma during childbirth , sequelae after gynecological surgery, etc.- or psychological causes. The treatment for this type is the same as for the primary, however, in these cases, the fact that previously it was possible to achieve a penetration satisfactorily is a factor that predisposes to the condition can be solved more quickly.

Treatment

There are a variety of factors that may contribute to the development of vaginismus. These can be physical, psychological or both, and the treatment required depends on the reason for the onset of this disease. As each case is different, it is desirable that the therapy be individual.

This condition does not necessarily worsen due to lack of treatment, unless the woman continues to attempt penetration despite pain.

Some women prefer to abstain from sex before seeking treatment to resolve the problem.

Although few controlled trials have been conducted, many scientific studies prove the efficacy of treatment for vaginismus. In all cases where systematic desensitization, also known as dilatation, has been used, the success rate is estimated to be between 90-95% and even 100%.

It is recommended that vaginismus be treated both physically and emotionally, since it is a physiological-psychological condition.

According to Ward and Ogden’s qualitative studies on vaginismus (1994), the four main causes are:

• Fear of pain during intercourse;
• Strict and religious education where sex was shown to be bad or not discussed;
• Traumatic experiences in childhood (not necessarily of a sexual nature).
• Involuntary contraction of the plitude in stressful situations.

Vaginal cramp, also known as vaginismus are involuntary muscle contractions in the muscles surrounding the outer third of the vagina (vaginal). Muscle contractions means that it is difficult or impossible to introduce something into the vagina when the woman is awake. Sexually causes vaginismus, the woman is not, or only with great discomfort, can have intercourse. Usually, she can not introduce a tampon or complete a gynecological examination.

The condition has usually been lifelong or primary , that is, since the woman first attempted intercourse. Rarer are the so-called secondary vaginismus, which was acquired later in life. The woman may describe painful intercourse, but the fear of getting something introduced, more than the actual pain can be the deciding factor, which induces muscle contractions and thereby prevent intercourse.

In most cases, the woman may not even notice if she buckles, or is relaxed muscles around the vagina. Often there is a phobic fantasy combined with vaginism. The woman can imagine vagina really is too small to accommodate a penis or vagina are harmed by intercourse. Many women with vaginismus have no problems with sexual desire, arousal or orgasm, and can have long-term stable relationship.

Frequency

Vaginismus is a relatively rare disorder. In a new South African population study of 2,295 women aged between 16 and 95 years found that ½% of women had this always or almost always, and saw it as a problem. A total of 4% could describe vaginismus rarely or frequently. Pain during intercourse (dyspareunia) without the case of vaginismus, is more frequent, 3% of women had pain always or almost always, and saw it as a problem. A total of 25% could describe the pain rarely or frequently.

Causes of vaginal spasm

Psychological causes can be

• A perception that sexuality is sinful or foul.
• Fear of pregnancy and childbirth.
• Lack of knowledge about the anatomical structure of own genitals.
• Aversion to the man’s penis, semen or men in general.
• Erotic feelings toward other women.
• Not quite rare woman has been exposed to unpleasant sexual experiences. These may be actual sexual assault, or experience of a violent partner at the first attempts at intercourse, which she was not prepared for the experiment, and therefore the intercourse was painful.
• Some also had unpleasant experiences at first gynecological examination. She did not feel that she has been sufficiently informed about what was going to happen. She may have seen the study as an assault, which has been both mentally and physically painful.

Physical reasons can be:

• Shearing after a birth, or painful, for example, infection with herpes can be the operative painful condition by secondary vaginismus.

Investigation of vaginal spasm

Any complaint persistent pain associated with penetration of the vagina, requires a physical examination. The doctor can here exclude other causes than vaginismus. There could be no inflammation of the vulva or vagina.

If the pain is deep in the vagina, there may be something wrong with the cervix, uterus or ovaries. If there is a suspicion that something is wrong, and the doctor can not come to examine the vagina due. Vaginal spasm, it may be necessary to stun the woman to do the examination. When the woman is stunned’s muscles relaxed.

Treatment of vaginal spasms

Treatment consists of conversations with the woman or couple, if she is in a relationship, and instruction in home exercises.

• The woman instructed in self-examination of his genitals. Often she knows surprisingly little about his own anatomical structure.
• Although studies supplements she gradually with dilation (widening of the vagina). There are plastic rods of different sizes, gradually increase the stake size. Many women, however, prefer to use their own hands and start with one finger and then increase the number of fingers that she may have received in the vagina.
• It is necessary to use lube if the woman is not sufficiently wet, as will often be the case. The anxiety women with vaginismus have to get something into the vagina, inhibits lubrikationen – the moisture in the vagina.
• The woman instructed further in doing Kegel exercises while she tries dilatation. As she relaxes better of the pelvic floor, when she hitched up taking it easy sometimes. It also gives her a greater awareness of the pelvic floor muscles, so she gradually becomes better to feel when she buckles.
• Dilatationsbehandlingen she doing alone, complemented with the partner may be allowed to dilate with his fingers or plastic rods while they are doing joint exercises. You try first with the penis in the vagina when she is sufficiently dilated.
• Actually it is wrong to talk about dilitation, the vagina is large enough. Rather, it is that the woman gets used to having something of a certain size in the vagina.
• Alongside the exercises will be at the talks to try to unravel the psychological conditions that have caused the problem arose. Often the woman through this achieve a greater ability to generally take things more relaxed and have more self-confidence and self-esteem.
• Working with a specialist knowledgeable physiotherapist or relaxation therapist can be considered.

The course lasts for several weeks or months. The treatment is demanding, both temporally and psychologically, but unfortunately there are no easy detours.

“Helpful” doctors have tried so-called widen, or dilation under anesthesia, but it helps nothing, for there are as mentioned enough in the vagina if the woman dare relax. When she wakes up from the anesthesia tightens her muscles again.

Doctors have also tried to operate the vaginal opening larger, but it helps, of course not.

What can you do about vaginal spasm?

• Talk to your doctor about the problem. The woman should be examined to rule out other causes of discomfort than vaginal spasm.
• Reading self-help dealing with the problem (Vaginismus. When the body says no. By Else Skytte Christensen. Publisher: Body, Mind and Health, 2013).
• Talk with your partner about the problem, the situation deteriorates easily if there is not talked about it. Maybe partner observed something you do not even have discovered. Go possible. along to the family doctor for help.
• Try to vary your sex life, then you are not focused on intercourse.
• Working with dilatationsøvelser, such as are described above.