Vaginismus: Types, Causes, Symptoms, Diagnosis And Treatments

Vaginismus is defined as a condition in which the vaginal muscles or pelvic floor muscles spasm involuntarily causing distress and interpersonal difficulties. The recurrent and persistent spasm occurs with no abnormalities in the genitals.

Several factors are responsible for vaginismus but the primary cause is sexual intercourse. The condition can cause pain in the vagina and relationship problems along with difficulties in pelvic and gynaecological examinations. Take a look at the details.

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What Happens in Vaginismus?

Vaginismus usually starts during teenage or early twenties when a girl starts to use tampons or have sexual intercourse for the first time. However, it can also start later in life. [1]

In vaginismus, even if a person develops sexual desire, their vaginal muscles tighten involuntarily out of fear, distress or other psychological conditions or physical problems. The condition is often ignored by females or they find it embarrassing to discuss or openly talk about it with a medical expert or any of the family members for possible treatments.

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Types Of Vaginismus

1. Primary vaginismus (PV): In this type, the pain has always been present but is experienced during the first intercourse, first-time use of tampons or any pelvic area examination. In PV, a person may never be able to experience sexual pleasure until the condition is treated.

2. Secondary vaginismus: It occurs at a later stage of life due to medications, menopause, childbirth, trauma or surgery.

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Causes Of Vaginismus

The cause of vaginismus can be psychological or physical or both. The limbic system of the brain starts an internal alarm and alerts the body of potential pain. This causes the vagina to tighten automatically to protect itself from any kind of harm.

As a result, the body remembers this experience and causes the vagina to tighten every time a person feels the below-mentioned psychological factors. [2]

The psychological cause is often related to:

• Any trauma of past events like rape or history of abuse.
• Anxiety of sexual performance.
• Previous relationship problems, having an abusive partner, fear of commitment or distrust.
• Negative perspective towards sex due to rigid parenting or inadequate sex education.
• Fear of the pain related to sex.
• Early exposure to sex or sexual images.
• Bad marriage experience.
• Anxiety about being vulnerable or losing control.

Physical causes include:

• Pelvic surgery
• Urinary tract infection
• Insufficient lubrication
• Childbirth
• Age-related changes
• Side effects of certain medications.

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Symptoms Of Vaginismus

• Dyspareunia, painful intercourse. [3]
• Pain during insertion of tampons.
• Pain during any kind of gynaecological or pelvic examination.
• Severe spasmodic introital pain (pain in the opening of the vagina when the partner attempts for sex).
• Uncontrollable vaginal constriction making the penis insertion difficult or impossible.
• Decrease in sexual desire due to guilt.
• Burning or stinging sensation in the vagina.
• Shift of interest from penetrative sex to non-penetrative sexual activities.
• Temporary halt of breathing when the partner attempts sex.

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Complications Of Vaginismus

The complications of vaginismus are mainly responsible for the inability to have a relationship or start a family.

Diagnosis Of Vaginismus

Diagnosis mainly includes a discussion with a medical expert about the first occurrence of the problem, any history of abuse, surgery in the past, medications and other relevant details. As people with vaginismus often get fearful or nervous about the gynaecological examination, discussion related to comfortable possible ways are also included.

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Treatment Of Vaginismus

• Hymenectomy: Surgical opening created in the hymen responsible for blocking the vagina and causing problems during sexual intercourse.
• Sex therapy: It includes psychiatric discussion followed by sessions based on Keith Hawton. This includes the participation of the couple in educative sessions related to vaginismus and its treatment, exercises to be carried out, explanation of the reproductive anatomy and sexual act, Kegel's exercise and the usage of lubricants. [1]
• Vaginal dilators: Helps to stretch the vaginal muscles and make them flexible, to be done under expert supervision.
• Relaxation techniques: Such as a massage or breathing exercises. [4]

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Common FAQs

1. What causes Vaginismus? Is it caused by sexual abuse?

The exact cause of vaginismus is still unknown. However, several factors contribute to the condition such as sexual abuse (especially during childhood), fear of sex, inadequate knowledge about sex, strict parenting, surgery or ageing.

2. Is there a permanent cure for vaginismus?

Vaginismus is permanently treated when the underlying illness responsible for the conditions are treated. The main cause is psychological triggers such as anxiety, depression, performance fear or past trauma. When they are handled with proper psychiatric consultation, the chances of decrease in vaginismus symptoms are more.