Vaginismus: Types, Causes, Symptoms, and Treatment

Introduction

Have you ever felt a sudden tightening or contraction in your vagina during sexual activity or when inserting a tampon? If yes, you might be facing a condition known as vaginismus. This involuntary tensing of the vaginal muscles can cause discomfort and pain during sex, tampon use, or pelvic exams. But, what exactly is vaginismus? How common is it? And, most importantly, what are the effective treatment options available?

In this comprehensive guide on vaginismus, vaginismus treatment, vaginismus symptoms and vaginismus causes, we aim to answer these questions and more. We will also discuss various types of vaginismus and share helpful self-care exercises to help you in managing this condition.

What is Vaginismus?

Vaginismus is a medical condition where the vaginal muscles tighten whenever something tries to penetrate it, like a tampon or during sexual intercourse. This might range from a mild discomfort to an intense pain. This condition can be divided in two types: primary and secondary vaginismus. It involves involuntary muscle spasming around the vagina when penetration is attempted, by a penis, finger, tampon or even a medical instrument during an examination.

Primary Vaginismus

Also known as lifelong vaginismus, this type occurs when a woman experiences pain whenever there is an attempt to penetrate the vagina or if she has never been able to insert anything into her vagina.

Secondary Vaginismus

Secondary or acquired vaginismus occurs when a woman who had previously experienced painless penetrative sex suddenly finds it difficult or impossible due to discomfort or pain.

How Common Is Vaginismus?

It's hard to determine the exact prevalence of vaginismus as many individuals may feel uncomfortable discussing it with their healthcare providers. Therefore, the condition may remain underreported globally. The condition remains under-researched due to existing stigmas around female sexuality and health. However, studies have also suggested that it affects roughly 1% to 7% of females worldwide. The prevalence might actually be higher, given that many women may hesitate to report their difficulties due to societal norms or their own embarrassment.

Who Might Get Vaginismus?

Any woman can experience vaginismus symptoms during her late teen years or an early adulthood when engaging in sexual activities for the first time. However, some women may develop vaginismus later in life, even after years of having pain-free sex. Spasms or discomfort can happen at any point during vaginal penetration. Vaginismus can affect women of all ages and is often associated with anxiety or fear related to sex. Women who have had infections, those undergoing menopause, or having certain medical conditions might also experience it.

What Causes Vaginismus?

The exact cause of vaginismus remains unknown, but several factors are thought to contribute to its development, including:

• Anxiety disorders
• Injuries from childbirth, such as vaginal tears
• Previous surgeries on or near the vagina
• Fear or negative emotions related to sex stemming from past sexual abuse or trauma

Interestingly, the exact causes of vaginismus are still unknown. It's usually linked with fear or anxiety around sex, it's not always clear which comes first: the vaginismus or anxiety. Some women may experience vaginismus in every situation and with any object, while others may only encounter it in certain circumstances.

What Conditions Are Similar to Vaginismus?

Symptoms similar to those of vaginismus can also be caused by conditions such as:

• Vaginal Atrophy: This occurs due to decreased estrogen levels after menopause, leading to a thinner and drier vaginal lining.
• Vulvar Vestibulitis (Provoked Vestibulodynia): This condition results in painful intercourse (dyspareunia), with pain varying from initial penetration throughout the entire experience.

Dyspareunia (pain during sexual intercourse) and genito-pelvic pain/penetration disorder (GPPPD) are two conditions similar to vaginismus. However, it is essential to clarify that each condition has its unique features and requires a specific diagnosis and treatment plan.

What Are the Symptoms Of Vaginismus?

Some common symptoms include:

1. Dyspareunia (painful intercourse)
2. Difficulty inserting anything into the vagina
3. Long-term sexual pain
4. Pain during tampon insertion
5. Discomfort during gynaecological examination

These symptoms vary from person to person and range from mild discomfort to severe pain during attempts at vaginal penetration. If you have painful sex or discomfort while inserting a tampon, it's essential to consult a doctor as these feelings aren't normal.

How Is Vaginismus Diagnosed?

For diagnosing vaginismus healthcare provider will review your medical and sexual history and conduct a pelvic exam to rule out other potential causes of your symptoms. A topical numbing cream may be applied to make the process more comfortable. Your healthcare provider will also discuss symptoms and medical history as part of the diagnosis, and the pelvic exam may also be conducted to rule out other health conditions that could cause pain.

How is Vaginismus Treated?

Vaginismus treatment usually involves exercises at home to learn how to control and relax the muscles around the vagina. This approach is known as a progressive desensitisation. Kegel exercises are often advised, and for some women undergoing a therapy may also provide support, particularly if vaginismus is linked to fear or anxiety.

Luckily, various treatment methods address both physical and psychological aspects of vaginismus. Your healthcare provider may recommend one or more of the following treatments:

1. Topical Therapy: Topical lidocaine or specially compounded creams may alleviate pain associated with vaginismus.
2. Pelvic Floor Physical Therapy: A physical therapist will guide you in learning how to relax your pelvic floor muscles.
3. Vaginal Dilator Therapy: Vaginal dilators are used to gently stretch the vagina and help it adjust to penetration.
4. Cognitive Behavioural Therapy (CBT): CBT focuses on understanding how your thoughts impact your emotions and behaviours, making it effective for addressing anxiety, depression, and PTSD.
5. Sex Therapy: Trained sex therapists assist individuals and couples in rediscovering pleasure in their sexual relationships.

What Are the Complications of Vaginismus?

Without treatment, vaginismus can cause emotional distress, relationship problems, and problems with self-esteem issues. However, with an effective treatment and support from healthcare providers, these complications can be mitigated. Vaginismus can impact your sexual life, causing stress in relationships, and affect your mental health if not addressed. It can also make it harder to conceive if you're trying to get pregnant.

How Can I Prevent Vaginismus?

Preventing vaginismus mainly involves managing risk factors such as anxiety or stress related to sex and addressing any underlying medical conditions that may cause pain during penetration. Additionally, regular pelvic floor exercises can help maintain healthy muscle tone.

What is Outlook for People with Vaginismus?

With the right treatment plan and support, women with vaginismus can regain control over their bodies and enjoy a healthy sex life. Therapy often plays a crucial role in this process.

When to See a doctor?

If you experience recurring pain during sex or find it impossible to have penetrative sex due to discomfort or pain, it's advisable to consult a healthcare provider. Early diagnosis can lead to more effective treatment.

Conclusion

Vaginismus which can be challenging and uncomfortable, is treatable with a proper care. Understanding your body better helps you make informed health choices. Metropolis Healthcare offers an extensive diagnostic services providing valuable insights into your health. Their team of skilled technicians ensures a safe at-home blood sample collection service for analysis at advanced diagnostic labs. Additionally, Metropolis Healthcare is committed to deliver reliable results, helping you prioritise your health.

Don’t let vaginismus go untreated; reach out for professional guidance today.