Vaginismus is a sexual dysfunction that affects 3 to 17 percent of women. One of the non-obvious causes of pain may be a latex allergy, says the drug. med. Tomasz Basta.
Vaginismus is a sexual dysfunction that makes it difficult or impossible not only to have vaginal intercourse, but even basic gynecological examinations, such as cytology. This is because some of the muscles in your vagina involuntarily contract when you try to penetrate, and continuing to approach or test causes discomfort and pain.
According to some studies, this dysfunction affects from 3 to 17 percent. women, however, it is extremely difficult to estimate the scale of the problem. This is for a number of reasons. First of all, patients are ashamed of their symptoms and do not tell their doctors about them. Second, vaginismus is easily confused with other disorders such as dyspareunia, vulvodynia, and vestibulodynia.
Not only vaginismus
The symptoms of dyspareunia, or soreness during intercourse, can resemble vaginismus. The main difference is that women suffering from dyspareunia can have intercourse (there is no muscle contraction), and pain occurs not only before intercourse, but also during and after it. This ailment often occurs in menopausal women, when mucosal atrophy occurs as a result of the decline in sex hormones. Often, the use of moisturizers (e.g. based on hyaluronic acid) solves the problem.
Vaginismus is much more difficult to distinguish from vulvodynia, which is chronic pain, burning or stinging felt in the intimate area that is not caused by infection but most likely by damage or inflammation of the nerves. One of the varieties of vulvodynia is vestibulodynia, i.e. the syndrome of vaginitis. Its symptoms may resemble vaginismus so much that only an experienced doctor, based on an in-depth conversation with the patient and after performing tests (e.g. Q-tip test or observation of characteristic redness), can make a correct diagnosis.
A key conversation
During the first visit, the gynecologist conducts a detailed interview to determine the causes of vaginismus, which manifests itself in such a strong muscle contraction that penetration is impossible (in extreme cases, the contraction occurs just at the thought of sexual intercourse). The causes of this disease are divided into primary, i.e. those that appeared before sexual intercourse, and secondary, that occurred in a sexually active woman.
– During the conversation with the patient, it should also be determined whether we are dealing with organic or psychogenic causes – adds the drug. med. Tomasz Basta from the Krakow Intima Clinic. – This is very important as vaginismus is usually a psychosomatic disorder.
In the case of primary vaginismus, psychogenic causes may be the fear of having sex or becoming pregnant, religious rigorism, hidden homosexual tendencies or trauma, e.g. related to sexual abuse. Organic causes include malformations of the reproductive organs, e.g. congenital atresia of the reproductive organs, the presence of partitions in the vagina or uterus, or congenital absence of the vagina.
The causes of secondary vaginismus include: endometriosis, mucosal atrophy (e.g. associated with manopause), vaginitis and abrasions.
One of the non-obvious causes of pain may be a latex allergy, says the drug. med. Tomasz Basta. – A woman often does not even know that she is allergic. Irritation, redness and pain appear after each intercourse. The ailments may become permanent and become vaginismus.
Due to the severity of the symptoms, there are also four stages of vaginismus: from light (intercourse is possible, but intercourse is painful), through moderate (intercourse is impossible, but a medical examination is possible) to advanced (medical examinations are performed under anesthesia).
Treatment plan
Treatment of vaginismus requires close cooperation between the patient and the gynecologist. If the dysfunction is caused by psychogenic factors, it is also necessary to consult a sexologist.
– I start the therapeutic process with a conversation during which I determine the cause of vaginismus – explains the drug. med. Tomasz Basta. – If psychogenic causes predominate, the patient must additionally consult a sexologist. However, if there are organic causes that can be removed, for example during surgery, there is no need to do so. My proprietary treatment method, which includes sexual education, an exceptionally gentle way of carrying out gynecological examinations and a gradual understanding of the patient’s own body, gives very good treatment results, which appear in my patients after only four sessions – the doctor assures.
Recognizing the patient’s own body may include: viewing her intimate organs in a mirror, gentle massage, and accustoming the vagina to penetration using vaginal dilators (they have many sizes, the goal of therapy is to gradually increase their diameter, and eventually introduce a dilator into the vagina that resembles penis). The PelviFly device can help you perform the exercises recommended by a specialist. It teaches you to squeeze and relax the vaginal muscles in a controlled way through an application.
Pharmacological treatment for vaginismus includes the use of local anesthetics and relaxants or hyaluronic acid creams, botulinum toxin injections, topical hormone therapy, and the use of anti-anxiety medications.
After the treatment is completed, it is worth doing exercises that will strengthen the pelvic floor muscles (e.g. stopping the urine stream for about 3 seconds) and will allow you to better understand your sexual needs and your partner’s (joint massages, using a vibrator).
The important role of a partner
Although sexual intercourse is inadvisable during the therapy, the partner should support the patient, e.g. helping her accept and get to know her body gradually. Talking honestly about your fears, needs, and fantasies can also help a woman accept her sexuality.
– If I know that my patient’s partner is involved in her treatment, I invite him to my office – says the drug. med. Tomasz Basta. – I describe how she can support a partner and show how to perform the recommended exercises so that they are not a chore, but a form of fun that brings partners together. However, full intercourse is only possible when I consider that the treatment has ended.
The beginning of a successful sex life
It’s worth remembering that pain, whether before, during or after intercourse, is nothing to be ashamed of. Such ailments should prompt a visit to the office of a specialist who will determine the causes of the pain and propose effective therapy. As our expert argues, effective treatment of vaginismus does not have to take months, and removing the pain can bring partners closer together and make their sex life take on new colors.