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Vaginismus is the contraction of the muscles around the entrance to the vagina. The cause of this sexual dysfunction is independent of the woman and may indicate neurosis and the inability to have sexual intercourse. Vaginismus can cause pain when attempted to penetrate.
What is vaginismus?
Vaginismus is a type of sexual dysfunction otherwise known as Marion-Sims syndrome. This disorder makes sexual intercourse impossible. This is influenced by mental and somatic factors that cause the muscles surrounding the vaginal opening to contract. In addition, vaginismus causes severe pain when trying to insert the penis inside the vagina. The contractions that occur are involuntary. Sometimes the thigh muscles contract, which also makes it difficult to have sexual intercourse. Vaginismus may be a secondary consequence of a fungal infection or trauma, but primary vaginismus, which appears from the first sexual intercourse, is more common. Then the cause should be sought in the psyche. Vaginismus very often affects young women and is treated both by a gynecologist and a psychologist.
Sexual disorders can also take the form of:
- excitement disorders,
- reducing sexual needs,
- orgasm disorders,
- aversion to sex,
- reducing libido (sex drive).
The above factors often coexist with each other. Sexual dysfunction is a problem that affects women mainly in their 50s. It is usually associated with hormonal changes that occur during the menopause. The occurring hypoestrogenism causes changes in the vaginal mucosa, which are very thin and much less moistened and supplied with blood than before the menopause. Consequently, the woman experiences pain during sex. In women, after the menopause, the level of libido also drops, which affects sexual functions. Androgens, the concentration of which are also lower after the menopause, have the greatest influence on libido.
Vaginismus – causes
There can be many causes of vaginismus, ranging from gynecological disorders to mental problems, with both problems being the most common determinants. The incidence of this ailment ranges from 3 to 17 percent. Such a discrepancy is due to the fact that vaginismus is often confused simply with painful intercourse, which has a completely different background. For this reason, vaginismus should be differentiated from dyspareunia. Sometimes vaginismus can be associated with general ailments such as obesity, diabetes, and even depression. Drugs used against these diseases can also have a negative impact on the quality of sexual life. Antidepressants and sedatives are of particular importance.
The causes of vaginismus can be divided into:
- Gynecological changes: e.g. cracks and ulcers in the genitals, which, exacerbated by problems with neurosis, cause the muscles of the vulva to contract and prevent penetration.
- Sexual readiness syndrome: clitoral blood supply and innervation disorders, vaginal dryness – caused by a mental block that leads to mucus secretion disorders. The blockage may result, for example, from the fear of becoming pregnant.
- Neurotic tenderness: sexual arousal occurs along with pain in the clitoris, which has psychosomatic causes – e.g. itching of the vulva and lack of sexual satisfaction.
Other factors of vaginismus are:
- disorders in the genital organs as a result of mental factors,
- reluctance to have sexual intercourse with a partner and general neurotic disorders of a hysterical-neurasthenic nature,
- bad relations with a sexual partner,
- dysmenorrhea, amenorrhea, scanty periods and heavy, frequent menstrual and intermenstrual bleeding,
- the fact of the lack of offspring,
- fear of being covered by third parties,
- sexual perversions.
Psychological background of vaginismus
Vaginismus is often the result of uninteresting sexual experiences, such as failed intercourse, childhood sexual harassment or rape. Often also a series of complexes about your own body, shame or bad associations with sex – completely disturb sexual intercourse. It often turns out that the cause of vaginismus is poor sexual education and negative information about men.
When talking about the psychological background, it is worth mentioning excessive religiosity and morals. Some women argue that sexual intercourse is only for procreation, and that it is forbidden and inappropriate to obtain pleasure during sex.
Other reasons include:
- fear of pregnancy,
- disgust at the semen of a man,
- fear of losing virginity,
- forced to have sex.
Types of vaginismus
1. Primary vaginismus – occurs from the beginning, from the first sexual intercourse. The woman has hardly experienced sex that would not bring penetration without feeling painful. The primary type of vaginismus is a problem especially for teenagers and young women, and for those who have a busy life, have had a bad sex experience (molestation, rape, witness sexual assault) or have been brought up with the idea that sexuality is wrong. The ailment also applies to patients suffering from fungal infections of the urinary tract, but sometimes it is idiopathic.
2. Secondary vaginismus – applies to women who have had no problems with their partner so far and have not felt any discomfort because of it. Secondary vaginismus can be caused by fungal infections, trauma or psychological problems.
Symptoms and diagnosis of vaginismus
The symptom of vaginismus is the automatic and independent closure of the vaginal opening every time there is an attempt to penetrate the vagina during sexual intercourse. Muscle cramps may also occur when trying to apply a tampon. In patients with suspected vaginosis, a thorough medical history and gynecological examination are important in order to exclude organic causes of the disease, e.g. anatomical vaginal defects.
If the cause is hormonal changes – the vaginal mucosa will be very dry with visible abrasions. It should be mentioned that vaginal dryness is a common problem for women taking oral contraceptives. Then the problem of pain during intercourse is eliminated with the help of vaginal globules or ointments. Another symptom that indicates the presence of vaginismus is excessive tension and hypersensitivity of the posterior frenulum of the vagina.
In the case of vaginal dryness, it is worth reaching for the Woman Aqua Pjur water-based lubricant, which will additionally moisturize intimate places. The product is safe for condoms.
In addition to the medical history and gynecological examination, the patient should undergo general blood and urine tests, microbiological tests and hormone tests. Microbiological examination is particularly important, as pain during intercourse may be caused by infection of the genital organs (bacterial and fungal infections, chlamydiosis).
Treatment of vaginismus
Treatment for vaginismus includes both local methods and psychotherapy. In primary vaginismus, the help of a psychotherapist and a physiological approach are of the greatest importance. Doctors often suggest patients regular masturbationthanks to which they can get to know their body better and prepare themselves to enjoy sexual intercourse. In addition, penetration of the vagina by inserting objects or fingers into it allows the woman to get used to penetration and eliminate involuntary vaginal contractions. It doesn’t have to be just masturbation, a partner can help you through the right one foreplay relax the woman and build a positive image of sexual intercourse. Treatment will be effective only if the patient has a strong will to fight and will to treat, as well as acceptance of therapeutic methods. Besides, it is very important partner supportwho will not only understand the woman’s problem, but will also be with her during treatment. If vaginismus is the result of a conflict between partners – it is necessary nucleoside.
It is not without significance sex education and providing unbiased information about sex. When it comes to pharmacological agents, anxiolytics, small doses of antidepressants and analgesics are used as an auxiliary. However, it is important to remember that medications will not improve the situation if the relationship between the partners remains the same. The effectiveness of vaginismus treatment is about 80%, it requires time and many visits to the gynecologist and psychologist.
In a certain group of women, vaginismus prevents a gynecological examination (colonoscopy), which is a big problem for women who want to enlarge their family. It is a big mistake to ignore the problem and not take any treatment, as vaginismus is a treatable problem.
Read also: Pain during sexual intercourse – expert advises