Vaginismus is a female sexual disorder characterized by an involuntary and persistent contraction of the muscles surrounding the vagina, making penetration painful or impossible. This disorder affects between 5 and 17% of women and can have physical, emotional and relational implications, and it is important to understand its causes, symptoms and available treatment approaches.
Many people report the sensation of a wall, of very strong tension, in the vulva, vagina and sometimes the entire body.
Vaginismus can take several forms: it can occur at the start of sexual life or occur later. It can be total or partial, which means that certain penetrations remain possible, depending on the situation.
The causes of vaginismus
The causes of vaginismus can be varied and include physical, emotional and psychological factors. Understanding the underlying causes of this phenomenon is crucial for effective diagnosis and treatment. Let's take a closer look at the factors that can contribute to the development of vaginismus.
Psychological Factors
Stress, anxiety, and sexual trauma are often cited among the main psychological causes of vaginismus. Previous negative sexual experiences, whether sexual abuse, coercion, or simply repressive sex education, can create negative associations with penetration, thereby triggering involuntary muscular responses.
Fear of pain during sex can also play a significant role. Negative expectations related to sexuality, often rooted in cultural or family beliefs, can contribute to the manifestation of vaginismus.
Physical Factors
Although vaginismus is primarily a psychological disorder, some physical factors can also play a role. Gynecological infections, post-surgical scars, hormonal disorders or medical conditions such as vestibulodynia can lead to vaginal pain, thereby triggering reflex muscle spasms.
Sex education
Insufficient or inadequate sex education can also contribute to the development of vaginismus. Women who have little information about sexuality or who have been raised in environments where sexuality is taboo may develop inhibitions and apprehensions that manifest physically.
How does vaginismus manifest?
Symptoms of vaginismus can vary in intensity. Women with this disorder may experience severe pain or discomfort when attempting vaginal penetration. Involuntary muscle spasms can make it difficult or impossible to insert tampons, medical instruments, or even a finger.
Difficulty or impossibility of penetration
The main characteristic of vaginismus is difficulty inserting anything into the vagina, whether it is a penis, tampon, finger or any other object.
Pain during sex
Women with vaginismus may experience severe pain when attempting intercourse. This pain is often described as a burning sensation.
Involuntary muscle contractions
Involuntary muscle spasms occur around the vagina, which creates resistance to penetration. These contractions can be difficult to consciously control.
Anxiety and sexual apprehension
Women with vaginismus may feel intense anxiety, fear, or apprehension about having sex. These emotions can contribute to reinforcing the cycle of vaginismus.
Additionally, due to the associated pain and anxiety, women with vaginismus may avoid sexual activities altogether. This can lead to relationship problems and a deterioration in quality of life. Intimate relationships can become strained, and emotional distress can be significant. It is crucial that partners are understanding and seek mutual support to face this challenge.
Difficulty using tampons or medical instruments
Even inserting tampons or medical instruments, such as gynecological specula, can be extremely difficult or impossible.
Generalized pelvic tension
Outside of attempts at penetration, some women with vaginismus may experience generalized pelvic tension, even in nonsexual situations.
How to treat vaginismus?
Medical consultation
If a woman suspects she is suffering from vaginismus, it is essential to consult a healthcare professional, such as a gynecologist. A thorough medical examination can help rule out other underlying medical problems and determine the cause of vaginismus.
Therapeutic approaches
Treatment of vaginismus may include a multidisciplinary approach. Sex therapy, cognitive behavioral therapy (CBT), and physical therapy may be recommended. CBT aims to identify and change negative thought patterns associated with sex, while physiotherapy can help release muscle tension through specific exercises and techniques.
Here are the most frequently used therapeutic approaches to treat primary vaginismus:
- Use of local injections of botulinum toxin or hyaluronic acid for temporary treatment purposes.
- Administration of drug treatments with temporary effects, such as analgesics, muscle relaxants or antidepressants.
- Muscle rehabilitation using vaginal dilators.
- Consultation with a sexologist to benefit from sex therapy.
- Reconstructive surgery in case of uterine malformation.
- Exercises aimed at strengthening the pelvic floor.
- Use of antifungals for yeast infections and antibiotics or antivirals as needed.
- Use of vaginal lubricants to facilitate sexual intercourse.
- Hormonal treatment based on estrogen, in different forms.
- Taking probiotics to restore the balance of the vaginal flora.
Conclusion
Vaginismus is a complex sexual disorder that can have significant physical, emotional and relational impacts. Management of vaginismus often requires a holistic approach, combining medical, psychological and physical interventions. Awareness and education are also essential to create a supportive environment and help promote better understanding and encourage the search for appropriate solutions.
If you think you may be affected by vaginismus, do not hesitate to consult a healthcare professional for appropriate assessment and support.