Vaginismus - Types, Causes and Treatment

Introduction:

Vaginismus is a condition in which the vaginal muscles tense instinctively due to vaginal infiltration (not necessarily penile penetration). Vaginismus does not prohibit entry, but it does interfere with arousal. This article will provide insight into the causes, symptoms, and treatment options for vaginismus.

What Are the Different Types of Vaginismus?

There are two sorts of vaginismus:

• Primary or Essential Vaginismus - This is seen when the woman has pain or difficulty in penetrative sex or any activity that involves vaginal infiltration, such as inserting a tampon. This condition exists from the very first sexual interaction.

• Secondary or Acquired or Optional Vaginismus - This occurs when there is no previous history of painful sex, but now the condition exists.

What Are the Causes of Vaginismus?

Various physical and psychological factors are responsible for vaginismus.

1. Psychological Causes:

• An unpleasant experience - History of past sexual abuse or a painful coital examination, any bad experiences that can lead to fear of sex.

• Unexpressed negative feelings towards the partner.

• Religious orthodoxy.

• Pain and tension cycle - Tension buildup due to painful sexual intercourse and vice versa.

2. Physical Causes:

• Pelvic inflammatory disease (PID) - An infection of the uterus, fallopian tubes, ovaries, or any two parts of the reproductive organ.

• Endometriosis - Endometriosis is a chronic condition marked by pathological features such as endometrial glands in the anatomical sites and organs outside the uterine cavity.

• Scar or any physical injury.

• The partial imperforate hymen - A tiny aperture remains in the vaginal canal but is sealed by additional tissue.

• Vaginal stenosis - The vaginal mucous membrane becomes thin and loses its firmness, and the aperture becomes smaller due to an unusual fibrous tissue.

• Dyspareunia - A condition of persistent pain before or following a sexual encounter.

What Are the Signs and Symptoms of Vaginismus?

The following are a few clinical signs and symptoms of vaginismus:

• Involuntary vaginal spasms.

• Dryness of the genital organ.

• Vaginal burning.

• Persistent vulvar irritation, burn, and pain.

• Recurrent intractable vaginal infections.

• Aversion to speculum examination.

• Painful sexual intercourse.

• Pelvic floor spasms.

• Decreased sex drive.

• The genital area feels swollen.

What Are the Various Degrees of Vaginismus?

Vaginismus is divided into five degrees, according to Lamont and Pacik:

How Is Vaginismus Treated?

Vaginismus is one of the sexual problems with a high treatment success rate. As stated above, there are physical and emotional causes for vaginismus. Therefore, the first step includes identifying the grounds with a complete medical and physical history.

The following steps can be used to help with vaginismus:

• Psychosexual Therapy - Tries to help one understand and modify the feelings about one's body and sex.

• Yoga - Mindfulness, breathing, yoga, and mild touching exercises can help the patient learn to relax inner vaginal muscles.

• Kegel's Exercises - Kegel's exercises or pelvic floor exercises can be done to gain control of the vaginal muscles. Sensate concentration exercises can be practiced to help one to relax and improve the sex drive (libido).

• Trainers for the Vaginal Area - Tampon-shaped equipment of various sizes can help one progressively become accustomed to having anything inserted into the vaginal canal.

• Surgical Treatment - The surgical treatment for vaginismus is rapid and successful. To treat the tall but thin hymen types, a "hymenectomy" operation is performed, and it takes less than an hour to complete.

Should You See a Doctor if You Have Vaginismus?

Some women's vaginismus may be caused by an underlying physical condition that needs to be identified and addressed. However, when a medical problem is involved, diagnosis can be difficult. Therefore it is advisable to see a doctor for vaginismus.

For How Long Does Vaginismus Require Treatment?

Since the pelvic floor might be in spasms for ages, training and lengthening the pelvic floor can take some time. Although each patient is unique, a standard line of therapy lasts between four and twelve months.

Can Other Conditions Be Compared to Vaginismus?

These issues can cause symptoms that are similar to vaginismus:

• Vaginal Atrophy - After menopause, the vaginal lining becomes thinner and drier due to a lack of estrogen.

• Vulvar vestibulitis - It is a painful sex condition that may endure pain during the entire encounter due to the first insertion.

How to Prevent Vaginismus?

Wrong perceptions about intercourse cause vaginismus; sexual education, pre-marital counseling, and clearing the concepts about the anatomy and physiology of genital organs can help to prevent vaginismus.

Is it possible to have intercourse with someone who has vaginismus?

Yes. Vaginismus does not prohibit penetration, but it does interfere with sexual arousal. A simple pelvic examination usually reveals no reason for the contractions. There are no physical anomalies that contribute to the problem. Sexual dysfunction can affect both men and women and is frequently treatable.

Are Dyspareunia and Vaginismus the Same Thing?

No, dyspareunia is a condition of persistent pain before or after a sexual encounter, whereas vaginismus is where muscle spasms make it impossible to penetrate. Both can exist simultaneously, but they are not the same.

Conclusion:

One of the most common reasons for non-consummated marriages is vaginismus. Vaginismus is a clinical syndrome characterized by pain, anxiety, and impossible penetrations and spasms. Vaginismus is treatable; the condition's cause is the individual's perspective and attitude toward a sexual interaction, not the brain or the vagina. Dyspareunia, vulvodynia, and vestibulodynia all overlap with vaginismus; therefore, the existence of an involuntary vaginal spasm is not enough to diagnose vaginismus.