At times, maintaining satisfying sexual relationships becomes extremely difficult, no matter how simple it may seem. Most marriages in western countries slowly becomes deprived of sex as the couple fails to consummate their relationship. Unfortunately, in most cases, the cause is not an organic issue such as cancer; but a gynecological problem like vaginismus.
What Is Vaginismus?
Vaginismus is a condition which involves incessant involuntary stiffening of vaginal muscles at the time of every attempted penile penetration. It can be a major obstacle in sex life and may resultantly lead to depression, low self-esteem and a marriage in tatters. It may also make pelvic and gynecological examinations complicated or intricate to carry out. Poorly managed vaginismus may drive away the husband either in confusion or anger, and the woman is left feeling nothing but guilt and anxiety.
Classic Symptoms Of Vaginismus
The symptoms of vaginismus may vary from women to women. Some women do manage to engage in sex however, sexual encounters will be painful or unpleasant for them. Others may be able to insert a tampon but fails to have a satisfying sexual encounter. There is an even smaller percentage of population of women, who can’t bear inserting anything. The classic symptom of vaginismus are, difficult and excruciating sex and absence of satisfaction or sexual gratification. The pain may or may not go away after the activity.
How To Manage Vaginismus?
If a physical cause is identified such as oversensitive nerves or infection at the vaginal opening, the symptoms can be easily treated with medications. But if there’s no clear clinical picture, then following methods are usually recommended:
- Sex therapy: A thorough counseling by an expert on sex therapy, psychoanalysis and psychosexual medicine, may help to get a hand on the condition. Cognitive behavioral therapy is also used to highlight and deal with any psychological conditions like anxiety or fright.
- Vaginal trainers: These are special mechanical trainers to help train the vagina in getting used to penetration without any involuntary tightening, at a gradual pace. These trainers are available as 4 penis-shaped objects, made of plastic and in different sizes. The vaginal training begins with the smallest trainer as it is inserted into the vagina with or without lubrication. This way the vagina is trained and gradually the next bigger size is used. Women are recommended to go on the pace that makes them comfortable. Once the training is completed successfully without any pain, the couple may go on have sex.
- Touching and Relaxation: Progressive relaxation is a method that includes tensing and relaxing various muscles in a step-wise pattern. Tensing and relaxing the pelvic floor muscles prior to finger or cone insertion may also help. If finger is successfully inserted into the vagina then the next step would be to inserting a tampon with or without lubrication.
- Pelvic Floor Exercise: Regular pelvic exercises can be performed to relax and control the vaginal muscles. Kegel exercises help alleviate this condition. These exercises are performed by squeezing the muscles, which are used to hold back urine at the time or urination, for two seconds and followed by relaxing the muscles that make the pelvic floor. Doing this 20 times followed by dilator or finger insertion may help to minimize the stiffening of vaginal muscles. A biofeedback device may also be used during kegel exercises, as it involves insertion of a probe into the vagina that senses the feedback of the exercise and displays it on the monitor.
- Sensate focus: Sensate focus may be done with the partner to spark the intimacy as the couple touches each other’s body parts making each other sexually aroused. This helps in painful vaginal penetration.
- Surgery: Surgery is very rare but performed only when a physical cause is the culprit of vaginismus.
- Vaginal enlargement: At times the vagina is surgically enlarged and the results are very promising.
1. Melles, R. J., Dewitte, M. D., Ter Kuile, M. M., Peters, M. M., & de Jong, P. J. (2016). Attentional Bias for Pain and Sex, and Automatic Appraisals of Sexual Penetration: Differential Patterns in Dyspareunia vs Vaginismus?. The Journal of Sexual Medicine, 13(8), 1255-1262.
2. Lahaie, M. A., Amsel, R., Khalifé, S., Boyer, S., Faaborg-Andersen, M., & Binik, Y. M. (2015). Can fear, pain, and muscle tension discriminate vaginismus from dyspareunia/provoked vestibulodynia? Implications for the new DSM-5 diagnosis of genito-pelvic pain/penetration disorder. Archives of sexual behavior, 44(6), 1537-1550.