Reviewed By Dr. Shankar Rao

Vaginismus is characterized by involuntary muscle contractions in the pelvic floor muscles, surrounding the vagina. These contractions can make it painful, difficult, or even impossible for individuals with Vaginismus to engage in vaginal penetration, including sexual intercourse and the insertion of tampons. This condition can cause significant distress and may impact sexual relationships and overall well-being. It can be lifelong or even situational occurring only in particular situations or with certain partners. To further elaborate on what is vaginismus, according to the DSM-IV, vaginismus meaning is a sexual pain disorder. It occurs when there is an interference of a recurrent or “persistent involuntary spasm of the musculature of the outer third of the vagina” with intercourse. ^[1] In this article, we will delve into the vaginismus symptoms, causes, types, and vaginismus treatment options available.

What are the symptoms of Vaginismus?

Some of the most common vaginismus symptoms include:

• Pain or discomfort during attempts at vaginal penetration can be one of the early signs of vaginismus.
• Involuntary muscle contractions in the pelvic floor are yet another of the various vaginismus symptoms.
• Tightening or closing of the vaginal opening.
• Among the other vaginismus symptoms is anxiety or fear related to attempts at vaginal penetration and painful sex.
• Avoidance of sexual intercourse or other activities involving vaginal penetration. ^[1]

What are the causes of Vaginismus?

The exact vaginismus causes are not fully understood. However, several factors may contribute to the development of this condition:

Psychological factors:

Past experiences or witnessing traumatic sexual encounters, anxiety, fear of pain, or negative beliefs about sex can contribute to the development of vaginismus.

Physical factors:

Various organic factors can affect the pelvic area and can lead to vaginismus, including hymeneal abnormalities, congenital abnormalities, prolapsed uterus, vulvar vestibulitis syndrome, endometriosis, infections, vaginal lesions and tumors, vaginal atrophy due to vaginal surgery or intravaginal radiation, sexually transmitted diseases, and several others.

Cultural or religious factors:

Societal or cultural taboos surrounding sex and negative messages about sexuality can be among the other major vaginismus causes. Sometimes high moral expectations instilled in a child and strict religious orthodoxy in her upbringing lead to sexual guilt and in turn result in vaginismus.

Male partner’s sexual dysfunction:

This is yet another cause of vaginismus that also keeps the couple from confronting the man’s problem. During intercourse, some women complain of a burning sensation or a feeling that the man’s sex organ is “hitting a wall.”

Parent’s relationship and the father-daughter relationship:

It has been seen that fathers of women with early signs of vaginismus have been extremely domineering, moralistic, and threatening when these women were children. Such poor relationships, violence, and even physical abuse have led to this condition in many women.^[2]

What are the types of Vaginismus?

To understand what is vaginismus exactly one needs to understand its two basic types:

Primary vaginismus:

This occurs when a person has never been able to engage in vaginal penetration due to involuntary muscle spasms. It often manifests from the first attempt at intercourse.

Secondary vaginismus:

In this case, a person who previously experienced painless vaginal penetration develops vaginismus later on, often due to physical or psychological factors including infection, menopausal change, or pelvic pathology. ^[2]

How can Vaginismus be diagnosed?

Diagnosing vaginismus may be a difficult process since the symptoms of women with superficial dyspareunia and those with vaginismus can be similar. It is thus important to know what is vaginismus and involves a comprehensive evaluation, and detailed medical, psychosocial, relationship, and sexual history. The various methods include:

Medical history:

The healthcare provider will inquire about symptoms, sexual history, and any underlying medical conditions. They will also seek information about sexual knowledge and family attitudes to sexual behavior.

Physical or genital examination:

A pelvic examination may be conducted to rule out the possibility of any physical causes of pain or discomfort. This could involve a physical insertion of the finger into the introitus to check for discomfort or pain.

Psychological assessment:

Assessing psychological factors, such as anxiety or trauma including any episodes of traumatic sexual experience, may help determine the underlying cause of vaginismus. The medical practitioner will seek a clear description of the pain, fear, and avoidance, if any, from the patient. ^[1]

What are the treatment options for Vaginismus?

Vaginismus treatment involves a combination of education, counseling, and behavioral exercises and is tailored in accordance with the patient’s needs. Their primary goal may be to experience penetrative painless intercourse, tampon use, painless vaginal examination, or conception. Some of the options that suggest how to treat vaginismus include:

Progressive relaxation:

This vaginismus treatment involves working with a physical therapist to learn relaxation techniques and exercises to help control and relax groups of muscles. It is usually taught to the patient before self-fingering or insertion of vaginal trainers. Pitchudharana, and Dashamula kwath are also helpful in this respect. These Ayurvedic management methods can help in muscular relaxation most effectively.

Counseling or therapy:

Psychotherapy, such as cognitive-behavioral therapy, informative literature, and support from a therapist can help address any psychological factors contributing to vaginismus and develop coping strategies.

Gradual desensitization:

This vaginismus treatment technique involves inserting graded vaginal trainers into the vagina starting with the smallest to larger trainers over time to help desensitize and stretch the vaginal muscles gradually.

Electromyography:

In some cases, techniques like electromyography are used to detect the electrical potential generated by muscle cells when active and at rest. This helps evaluate and record the activation signals of muscles.

Couple therapy or Sensate focus:

Involving a partner in therapy sessions can help improve communication, reduce anxiety, and increase comfort with physical intimacy, all facilitated in a supportive environment. The vaginismus treatment method primarily focuses on touch and several exercises that make them gradually move up from various stages of intimacy to finally penetration. ^[1]

FAQs

• What are some of the best coping strategies and self-care techniques for women suffering from vaginismus?

Some ways to cope with vaginismus include:
1. Open communication with your partner about your condition and any fears or concerns.
2. Engaging in non-penetrative sexual activities to maintain intimacy.
3. Practicing relaxation techniques, such as deep breathing exercises or yoga, reduces anxiety and promotes muscle relaxation.
4. Exploring alternative forms of sexual pleasure, such as oral sex or manual stimulation.
5. Seeking support from support groups or online communities to connect with others who have experienced similar challenges.

• Can vaginismus be cured through Ayurveda?

Yes, there are various Ayurvedic remedies for vaginismus including:

1. Ashoka: This tree is used for various female reproductive problems and can be applied topically to bring down the pain and tightness associated with vaginismus.
2. Lodhra: This can improve overall vaginal health and can make penetration comfortable
3. Haridra: Helps manage the pain and has anti-inflammatory properties
4. Shatavari: Balances the female hormones and can be used for menopause symptoms and vaginismus
5. Guggulu: This gum resin acts as a natural muscle relaxant and helps with vaginismus.

• How to get over vaginismus?

If you are thinking about how to get over vaginismus, there are various methods including topical therapy, pelvic floor physical therapy, vaginal dilator therapy, CBT, and sex therapy.

Conclusion

Vaginismus is a complex condition that can significantly impact an individual’s sexual and emotional well-being. Understanding vaginismus meaning, the vaginismus symptoms, causes, types, and knowing how to treat vaginismus is crucial for those affected by vaginismus. With the right support, including medical and psychological interventions, individuals with vaginismus can find relief and regain control over their sexual experiences.

Disclaimer: This article is written from a health and wellness perspective only and is not a piece of medical advice. Kindly seek the help of a certified medical practitioner before initiating any treatment.

References:

1. Diagnosing and managing vaginismus
2. The Pathophysiology and Etiology of Vaginismus

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