Vaginismus is a condition involving a muscle spasm in the pelvic floor muscles. It can make it painful, difficult, or impossible to have sexual intercourse, to undergo a gynecological exam, and to insert a tampon.
When you try to insert an object such as a tampon, penis or speculum into the vagina, it tightens up because of an involuntary contraction of the pelvic floor muscles.
This leads to generalized muscle spasm, pain and temporary cessation of breathing.
The most common muscle group affected is the pubococcygeus (PC) muscle group. These muscles are responsible for urination, intercourse, orgasm, bowel movements and childbirth.
Without treatment, it can lead to frustration and distress, and it may get worse. However, treatment is possible.
Types
There are different types of vaginismus that can affect women at different ages.
Primary Vaginismus
This is a lifetime condition in which the pain has always been present. It will be difficult to use a tampon and to undergo a gynecological exam.
It is often experienced by women during their first attempt at intercourse. The male partner is unable to insert his penis into the vagina. He may describe a sensation like “hitting a wall” at the vaginal opening.
There may be pain, generalized muscle spasms, and the woman may temporarily stop breathing. The symptoms are reversed when the attempt at vaginal entry is stopped.
Secondary Vaginismus
This develops after a woman has already experienced normal sexual function. It has not always been present. It can occur at any stage of life, and it may not have happened before.
It usually stems from a specific event, such as an infection, menopause, a traumatic event, development of a medical condition, relationship issues, surgery, or childbirth.
Even after any underlying medical condition is corrected, pain can continue if the body has become conditioned to respond in this way.
Global Vaginismus
Vaginismus is always present, and any object will trigger it.
Situational Vaginismus
This occurs only in certain situations. It may happen during sex but not during gynecological exams or tampon insertion.
Symptoms
The symptoms vary between individuals.
They may include:
- painful intercourse (dyspareunia), with tightness and pain that may be burning or stinging
- penetration being difficult or impossible
- long-term sexual pain with or without a known cause
- pain during tampon insertion
- pain during a gynecological examination
- generalized muscle spasm or breathing cessation during attempted intercourse
- Pain can range from mild to severe in nature and from discomfort to burning in sensation.
Vaginismus does not prevent people from becoming sexually aroused, but they may become anxious about sexual intercourse, so that they try to avoid sex or vaginal penetration.
Causes
Vaginismus is a condition which can be caused by physical stressors, emotional stressors, or both. It can become anticipatory, so that it happens because the person expects it to happen.
Emotional triggers
These include:
- fear, for example, of pain or pregnancy
- anxiety, about performance or because of guilt
- relationship problems, for example, having an abusive partner or feelings of vulnerability
- traumatic life events, including rape or a history of abuse
- childhood experiences, such as the portrayal of sex while growing up or exposure to sexual images
Physical triggers
These include:
- infection, such as a urinary tract infection (UTI) or yeast infection
- health conditions, such as cancer or lichen sclerosis
- childbirth
- menopause
- pelvic surgery
- inadequate foreplay
- insufficient vaginal lubrication
- medication side effects
- Sexual problems can affect both men and women. They are not anyone’s fault, and they are nothing to be ashamed of.
In most cases, treatment can help.
