We know how powerful a woman’s vagina is (hell yeah! we can bring forth a human into the world, right?), but see, there are women who can’t have the ability to even have sex.
Not that they don’t want to but they really can’t. It’s not that they have a phobia of sex but their vaginas cannot tolerate actual penetration, that even wearing tampons or even penetration involving gynaecological examinations (pap tests) is impossible, lest sexual intercourse.
If you’re one of these women, you may want to know more about vaginismus or vaginism.
What is vaginismus?
This is not to be confused with vaginitis (an infection or inflammation of the vagina). Vaginismus or sometimes called vaginism, is a woman’s inability to engage in vaginal penetration, such as sexual intercourse, manual penetration, inserting tampons or menstrual cups or those involving gynaecological examinations such as pap tests.
Women with vaginismus feel pain whenever there’s a vaginal penetration. The pain is a result of an involuntary vaginal muscle spasm that happens when there’s an attempt of vaginal penetration, making sex or any penetration impossible.
Now, if you’re wondering if this is a conscious act? No. A woman with vaginismus does this involuntarily which means she cannot control the spasm, much like a reflex that happens when something is about to poke you in the eye and you automatically shut your eye.
Study shows that around 18-20% of British and Australian women were found to manifest dyspareunia, a painful sexual intercourse due to medical or psychological causes.
A woman may
not find out she has vaginismus until she reaches her teenage years or
around her early twenties when she first attempts to use tampons, have
sex or undergo pap smear.
What causes it?
Although
doctors have not clearly identified yet what is causing vaginismus,
they often suggest that the muscles responsible causing the spasm (that
leads to pain during penetration) could be the pubococcygeus muscle,
sometimes referred to as the “PC muscle”. However, they also suggest
that spasm in the muscles such as the levator ani, bulbocavernosus,
circumvaginal, and perivaginal could also be causing the pain.
What are the factors that contribute to vaginismus?
Vaginismus
can be classified into primary vaginismus which happens when a woman
feels pain everytime she has sex or vaginal penetration or secondary
vaginismus which occurs when a woman, who has previously been able to
allow penetration, but due to some causes such as a yeast infection or
trauma during childbirth, develops vaginismus.
There are both physical and psychological factors that are causing vaginismus. These include:
Physical:
- vulvar vestibulitis syndrome, focal vaginitis, a so-called sub-clinical inflammation, in which no pain is perceived until some form of penetration is attempted
- urinary tract infections
- vaginal yeast infections
- sexual abuse, rape, other sexual assault, or attempted sexual abuse or assault
- domestic violence or conflict in the early home environment of the same nature
- chronic pain conditions
Psychological:
- witnessing sexual or physical abuse of others, without being personally abused
- fear of pain associated with penetration
- any physically invasive trauma (not necessarily involving or even near the genitals)
- generalised anxiety
- stress
- negative emotional reaction towards sexual stimulation
- Fear of losing control
- Not trusting one’s partner
- Self-consciousness about body image
- Misconceptions about sex
- Fear of vagina not being wide or deep enough
- Fear of partner’s penis being too large
How will you treat it?
If you’re getting worried now, fret not for there are ways to treat vaginismus.
Botulinum toxin A (Botox)
It
is one treatment option doctors consider because it temporarily reduces
the hypertonicity of the pelvic floor muscles. However, there have been
no controlled trials done with this treatment, but experimental studies
with small samples show it could be effective.
Anxiolytics and antidepressants
If
the condition was caused by anxiety, doctors may give anxiolytics and
antidepressants or other pharmacotherapies to temporarily help although
results from taking these have not been consistent.
Kegel Exercises
When a woman experiences painful sexual intercourse, doctors recommend Kegel exercises and prescribe more lubricants.
Kegel exercises help strengthen and relax the muscles that unconsciously tighten during vaginismus, while lubricants can also help in successful penetration, because women who are anxious and in pain may not lubricate naturally.
Do Kegel exercises by squeezing the muscles that you use to stop your urine flow whenever you urinate. Hold it for about 10 seconds then relax the muscles. You can repeat this around 20 times or as many times a day.
After a few days, if you feel comfortable enough, insert one finger (fingernails clipped) up to about the first knuckle joint inside the vagina while doing the exercises. Use a lubricating jelly or do it in a bathtub so the water can act as a natural lubricant.
You can start with one finger and work your way up to three, and feel the muscles of your vagina contracting around your finger. You can remove it once you feel uncomfortable.
If these doesn’t work, therapy may help.