07 Apr Vaginismus
Vaginismus or difficulty to allow penile penetration during sex is a common cause of female sexual dysfunction. It is due to involuntary spasm of the muscles around the vaginal opening. These muscles go into spasm because of pain or fear of pain. Vaginismus is common in non-consummated marriages and affects many women with a different background. It causes many women to suffer in silence resulting in anxiety, isolation, stress, low self-esteem, and marital discord.
Vaginismus is usually not related to a physical abnormality of the genitals. Some women may wonder if their vagina is too small to fit a penis, or they may have a rigid hymen, or no vaginal opening at all. These concerns, however, are erroneous as the genital area is usually normal.
Majority of cases are psychological and they include:
- rape and past sexual abuse
- exposure as a child to shocking sexual imagery
- violence at home
- painful intercourse
- overly strict or unbalanced religious teaching at home
- rigid parenting
- inadequate sexuality education
- lack of experience in sexual intimacy
Vaginismus is treatable. A full recovery from vaginismus can be expected, with a treatment program that combines education and counselling, with behavioural exercises. Proper understanding and discussion of the sexual anatomy, physiology, the sexual response cycle and common myths about sex, will helps to reduce anxiety.
Exercises include, pelvic floor muscle contraction and relaxation (Kegel exercises), to improve voluntary control. Doing this regularly is very helpful. Vaginal dilation exercises are recommended, using plastic dilators. This should be done under guidance, starting out with the smallest dilator and slowly increasing in size. Treatment should involve the partner. This should gradually include more intimate contact, ultimately resulting in intercourse.
Pain-free and pleasurable intercourse is attainable for most couples if they are motivated.