Published on 01 Sep 2016 | 8 months ago
Vaginismus, sometimes called vaginism, is a condition that affects a woman's ability to engage in vaginal penetration, including sexual intercourse, manual penetration, insertion of tampons or menstrual cups, and the penetration involved in gynecological examinations (pap tests). This is the result of an involuntary vaginal muscle spasm, which makes any kind of vaginal penetration painful or impossible. While there is a lack of evidence to definitively identify which muscle is responsible for the spasm, the pubococcygeus muscle, sometimes referred to as the "PC muscle", is most often suggested. Other muscles such as the levator ani, bulbocavernosus, circumvaginal, and perivaginal muscles have also been suggested.
A woman with vaginismus does not consciously control the spasm. The vaginismic reflex can be compared to the response of the eye shutting when an object comes towards it. The severity of vaginismus, as well as the pain during penetration (including sexual penetration), varies from woman to woman
A woman is said to have primary vaginismus when she is unable to have penetrative sex or experience vaginal penetration without pain. It is commonly discovered in teenage girls and women in their early twenties, as this is when many girls and young women in the Western world first attempt to use tampons, have penetrative sex, or undergo a Pap smear. Women with vaginismus may be unaware of the condition until they attempt vaginal penetration. A woman may be unaware of the reasons for her condition.
A few of the main factors that may contribute to primary vaginismus include:
a condition called vulvar vestibulitis syndrome, more or less synonymous with 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
knowledge of (or witnessing) sexual or physical abuse of others, without being personally abused
domestic violence or similar conflict in the early home environment
fear of pain associated with penetration, particularly the popular misconception of "breaking" the hymen upon the first attempt at penetration, or the idea that vaginal penetration will inevitably hurt the first time it occurs
chronic pain conditions and harm-avoidance behaviour
any physically invasive trauma (not necessarily involving or even near the genitals)
negative emotional reaction towards sexual stimulation, e.g. disgust both at a deliberate level and also at a more implicit level
strict conservative moral education, which also can elicit negative emotions
Secondary vaginismus occurs when a person who has previously been able to achieve penetration develops vaginismus. This may be due to physical causes such as a yeast infection or trauma during childbirth, while in some cases it may be due to psychological causes, or to a combination of causes. The treatment for secondary vaginismus is the same as for primary vaginismus, although, in these cases, previous experience with successful penetration can assist in a more rapid resolution of the condition. Peri-menopausal and menopausal vaginismus, often due to a drying of the vulvar and vaginal tissues as a result of reduced estrogen, may occur as a result of "micro-tears" first causing sexual pain then leading to vaginismus.
Further factors that may contribute to either Secondary or Primary Vaginismus include:
Fear of losing control
Not trusting one’s partner
Self-consciousness about body image
Sexual abuse, rape, other sexual assault, or attempted sexual abuse or assault
Misconceptions about sex or unattainable standards for sex from exaggerated sexual materials, such as pornography or abstinence
Fear of vagina not being wide or deep enough / fear of partner’s penis being too large
Undiscovered or denied sexuality (specifically, being asexual or lesbian)
Undiscovered or denied feelings of being transgender
According to Ward and Ogden's qualitative study on the experience of vaginismus (1994), the three most common contributing factors to vaginismus are fear of painful sex; the belief that sex is wrong or shameful (often the case with patients who had a strict religious upbringing); and traumatic early childhood experiences (not necessarily sexual in nature).
People with vaginismus are twice as likely to have a history of childhood sexual interferen
Often, when faced with a person experiencing painful intercourse, a gynecologist will recommend Kegel exercises and provide some additional lubricants. Strengthening the muscles that unconsciously tighten during vaginismus may be extremely counter-intuitive for some people. Also, vaginismus has not been shown to affect a person's ability to produ