What is Vaginismus?
Vaginismus
refers to tension in the vaginal muscles, which in turn causes painful
intercourse. Women with vaginismus
may have vaginal muscles that become so tight the vagina cannot be entered.
They often experience pain in the genital, vaginal or pelvic area, and
they fear penetration and intercourse.
Sometimes
this tension occurs only during sexual encounters, resulting in the inability to
have intercourse. Or it may be more global, preventing the woman from inserting
a tampon or having a pelvic examination. Many
women with vaginismus have a medical condition that causes pain in the vulva,
vagina or pelvis. This pain may be
constant, occasional, or only during sex.
Vaginismus is an involuntary reaction of a woman's body to protect
from anticipated pain.
Some
women have positive attitudes toward sex and enjoy many pleasurable sexual
activities with their partners, including orgasms.
Only intercourse is a problem. Other
women have not had any specific negative sexual experience but have
strong fears or negative feelings about sex.
They may have been raised with little or no accurate information about
sexual anatomy or functioning and may have many misconceptions.
They may believe that sex is painful, sinful or dirty, their genitals are
ugly or disgusting.
Some
women with vaginismus have a history of sexual abuse, rape or other trauma and
have an intense fear of further pain, penetration or violation.
The tightening of the vaginal muscles may be an unconscious effort by
these women to protect themselves.
Diagnosis and
Treatment of Vaginismus
The
diagnosis of vaginismus requires a detailed history and physical examination by
a gynecologist familiar with the problem. Because
vaginismus is often situation-dependent, it can be difficult to diagnose and its
presence or absence during a gynecological exam is not a definitive diagnosis.
For example, while involuntary contraction of the vaginal muscles may
prevent insertion of the penis, a pelvic exam might not be as anxiety provoking,
and even insertion of a speculum might be possible.
(A speculum is the instrument used to hold the walls of the vagina apart
so the interior can be examined). For
some women, vaginismus may occur with one partner but not with another. For others, it might occur in all situations.
For an accurate diagnosis, the combination of a physical exam,
gynecological history and sexual history from both partners is often necessary.
Treatment
for vaginismus is promising, with research studies reporting success rates of
80% or better. Typically, treatment
includes relaxation, Kegel exercises (to relax the vaginal muscles) and
individual and partner involvement in a series of at-home exercises, including
repeated practice with insertion (dilation) training.
Each woman moves at her own pace and decides when she is ready for the
next step. Pain and discomfort are
avoided throughout the treatment.
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This
website was created by:
Denise Alberto, MPT, Mary Buxton,
LCSW, Maia Chakerian, M.D.,
Annemarie Cosby, MPT, Paul D. Indman, M.D., Linda R. Janowitz,
Ph.D., and
Diane Morrissette, Ph.D.
Each
person is an individual practitioner practicing independently of the others. We
work cooperatively, with our client's permission, to enhance treatment.
©2001
