VAGINISMUS (PART 1)

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We all expect ‘sex‘ to feel good and pleasurable. The truth is experiencing pain during sex is extremely common in women. Some people are physically unable to have sex because of the pain. If this describes you, you may have Vaginismus, a condition that causes involuntary contraction of the muscles surrounding the vagina, making penetration extremely painful and often impossible.

WHAT IS VAGINISMUS?

The vagina is part of the female reproductive system. It connects the lower part of the uterus (cervix) to the outside of the body. Vaginismus is an involuntary tensing or contracting of the muscles around the vagina. It is a complex condition that can make having sexual intercourse, gynecological exam, or inserting a tampon painful, difficult or impossible. When attempting to insert an object into the vagina, the muscles surrounding the opening of the vagina or in the pelvic floor may contract involuntarily, causing mild discomfort to severe pain. Vaginismus, if left untreated can create discomfort and distress and it may worsen. However, treatment is possible. 

TYPES OF VAGINISMUS

There are two main types of vaginismus.

  1. Primary Vaginismus

This is a chronic condition in which the pain begins the first time a person attempts sexual intercourse or inserts an object into the vagina, such as a tampon. A gynecological exam may also be difficult for a person to undergo. A partner is unable to insert anything into the vagina during sex. They describe it as “hitting a wall” at the vaginal opening. A person may feel pain, burn, or have generalized muscle spasms or contraction. When the attempt at vaginal entry stops, the symptoms stop. It is most commonly found in teenage girls and women in their early twenties, as this is when many girls and young women attempt to use tampons, have penetrative sex, or undergo a pap smear for the first time. Vaginismus may not be recognized until vaginal penetration is attempted.

  • Secondary Vaginismus

This happens when a woman has previously had sex without pain, but then it becomes difficult or impossible. It is also called acquired vaginismus. It can happen at any age. This is usually the result of a single event, such as an infection, menopause, medical condition, surgery, or childbirth. Even after the doctor has successfully treated any underlying medical condition, pain may persist if the body has become conditioned to respond in this manner.

CAUSES OF VAGINISMUS

Vaginismus is a condition that may occur due to physical or emotional factors, or both. It can become anticipatory, which means it occurs because the person expects it to. It is frequently associated with anxiety or fear of having sex, but it is not always clear which comes first, the vaginismus or the anxiety.

Some women have vaginismus in all situations and with all objects, whereas others only have it in certain situations such as with one partner but not others or with sexual intercourse but not with tampons or during medical exams.

Factors that may contribute to vaginismus can cause a physical, psychological and sexual issue, which includes:

  • Vaginal damage, such as from childbirth
  • Fear of penetration hurting because the vagina is thought to be too small
  • Expecting sex to be painful
  • Painful experiences the first time having sex
  • Relationship issues, such as having an abusive partner or feeling vulnerable
  • Trauma from sexual assault or childhood sexual abuse
  • Vaginal insertion trauma from a gynecological examination or other medical procedure
  • Childhood experiences, such as exposure to sexual images or portrayals of sex while growing up.
  • Infections like a urinary tract infection (UTI) or yeast infection
  • Anxiety about pain or pregnancy
  • Insufficient foreplay
  • Inadequate vaginal lubrication
  • Negative sexual perceptions or belief in sexuality myths
  • A painful medical condition such as thrush
  • Performance anxiety or feelings of guilt
  • Medical conditions like cancer or lichen sclerosus
  • Menopause

Sexual problems can affect both men and women. A person should not blame or feel ashamed. In most cases, treatment can be beneficial.

SIGNS AND SYMPTOMS OF VAGINISMUS

Dyspareunia (painful sex) is frequently the first sign of vaginismus. Only with penetration does the pain occur. It usually goes away after withdrawal, but this is not always the case. Many women with vaginismus experience pain when inserting a tampon or having a pelvic examination. These symptoms are involuntary, which means that a woman cannot control them unless she receives treatment.

The symptoms vary between individuals. Some may include: 

  • Dyspareunia (painful intercourse), with tightness and pain that may be burning or stinging
  • Difficult or impossible penetration
  • Chronic sexual pain, with or without a known cause
  • Pain during tampon insertion
  • Discomfort during a gynecological examination
  • Muscle spasm throughout the body during attempted intercourse

Pain can range from mild to severe intensity, and the sensation can range from mild discomfort to a burning sensation.

Vaginismus does not prevent people from becoming sexually aroused, but it may cause people to be anxious about sexual intercourse and avoid sex or vaginal penetration. A person with vaginismus can still have an orgasm from clitoral stimulation during sexual activity. This ability is not impaired by the condition, which only affects penetrative sex. Some people with vaginismus, on the other hand, have other sexual dysfunctions, such as difficulty reaching orgasm……………………………….TO BE CONTINUED

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