Vaginismus occurs when the muscles around the vagina tighten.
What is vaginismus?
Vaginismus occurs when the muscles around the vagina tighten when something enters the vagina (a tampon, a penis or during a pelvic examination). When the muscles tighten, this can cause pain or discomfort.
Why does this occur?
The muscle tightening often occurs as a response to previous pain, or expectation of pain or discomfort. The muscle tightening is an involuntary response which means that it is not done consciously.
What is primary versus secondary vaginismus?
Primary vaginismus means that there has always been pain/tightness with anything in the vagina (first tampon use or first episode of sexual intercourse). Secondary vaginismus occurs when there has been no pain/tightness associated with entry into the vagina but then pain develops over a period of time.
What causes vaginismus?
The cause of vaginismus is unknown. Some factors that may contribute include having pain along the opening of the vagina (localised provoked vulvodynia), recurrent bladder infections, yeast infections such as thrush, fear that anything entering the vagina might be painful, previous abuse or trauma, or injury during childbirth. In many cases no specific cause is found.
What are the treatment options for vaginismus?
Common therapies include pelvic floor physiotherapy and the use of vaginal dilators or stretching, special breathing techniques and learning how to relax the pelvic floor muscles, cognitive behavioural therapy and sex therapy. Some women need more than one type of therapy and the time involved to improve the symptoms varies between women. Dr Kliman will often refer you to a physiotherapist who specialises in pelvic relaxation. Localised provoked vulvodynia can be helped significantly with the use of special creams that contain a neuromodulator (a drug that alters nerve fibre behaviour).
Can vaginismus improve?
It takes time and effort but many women with vaginismus improve dramatically with the appropriate treatment. There is however, no quick fix but becoming pain free again without vaginal tightening usually occurs. Even with vaginismus many women still have satisfying sexual relationships by engaging in sexual activities other than intercourse.
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