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New Treatments for Vaginismus

By: Kathryn Senior PhD - Updated: 25 Jan 2014 | comments*Discuss
Vaginismus Sexual Problem Vagina

Vaginismus is a female sexual problem that few women discuss very openly. This may prevent them accessing the various treatments that are available, most of which are usually successful.

The new approach to vaginismus is to treat it with a combination of different methods that are generally non-invasive and are directly under the control of the woman herself. These include psychotherapy to discover and work on any psychological reasons for the disorder, pelvic floor exercises, the insertion of vaginal dilators and expanders as well as strategies to deal with the muscle tightening and muscle spasms that occur as a response to pain.

What is vaginismus?

Vaginismus is an involuntary tightening of the muscles of the vagina when a couple attempts to have penetrative sex. It may start because of pain during intercourse caused by a variety of factors. A woman may have a thrush infection, or a couple may try to have sex too soon after childbirth, or there may be an underlying condition that causes vaginal dryness.

Painful penetration is difficult to cope with emotionally and the experience can lead to a positive feedback cycle in which the memory of pain during sex creates anticipation of that pain returning. The muscles of the vagina tense up, penetration becomes difficult and painful, and this reinforces the psychological barriers that prevent full sex taking place.

Vaginismus can affect young women having their first sexual relationships, or it can develop due to one of the reasons mentioned above after years of being able to have enjoyable sex normally.

Why it is important to seek vaginismus treatment

Many women think that vaginismus is something that they have to learn to live with. Some do not even realise that they have a treatable condition; they regard themselves as sexually frigid and may avoid relationships altogether.

Unfortunately, this means that they put off dealing with the problem and the vaginismus can affect their quality of life. For women in a relationship, untreated vaginismus can lead to a loss of intimacy and break down of a marriage or long term partnership.

It is also important for someone who is experiencing pain on penetration, or during sex to have a careful gynaecology examination to make sure that something more serious is not causing the pain. A prolapsed uterus, in which the uterus drops down and protrudes into the vagina, can cause difficulties with penetration and pain during sex, but the cause here is physical and will probably need surgical treatment.

Vaginismus treatments available

The first thing that a healthcare professional will do is ask you about your experiences with sex and they will then perform a clinical examination. This will confirm the diagnosis of vaginismus, and will rule out any physical cause.

You will then probably be referred to a specialist sex therapist or gynaecologist who has experience of treating female sexual problems to start a programme that combines self-help with guided medical intervention.

As well as arranging sessions of psychotherapy, you will also see a specialist nurse who can show you how to do pelvic floor exercises to strengthen the muscles of your vagina and also the muscles that support your uterus and other abdominal organs. You might think that having stronger muscles would make the problem of vaginismus worse, but better muscle tone means better control, and the muscles are less likely to tense when stimulated during normal sex.

You need to overcome the association between vaginal penetration and pain, so you will also be given special vaginal dilators and expanders to use at your own pace when you are at home. These start small and you can use larger ones as you become more confident.

They are designed to help you recognise the normal stretching sensations that occur when your vaginal walls expand, learning not to associate that with the anticipation of pain. Breaking this mental and physical cycle is very important to successful vaginismus treatment.

The final steps towards successful sex

The treatment for vaginismus is not an instant fix, and it will take several weeks or months for a woman to feel more comfortable with inserting dilators and to practise pelvic floor exercises so that the muscles that used to tense unpredictably remain in control.

The sex therapist will, at this point, encourage you to work with your partner to explore intimate touching and finally, full penetrative sex. For most women who have this type of vaginismus treatment, they find that they lose their previous anticipation of pain and then begin to enjoy their sexual relationship, some for the first time.

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