Vaginismus: Strangling Down Below
Muscle spasms can be extremely painful. When we think about muscle spasms, we often think it is located in the back, arms, or the legs. Muscle spasms can actually occur anywhere in the body that is covered with muscle. The heart, for example, is a muscle that can go into spasms that we classify as a heart attack. But what about vaginismus? What muscle does it affect?
Vaginismus is an extremely distressing and humiliating condition where the muscles of the vagina involuntarily contract and block the passage. The muscle spasm is located in the pelvic floor muscles surrounding the vagina and cannot be controlled by the sufferer. It may or may not cause discomfort, burning, or pain but it may affect a woman’s ability to engage in any form of vaginal penetration, including sexual penetration, insertion of tampons, and the penetration involved in gynecological examinations. It can suddenly occur in women even after years of engaging in sexual intercourse but can also occur in sexually inexperienced women. Sometimes this can be the cause of non-consummation in marriages. This can be classified as a sexual disorder with psychological causes such as past sexual trauma or abuse, psychological factors, or a history of discomfort with sexual intercourse similar to psychological impotence in males. Psychological impotence is when the male member is unable to achieve or sustain an erection suitable for sexual intercourse. Some women may have been led to believe that vaginal penetration should be naturally easy, and are shocked and upset when the muscle spasm makes penetration difficult or impossible. A pelvic exam can confirm the diagnosis of vaginismus, combined with a medical history and complete physical exam is important to rule out other causes of dyspareunia (painful sexual intercourse.)
There are two types of vaginismus, primary and secondary. Primary vaginismus is when a woman has never had sexual intercourse or been able to achieve penetration of any kind. This is commonly found in adolescent and young women, and is often discovered when the sufferer attempts to use a tampon, have penetrative sexual intercourse or undergo a pap smear. Inexperienced women may experience the involuntary muscle spasm when they first attempt to have sex with their partner, sometimes out of fear of the pain and blood from breaking their hymen or if they were conditioned to think that sex is vulgar and immoral. Secondary vaginismus occurs in sexually experienced women who have endured some form of injury or trauma to the pelvic or vaginal area such as a difficult childbirth or a yeast infection. Because of the psychological nature of the condition, sexual abuse is one of the contributing factors to an attack of vaginismus. The muscle spasm can then be interpreted as the body’s physical reaction to the violation by attempting to block the sexual passage, therefore making it inaccessible.
Vaginismus can happen to anyone at any age. While it is indeed distressing and humiliating, the muscle spasm is treatable. Treatment can involve extensive therapy that combines education, counseling, and behavioral exercises. Such exercises include Kegel exercises for pelvic floor muscle contraction and relaxation. Vaginal dilation exercises are recommended using plastic dilators. As with any treatment, it should be done under the direction of a sex therapist or other health care provider. Ultimately, vaginismus does not only affect the female sufferer but also her sexual partner, so any therapy should involve the partner, and can gradually include more intimate contact, ultimately resulting in intercourse.