DO I HAVE VAGINISMUS? - When Love Hurts

Vaginismus is the tightening of muscles around the vagina, making penetration painful or impossible. The muscles in the pelvic floor, around the vagina, will involuntarily tighten, possibly to spare you from pain or a possible threat of pain. You do not control the tightness of these muscles. It is merely a reflex.

SYMPTOMS & SIGNS

Fear and anxiety of painful penetration
Pain in the pelvic area
Difficulty inserting tampons
Difficulty having a gynaecological examination
Difficult or impossible penetration
Burning or stinging with tightness during sex
Muscle spasms during sex
Pain after sex
Ongoing sexual pain after a pelvic problem, medical issue, surgery or childbirth
Constant sexual pain and tightness with no discernible physical cause

CAUCES

In some cases, vaginismus appears to have no cause at all or the cause is not known, in other cases, it might stem from a physical or psychological event.

Physical change might trigger it:

Hormonal changes may inflict pain in the vagina, i.e. taking birth control, entering menopause, undergoing hormonal treatment
Illnesses that may contribute to pain in the abdominal or pelvic area, i.e. urinary tract infections, sexually transmitted infections, bowel problems, endometriosis, or other complications
Sex in spite of the pain, e.g. pain caused by insufficient foreplay or vaginal dryness
Stress and tension that can leave your body with high muscle tonus and pain
Abuse can trigger a reflexive tightening of the vagina
Injury, i.e. to the pelvis or from a bad fall on the bicycle crossbar, violent sex.

Psychological change might trigger it:

Fear is a common cause. Being scared can make the body tense up in defence, i.e. fear of sex itself, worrying about pregnancy, or if something could go wrong. Fear makes your body want to protect you
Anxiety and stress can give you difficulties in letting go in the muscle tone
Trauma e. a bad first time sexual; a gynaecological experience; being a victim of or witness to physical and psychological abuse; having repressed or forgotten memories about traumatic experiences; having been taught that sex is painful, wrong, dirty, or wrong. Incidents resulting in a deeply felt rejection
Not trusting your partner and afraid sex will lead to pain

DIAGNOSIS

No simple medical test can be taken to confirm vaginismus. It is diagnosed through understanding a patient’s history, the description of pain, and gynaecological examinations to rule out the possibility of other conditions.

THE DOCTOR

Women often suspect they have vaginismus from their symptoms, but getting medical confirmation can be challenging. Obtaining a medical diagnosis may take some visits to physicians or specialists. Some physicians are unfamiliar with vaginismus, so a part of the process is merely finding a physician that is knowledgeable about the condition. Every woman experiences vaginismus differently. While some can have a gynaecological examination but not sex, others can’t have a gynaecological exam, but sex is okay.

The fact that it may take some time for you to get your diagnosis does not mean you are in the wrong. So be patient.

TOOLKIT FOR TALKING TO DOCTORS

Honesty is of course best. Be specific when talking to your doctors. Their job is to help you, and the more information you can give them, the better. The doctors will probably want to do a gynaecological examination. Relax as much as possible, if you can. If you are not, let the doctor know. If you know you experience pain, some gynaecologists recommend taking mild painkillers or using analgesic cream around the vulva before having an examination. Ask your doctor if this is a good idea for you. Read Breathing, Seeing the Doctor

TREATMENT

There is no single cure for vaginismus. Be patient when it comes to finding what works for you. Make sure to talk to your health professional before making any changes or trying any treatments.

FIND A LEAD TO START THE CONVERSATION

Sometimes even little changes can give a good start.

Change of birth control methods. Sometimes going off the pill or switching to a different kind of birth control can ease pain and thereby vaginismus.
Muscle work. Do you have taut muscles or a habit of holding on to your muscles? Learn to relax, practice stretching, and reflect on why you tense your muscles unnecessarily. Read Care of muscles, Care of Pelvic Muscles, Breathing
Reflect: What is your immediate reaction when you think about having sex? Could there be something in your life that may have started this? Could that be a place to begin understanding and working with your vaginismus? It might not be so. We invite you to consider.

CHANGING HOW YOUR MUSCLES REACT

Your muscles and nerves respond to protect you. They reckon there are danger and a possibility of pain. The body considers it to be its most important job to protect you. Your post is to convince your body that you are safe. You might be able to change how and what your muscles react to. See if you can cognitively reframe your reaction to penetration.

One approach is the one psychologist use in case of phobias. A phobia can be fear of spiders. The cognitive treatment toward that would be to examine why you hold this fear:

What are your ground beliefs?
What have you accepted holding you on to the fear?
Are there issues that keep you alert?

Having a phobia, you must slowly and with guidance be exposed to whatever makes you afraid. Maybe a mindful approach can help you hold on to the present and not being thrown over by fear. Maybe breathing exercises can help. (Breathing)

If you work with vaginismus and not spiders, see if you can change your approach to penetration. You will have to reprogram muscles and nerves to accept that touch is fine and not dangerous. Read more Manage

THINGS TO REMEMBER

Believing in your treatment and efforts is key to your improvement. You need to have a healthcare provider that you trust and with whom you feel comfortable. When coping with vaginismus, you have to work with both your mind and body. You probably need both a physical and psychological approach.

Working with your nerves and muscles is a great way to create tangible results, and mentally treating yourself is very important.

If you find that repressed memories, trauma, or another psychological issue are playing a role in your vaginismus, it could be beneficial to talk to a psychologist. Leaving your mental problems hidden and unsolved will be a barrier on your road to curing your sexual pain.

Treating vaginismus is a roller coaster ride. You will have good days and bad days, but the most important part is that you do not give up. It could take weeks or years to cure. Patience and dedication are essential. Vaginismus is curable, but it will not disappear on its own. Commit to treating it and accept the ups and downs along the way.