Unaware of the causes, many women simply assume that discomfort and pain is a part of sexual intercourse, which is not always true. For some women, the vaginal muscles involuntarily or persistently contract when they attempt vaginal penetration. Not only during penetrations, this can happen when a woman is touched near the vaginal area. The spasm and tightening of your pelvic floor muscles can prevent sexual intercourse or make it very painful. This is called vaginismus, which is a female sexual disorder.

Sexual dysfunction can occur in both males and females and can usually be treated. It’s not your fault, and it’s nothing to be ashamed of. Nevertheless, these disorders can interfere with your relationships and your quality of life.

What is Vaginismus?

Vaginismus is a spasm of the muscles surrounding the vagina that occurs against your will. The spasms makes the vagina very narrow and can prevent sexual activity and medical exams. Vaginismus doesn’t interfere with sexual arousal, but it can prevent penetration. Not just intercourse, even inserting a menstrual cup feels exasperating. A gentle pelvic exam typically shows no cause of the contractions. No known physical abnormalities contribute to the condition.

Vaginismus Causes

While the exact cause of vaginismus is unknown, it is believed to be primarily a psychological condition. It’s usually linked to anxiety or fear of having sex. But it’s not always clear which came first, the vaginismus or the anxiety.

Some women have vaginismus in all situations and with any object. Others have it only in certain cases, like with one partner but not others. Or they might have it with sexual intercourse but not with tampons or during medical exams.

Doctors cite several possible causes of vaginismus including past sexual trauma or abuse, mental health factors and a response that develops due to physical pain. In various cases of vaginismus, there’s a disconnect between the brain and body. The taboo around sex is implanted from a young age, so even when you actively want to have sex, your conditioning drives your body and doesn’t allow it.

Other health problems like vaginal infections and dryness can also cause painful intercourse. It’s important to see a doctor to find out what’s causing it.

Types of Vaginismus

Vaginismus is classified into two types:

Primary Vaginismus:  This is when a woman has had pain every time something entered their vagina, including a penis (called penetrative sex), or when they’re never been able to insert anything into their vagina. It’s also called lifelong vaginismus.
Secondary Vaginismus: This is when a woman has had penetrative sex without pain before, but then it becomes difficult or impossible. It’s also called acquired vaginismus. It can happen due to factors such as gynecologic surgery, trauma, or radiation.
Some women develop vaginismus after menopause. When estrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful, stressful, or impossible. This can lead to vaginismus in some women.

Dyspareunia

Dyspareunia is the medical term for painful sexual intercourse. It’s often confused with vaginismus. However, dyspareunia could be due to:

• cysts
• pelvic inflammatory disease
• vaginal atrophy [Source: Healthline]

Vaginismus Symptoms

Involuntary tightening of the vaginal muscles is the primary symptom of vaginismus, but the severity of the condition varies between women. In all cases, constriction of the vagina makes penetration difficult or impossible.

However, some physicians have narrated painful sex (dyspareunia) as the first sign of vaginismus. The pain happens only with penetration. It usually goes away after withdrawal, but not always.

Some women describe it as a burning or a feeling like the penis is “hitting a wall.” Many women who have vaginismus also feel discomfort when inserting a tampon or having a pelvic exam at their doctor’s office.

Other symptoms of vaginismus include:

• Not being able to have penetrative sex or insert a tampon at all
• Fear of pain or sex
• Loss of sexual desire

These symptoms are involuntary, meaning a woman can’t control them without treatment.

Vaginismus Treatment

Pelvic floor exercises can solve your problem. Pelvic muscles should be contracted, held for 5-10 seconds, and then released. Repeat after a short rest (3-5 seconds). You will have more control over your pelvic floor by strengthening it through exercises.

Women with vaginismus can do exercises at home to learn to control and relax the muscles around their vagina. This is called progressive desensitization, and the idea is to get comfortable with insertion.

First, do Kegel exercises by squeezing the same muscles you use to stop the flow when you’re peeing:

• Squeeze the muscles.
• Hold them for 2 to 10 seconds.
• Relax the muscles.

Do about 20 Kegels at a time. You can do them as many times a day as you want to.

After a few days, insert one finger, up to about the first knuckle joint, inside your vagina while doing the exercises. You might want to clip your fingernails first and use a lubricating jelly. Or do the exercises in a bathtub, where water is a natural lubricant.

Start with one finger and work your way up to three. You’ll feel your vagina’s muscles clenching around your finger, and you can always take your finger out if you’re not comfortable.

After a while, you’ll be able to put cone-shaped inserts into your vagina for 10 or 15 minutes to help your muscles get used to pressure.

For women whose vaginismus is linked to fear or anxiety, therapy often helps. [Source: WebMD]

Therapy and Counseling

Education typically involves learning about your anatomy and what happens during sexual arousal and intercourse. You’ll get information about the muscles involved in vaginismus, too. This can help you understand how the parts of the body work and how your body is responding.

Counseling may involve you alone or with your partner. Working with a counselor who specializes in sexual disorders may be helpful. Relaxation techniques and hypnosis may also promote relaxation and help you feel more comfortable with intercourse.

Over time, using vaginal trainers or tube-like devices can relax and strengthen the muscles while also reducing the fear associated with sexual penetration. If you have a hard time using dilators on your own, obtain a referral to a physical therapist who specializes in the pelvic floor. They can help you:

• learn more on how to use dilators
• learn about deep relaxation techniques

Indulge into non-penetrative sexual experiences

If you have vaginismus, it doesn’t mean that you’ll stop enjoying sexual activities altogether. Sex is more than just penetration. Women who have the condition can still feel and crave sexual pleasure and have orgasms. Many sexual activities like massage and masturbation don’t involve penetration. Be intimate with each other before getting things steamy. Explore each other’s body, and if you’re comfortable, consider oral stimulation or even oral sex. If you do chose to try penetration, make sure you have enough of lube and consent.

Living with vaginismus

Sexual dysfunction can take a toll on relationships. Being proactive and getting treatment can be crucial in saving a marriage or relationship. It’s important to remember that there’s nothing to be ashamed of. Talking with your partner about your feelings and fears about intercourse may help you feel more relaxed.

Your doctor or therapist can provide you with ways to overcome vaginismus. Many people recover and go on to live happy sexual lives. Scheduling treatment sessions with a sex therapist may be beneficial. Using lubrication or certain sexual positions can help make sexual intercourse more comfortable. Experiment and find out what works for you and your partner.

Courtesy: WebMD & Healthline