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What is vaginismus?

Vaginismus means pain on attempting vaginal penetration. It is the most important cause of female sexual dysfunction. Vaginismus is characterized by involuntary spasm or contractions of the muscles in the pelvis and around the vagina when penetration is attempted.Therefore, these women are unable to have sexual intercourse.

Why is vaginismus important?

Vaginismus can lead to considerable interpersonal distress and interference with marital relationships and cause infertility. It is not uncommon for these women to have considerable anxiety and distress.

How common is vaginismus?

It is not uncommon to see patients with vaginismus, especially in a fertility clinic. It occurs in 5 % - 17% of women. This is a condition where couples often reluctant and postpone meeting a specialist due to embarrassment or fear.

How severe can vaginismus be?

The severity can vary from one woman to another. Some women manifest vaginal contractions resulting in difficulty in intercourse alone while others may have severe additional reactions like palpitations, shivering, sweating, hyperventilation, fainting etc.

When can vaginismus occur?

Vaginismus can be primary or secondary. Primary vaginismus occurs for the first time during attempted intercourse, tampon insertion or a gynecological examination. Secondary vaginismus occurs in women who have had normal intercourse earlier.

What are the causes of vaginismus? 

The exact cause of vaginismus is not clear. It could be dueto

·     Fear of intercourse

·     Religious/cultural beliefs which may make one assume that sex is shameful or wrong.

·     Association of intercourse with pain

·     Previous sexual assault

·     Previous painful vaginal examination

·     Fear of sexually transmitted infections.

·     Presence of thrush (simple fungal vaginal infection) or a skin infection leading to pain may trigger vaginismus.

‍How is vaginismus treated?

Vaginismus is often a distressing condition for any couple, especially those wanting a pregnancy. Vaginismus needs treatment so it is important to seek help from a specialist.

There are different interventions proposed depending on the severity of the condition.

The success of any treatment modality will depend on the interest and determination of the female partner to improve.

·     Treatment of local infections like candidiasis/boils etc.

·     Lubricant/local anaesthetic gels

These may be applied liberally before intercourse to ease penetration and help with associated pain. In minor degrees of vaginismus, this may be all that is needed.

·     Vaginal dilators

These can be purchased online. Dilators are smooth tube-shaped devices which are available in small to large sizes. Their purpose is to produce gradual stretching of the vagina. They are to be introduced into the vagina regularly to help overcome fear and inhibition associated with vaginismus. It is advisable to use a lubricant to ease insertion. With patience and proper usage, dilators can produce a remarkable improvement in treating vaginismus. Regular usage is followed by attempting natural intercourse whenever ready.

·     Reassurance

Women who suffer from vaginismus often need plenty of reassurance, counselling and support. It is important to dispel any fears they may have regarding vaginal capacity, sexually transmitted infections, negative feelings about sex etc.

·     Relaxation with breathing techniques and pelvic floor relaxing exercises may help improve pelvic muscle relaxation.

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