What is vaginismus?
Vaginismus, or difficulties experiencing vaginal penetration, is a frustrating and distressing women's sexual health problem. Vaginismus affects a woman's enjoyment of sexuality, her quality of life, her relationships, and her gynecological health care.
Vaginismus is defined as a protective tensing of the musculature of the vaginal entrance that makes vaginal penetration during sex, with a tampon, and/or during gynecological examinations painful or impossible. Women with vaginismus typically fear the pain they associate with vaginal entry and they experience a significant degree of anxiety associated with the prospect of vaginal insertion. Some women expressly wish to engage in intercourse and are very motivated to resolve the problem, while others feel more ambivalent towards intercourse. Many women are able to enjoy other sexual activities if they know intercourse will not be attempted. However, some women do not enjoy any aspect of sexual touching.
What causes vaginismus?
Reliable prevalence rates for vaginismus do not exist, but health care providers recognize the problem as more frequent than previously assumed. The causes of vaginismus have received some research attention recently, but more research is clearly necessary to understand why some women develop vaginismus. Some of the causes that have been associated with the development of vaginismus are:
- pain with attempted intercourse
- negative experiences with vaginal insertion (e.g., invasive or insensitive medical exams, sexual abuse)
- lack of knowledge or uncertainty about sexuality
- strong negative thoughts about sex (disgust, fear of genital incompatibility)
How is vaginismus treated?
Treatment for vaginismus has traditionally focused on progressive desensitization to vaginal penetration. While some studies report very good outcome, a recent, carefully conducted treatment outcome study resulted in very conservative results with only 1/3 of the women having resolved their vaginismus following treatment. Innovative new approaches are very promising however. For example, working with a psychologist or sex therapist while also consulting with a pelvic floor physical therapist can improve treatment outcome considerably. Likewise, recent studies carried out in the Netherlands indicate that treating vaginismus like a specific phobia (much like phobias of spiders, etc.) with exposure therapy had significant benefits for the majority of women. Referrals of health care professionals treating sexual pain problems.