What Is Vaginismus and How Does It Affect Your Sex Life?

Consensual sex can be one of the most exciting and intimate moments to share with a partner. For some, however, just the thought of having penetrative sex can cause them to become anxious and tense up before penetration happens.

These feelings may ease with foreplay and reassurance from their partner. However, some people cannot reach the point of relaxation, and their body tenses up, preventing penetration.

Defining vaginismus

The sexual health condition known as vaginismus is the body's automatic reaction to the fear of any vaginal penetration. When penetration is attempted, the vaginal muscles tighten up, preventing the insertion of any body parts or sex toys. Vaginismus doesn't always occur during the first attempt at penetration. An individual can have sex several times before experiencing vaginismus.

In addition, vaginismus is not only a sexual health problem. The condition may arise when inserting a tampon into the vagina or during a gynecologic examination.

Vaginismus falls into other conditions that can impact sexual function, such as vaginal atrophy, dyspareunia, and vulvar vestibulitis.

Risk factors for vaginismus

Vaginismus can arise based on different reasons that vary by each patient's case. Some of the physical or psychological risk factors that can lead to vaginismus are:

• Trauma during childbirth.
• Health conditions like endometriosis or pelvic inflammatory diseases.
• Sexual violence, such as rape or other abuse.
• Unpleasant or uncomfortable sexual intercourse.
• Fear of pain or penetration.
• Fear of pregnancy.
• Previous painful examination.

Mental trauma is often a cause of vaginismus. For example, patients may have experienced trauma in their past, which makes them negatively associate penetration with a traumatic experience. For these scenarios, any treatment for vaginismus should be paired with counseling or therapy to help patients address their psychological challenges.

How is vaginismus diagnosed?

The process of diagnosing vaginismus is facilitated by a consultation with a healthcare professional, such as a gynecologist. During an appointment, patients can expect to answer questions related to their medical and sexual history and undergo a pelvic exam.

A pelvic exam can help determine if vaginal muscle spasms are the issue. To comfort the patient during the exam, the physician may apply numbing cream to the outside of the vagina, which can help with the pain.

Vaginismus treatment

While no measures exist to prevent vaginismus, the health condition can be managed. Once vaginismus is officially diagnosed, the physician will recommend the best treatment options to manage the condition. Treatment options for the condition vary by each patient's needs but often involve medical creams or therapy.

Here are the most common treatment methods for vaginismus:

Topical creams. Lidocaine is a type of local anesthetic offered to patients with vaginismus. The medicine acts as numbing cream, blocking signals of nerve endings in the skin. Lidocaine is often combined with lubricants to reduce pain and discomfort for patients during sex.

Pelvic floor physical therapy (PFPT). Involves physical training of a patient's pelvic floor. PFPT is facilitated by a trained physical therapist and is often the first line of treatment for strengthening, relaxing, and coordinating the pelvic muscles of a vaginismus patient.

Vaginal dilator therapy. A vaginal dilator, also known as an insert, is a cylinder-shaped device with a rounded tip. The device is inserted into the vagina to help open and stretch the tissue. This method, which can last around 10 minutes, can train the vagina to become comfortable with penetration. Lubricant can be applied to the vagina and the dilator before insertion to make the process more comfortable.

Cognitive behavioral therapy (CBT). Cognitive behavioral therapy is a psychological approach to treating vaginismus. Considered to be a long-term treatment method for the health condition, a typical therapy session can involve a therapist addressing a patient's mental concerns around sex. A 2017 study revealed that CBT could help women reduce depression and anxiety symptoms associated with vaginismus and improve their relationships with their partners.

Sex therapy. Sex therapy can help patients overcome the issues surrounding vaginismus that affect their mental and physical health and their sexual relationships too. During a therapy session, which a sex therapist facilitates, couples can discuss how vaginismus impacts their sex life and find resolutions to keep both parties satisfied.

Sensate focus. This type of therapy provides vaginismus patients with touching exercises to keep them relaxed during sex. In addition, sensate focus therapy can increase a person's sex drive, which lessens feelings of fear and other negative thoughts during sexual intercourse.

If you believe you may be experiencing vaginismus, consult your healthcare physician to obtain a diagnosis and begin treatment to help improve your confidence around sex and other forms of penetration.