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Vaginismus – Overview

January 30, 2021


“Vaginismus is an involuntary contraction of the pelvic floor. So there’s usually some inciting event, but very often we don’t know what cause the vaginismus to start. So it can be a really bad bladder infection or really bad yeast infection. It can be childbirth, it could be, but not always, but it could be sexual trauma. And whatever causes the initial pain, the body then starts to register that when there is touching or penetration of the vagina, the body will set up a defense and it’s actually a reflex. So just like as if I was going to poke you in the eye, your pelvic floor, tightens and contracts as a defense to prevent any penetration or any pain in the pelvic area. Often vaginismus occurs a long time from the inciting event. So we don’t necessarily know what causes it, although we can usually look back and figure that out, not always.

And so once that reflex is set up, sometimes the woman doesn’t actually know that she’s contracting the pelvic floor and yet the spasming and contraction in the muscles around the vagina, around the anus and in the pelvic floor can be very painful or uncomfortable. And this can lead to a friction or a burning sensation during intercourse, or it can sometimes lead to an inability to have penal vaginal penetration, because the muscles are so tight. And the defense mechanism that’s been set up is ensuring that nothing can fit in the vagina. In fact, some women will have trouble with insertion of tampons or even using sexual toys or vibrators. Now, what is the treatment for vaginismus? Now, because vaginismus has become involuntary, and it’s a spasming of the pelvic floor. It takes sometimes an awareness of what is happening in the pelvic floor to be able to stop that reflex from happening. But curing vaginismus or vaginismus cure involves being treated, being assessed, understanding what is going on in the pelvic floor and for women to understand that this is not in their mind, that this is a real spasm or contraction in the pelvic floor and undergoing multiple stages of treatment to ensure that the pelvic floor muscles come under voluntary control again, and that can be multifaceted treatment.

It can involve exercises like Kegel exercises, where the woman tightens and relaxes the pelvic floor. It can involve gentle insertion of a finger or a tiny, small dilators into the vagina with contraction relaxation, so that the woman starts to understand when the pelvic floor is tight or constricted, and when it’s relaxed, so that ultimately she can learn to voluntarily relax those muscles when she needs to, or when she wants to have comfortable sexual intercourse.”

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