What is vaginismus?
Vaginismus denotes a sexual disorder consisting in the involuntary spasm of the vaginal muscles, which hinders penetration: the woman with vaginismus finds it difficult to "accept" the sexual act, despite the desire to do so.
More precisely, the actual pain upon penetration is perfectly expressed by dyspareunia, which differs from vaginismus since, in the latter case, the fear of pain is often unfounded and only reflects phobias anticipating the sexual act.
Incidence
It is estimated that vaginismus affects 1-2% of women of childbearing age: the percentage increases (15-17%) if the "incidence index" focuses only on women who undergo frequent clinical checks and who spontaneously declare disorder.
Unfortunately, however, it is not possible to accurately assess how many women actually have vaginismus, since, probably, women who do have it are ashamed to even talk about it with their doctor.
Symptoms
Vaginismus is a disease and, precisely for this reason, it should not be underestimated: we have seen that the phobia of sex and the spasm of the muscles of the vagina are the two main characteristics that characterize vaginismus. Therefore, to evaluate the severity of the disorder. , we must focus both on the intensity of the phobia (measured on an ideal scale of values: mild, moderate, severe), and on the intensity of the spasm. To give an example, we talk about low degree of severity of the spasm when it disappears with simple verbal reassurance: in this case, penetration is generally possible. The next stage is characterized by a spasm that lasts over time, often characterized by a moderate pain during intercourse (dyspareunia). In the stages of higher gravity, penetration is very difficult, since the spasm is so tight that it prevents coitus; tant "it is true that in the last level, the most serious, the woman also refuses the sight of it.
Based on the intertwined evaluation of these parameters, it is possible to delineate the severity of vaginismus.
Aftermath
It is understandable that the refusal of the sexual act by the woman, caused by vaginismus, can also have consequences for the partner. The man feels unsuitable, frustrated and unable to satisfy the desires of his woman: the erectile maintenance deficit certainly represents the more immediate effect, which in the long run could reflect on infertility. In fact, it is no coincidence that in a percentage varying from 5 to 7% of (improperly) “sterile” couples there is a lack of sexual intercourse.
Vaginismus causes a progressive (but inevitable) loss of sexual desire, associated with an "inability of sexual arousal with the partner: the erotic intimacy disappears and the partner, unmotivated, dissatisfied and depressed, does not feel" at "height. If the woman affected by vaginismus is defined as "the one who induces the symptom", the "man is" the one who brings the symptom ", since the unfounded feeling of guilt causes him sexual dysfunctions such as erectile deficits, inability to maintain an erection, loss of desire and premature ejaculation.
Vaginismus assumes the distinction of being the most frequent cause of unconsummated marriage.
Causes
Vaginismus is a rather complex condition, since the causes that cause it are often hidden and difficult to discover. The multimodal approach to vaginismus is essential for the treatment of the disease, in order not only to eliminate the woman's phobia and the related psychosomatic factors, but also to resolve the muscle spasm that occurs at the moment of penetration.
The triggering factors, as can be guessed, have a psychological and physical nature.
Let's start by analyzing the psychological factors that affect vaginismus:
- The sexual act is associated with a negative factor, "something dirty" that must be avoided: this thought affects most women with vaginismus, especially young women who are not yet acquainted with sexual maturity;
- Many women who have been subjected to sexual abuse / violence interpret sex as danger and pain, sensations that perfectly reflect vaginismus: this condition is understandable following a harassment, but psychiatric sessions can solve the problem, in a relatively short time;
- Even excessive attachment to parents could affect vaginismus, consequently the refusal of sex for fear of being judged;
- The fear (or, better said, the terror) of getting pregnant and that “something goes wrong” could lead the woman to the progressive refusal of sex;
- Vaginismus could be linked to other phobias of a neurobiological nature (agoraphobia, claustrophobia, etc.), stress and anxiety: it is a "hyperactivity of the emotion of fundamental command of anxiety / fear, which is reflected in the fear of penetration [Special female medical sexology, Jannini E.A. Lenzi A. Maggi M.].
If the psychological factors have been the subject of in-depth studies and research by scholars, the physical factors that trigger vaginismus are still covered by an aura of uncertainty: often, the two categories of causal factors (psychological and physical, for the " precisely) overlap and one can be a consequence of the other. It has been estimated that only 1% of women with vaginismus suffer from this disorder since the beginning of the first approaches to sex: a very rigid hymen and fibrous could be difficult to penetrate and create pain during intercourse. When the attempts of penetration are in vain because they are particularly painful for the woman, then the structure of the hymen could be a first causal factor that predisposes to vaginismus.
Pain during intercourse could, however, be induced by surgery or trauma; also the terrible practice of "infibulation, still performed by many African populations, could generate scarring in the female genital system and cause pain during penetration: in this case, the physical factor (the closure of the vagina at the height of the middle of the labia majora, with possible removal of the clitoris ) associated with psychological disorders (pain, fears) could act synergistically and trigger vaginismus.
Still, some serious pathologies, such as Mullerian vaginal agenesis, could contribute to the formation of vaginismus: it is a malformation that involves the lack of the vagina or part of it, typical of Rokitansky syndrome.
Causes of vaginismus: psychological and physical factors
Psychological causal factors
- The sexual act is associated with a negative factor, "something dirty" that must be avoided
- sexual abuse / violence
- excessive attachment to parents
- other phobias of a neurobiological nature
- terror of getting pregnant
- rejection of sex for fear of being judged
Physical causal factors
- The very stiff, fibrous hymen may be difficult to penetrate and create pain during intercourse
- surgery or trauma
- infibulation
- serious pathologies, such as Mullerian vaginal agenesis
Diagnosis and therapies
Obviously, the advice to change husbands does not reflect the best solution for resolving vaginismus; women who go to the doctor to complain of the disorder are often underestimated, as many specialists cannot immediately diagnose vaginismus. The specialist must pick up the signals sent by the woman, focusing on the degree of phobia, the severity of the situation and the hypertonus of the anal levator muscles located around the vagina, which hinder penetration. The doctor, therefore, must evaluate the prognosis not only of the single subject (woman), but of the couple, since the problem affects both partners.
The most popular therapies concern psycho-sexological treatments, but there is also no lack of endocrinological and urological analyzes.
In some cases, vaginismus could be "resolved" surgically: among the surgeries we remember the "episiotomy (or perineotomy), which consists of an "incision with scissors in the thickness of the peritoneum (which coincides with the area between the rectum and the vagina). Often times, however, surgery turns out to be useless for vaginismus.
Read also: All Remedies for Vaginismus »
Conclusions
The healthy impetuosity and balanced aggression of sexual intercourse, an exquisitely natural and human act, should be fully experienced by both partners: the fears, anxieties and worries related to vaginismus have a negative impact on the intimacy of the couple, often ruining even the simple interpersonal relationships. It would be useful to consult a specialist, leaving aside the shame and embarrassment that could derive from "exposing one's phobias: the doctor must" be able to listen to the couple's problems, interpret them and recommend a therapy to fully experience the sexual life. The psychological approach is not always easy, but it is (perhaps) the only chance to resolve vaginismus and savor the couple's relationship without any kind of trouble.
Summary
I disturb
Vaginismus: sexual disorder caused by the involuntary spasm of the vaginal muscles, which hinders penetration
Incidence
About 15-17% of women who undergo frequent gynecological checks spontaneously declare the disorder; it is not possible to accurately assess how many women are actually affected
Symptoms of Vaginismus
Sex phobia, vaginal muscle spasm, pain (dyspareunia)
Aftermath
The consequences are also reflected in the partner, who feels frustrated and unable to satisfy the woman: this leads to erectile deficits, inability to maintain an erection, loss of desire and premature ejaculation.
Causes
Psychological (abuse, morbid attachment to parents, neurobiological phobias) and physical factors (infibulation, harassment, trauma, infections)
Diagnosis
The specialist must focus on the degree of phobia, the severity of the situation and the hypertonicity of the anal levator muscles that surround the vagina and hinder penetration. Endocrinological and urological analyzes are also useful for diagnosing vaginismus.
Therapy
Psycho-sexological treatments are the most recommended therapy by specialists to resolve vaginismus. Surgery is not recommended
