Vaginismus: Why some women hate sex
For such women, sex is hardly pleasurable and only brings the anticipation of pain with it. But there is good news for women with vaginismus when it comes to treatment. Read about this condition that affects many women around the world.
If you feel mild or severe discomfort during sex, or if you experience an inability to have sexual intercourse, then you could possibly have a condition known as vaginismus.
In this article we'll tell you everything you need to know about vaginismus, including what you can do to alleviate its symptoms.
What is vaginismus?
Vaginismus, according to Singapore-based Clinical Sexologist Dr. Martha Lee, is the condition a woman experiences as a result of the involuntarily tightening of her vaginal walls when something enters her — like a penis, a tampon or during a pelvic exam by a doctor.
For many women, this condition comes as a surprise, usually when they attempt sexual intercourse. The pain a woman experiences comes from the tightening of the muscles around the vagina. And this happens without the woman's knowledge or conscious control.
According to experts in sexual health, "the vaginal tightness results from the involuntary tightening of the pelvic floor, especially the pubococcygeus (PC) muscle group, although the woman may not be aware that this is the cause of her penetration or pain difficulties."
Depending on the level of discomfort she experiences when this happens, a woman with vaginismus may find sex extremely uncomfortable, painful, or even impossible.
The pain experienced by women with vaginismus has been described by some as a tearing or burning sensation, or a "feeling like the man is 'hitting a wall.'"
In Singapore, the Ministry of Health does not track the number of vaginismus cases. However, according to a New Paper article, researchers said they see 20 to 30 such cases a year.
This condition is known to be the main cause of sexless marriages. It is also a common cause of ongoing pain during sexual intercourse. If not treated appropriately, vaginismus may cause problems in a marriage, even leading to separation and/or divorce.
A woman with vaginismus may experience the following symptoms, say experts:
- A feeling of burning or stinging with tightness during sex
- Pain during penetration, difficult or impossible penetration, uncomfortable insertion of penis
- A sexless marriage
- Difficulty inserting tampons or discomfort while getting a pelvic examination by a doctor
- Continuing sexual pain with no obvious reason for it
- Inability to breathe during sexual intercourse and spasms in other body muscle groups (legs, lower back, etc.)
- Ongoing sexual pain and discomfort after giving birth
- No interest in sex due to pain
- Avoidance of sex due to pain
Causes of vaginismus
A combination of physical and/or non-physical reasons may be behind vaginismus. Either way, these reasons cause the woman with vaginismus to anticipate pain at a sub-conscious level. So this, in turn causes her pelvic floor muscles to spasm and tighten, making sex difficult or impossible.
According to sexual health experts, "with attempts at sex, any resulting discomfort further reinforces the reflex response so that it intensifies more. The body experiences increased pain and reacts by bracing more on an ongoing basis, further entrenching this response and creating a vaginismus cycle of pain."
Dr. Martha Lee identifies the psychological and physical causes of vaginismus:
Almost 90% of women with vaginismus experience one or more of the following issues:
- Fear of pregnancy
- Anticipating sex as a painful act
- Intercourse-related performance anxiety
- Past experience of traumatic sexual experiences, including childhood memories of sexual abuse
- Poor emotional attachment with partner
- Poor sexual knowledge
The remaining 10% of women with vaginismus may experience one of more of these physical issues:
- Infections related to their reproductive system
- Complicated C-section; difficult vaginal birth
- Physical or sexual abuse, rape and/or harassment
- Vaginal dryness resulting from hormonal issues
- Poor vaginal lubrication due to menopause
- Pelvic pain from previous surgery or trauma
Experts point out that vaginismus triggers can be as basic as not having enough foreplay before sex, or simply general anxiety. Because of this, it's important to keep in mind that vaginismus is not a woman's fault.
"Once triggered, the involuntary muscle tightness occurs without conscious direction; the woman has not intentionally 'caused' or directed her body to tighten and cannot simply make it stop."
The good news is that vaginismus is considered by sexual health professionals to be highly treatable. In fact, studies have shown treatment success rates to be almost 100%.
The treatment process doesn't involve drugs and can mostly be done in the privacy of your own home. Dr. Martha Lee describes common methods of treatment she uses in her program to help women with vaginismus overcome the condition:
This method helps women suffering from vaginismus express their fears and emotions. They also discuss any relationship issues with their partners.
Dr. Lee explains, "psychotherapy is considered the most important part of the program as it helps both the therapist and client fully understand the most probable cause of the problem."
Different relaxation exercises are used to help the woman feel calm. And this allows her to release any emotions that might be holding her back from having sex with her partner.
Women are taught about their sexual anatomy, helping them understand what happens internally with vaginismus.
"The therapist explains how the different areas of the vaginal and pelvic floor muscles may cause pain and penile penetration difficulties," explains Dr. Lee.
Insertion and penetration exercises
Here, the therapist teaches women with vaginismus various techniques to help relax the pelvic floor muscles. "These techniques help women have full control over their sexual anatomy, thereby preventing involuntary tightness and allowing pain-free insertion and full penetration."
Also, pelvic floor muscles are gradually desensitised using vaginal dilators. These help to "reduce the reflexes that may trigger the muscles to tighten and cause painful sensations."
Readiness exercises for couples
According to Dr. Martha Lee, in order to successfully resolve vaginismus, the woman experiencing it needs to work closely with her partner. A sex therapist can assist with this, helping partners to strengthen their bonds of intimacy, trust and cooperation.
The couple will also be taught different exercises and techniques that are specially designed to "relieve the involuntary tightening of the pelvic floor muscles and have pain-free penetration during intercourse."
Where to get treatment in Singapore
If you think you may be suffering from vaginismus, first consult your gynecologist, who can determine if you have the condition or not.
If you are diagnosed with vaginismus, your gynecologist can either work on a treatment plan with you, or refer you to a sex therapist or other qualified health professional.
You may reach out to Dr. Martha Lee of Eros Coaching by following this link.
Other options include:
- Health & Fertility Centre for Women
- KK Women's and Children's Hospital (Sexual Health Clinic)
- O & G Partners Clinic for Women
- Peter Chew Clinic for Women
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