Vaginismus: causes, symptoms and possible solutions

A sexual behavior disorder that usually has psychological causes.

Human sexuality has been throughout history a taboo subject for society, being socially censored and its expression repressed.

The repression of libido and ignorance regarding the process and the different phases of sexual response has led to the appearance and non-treatment of various problems that have prevented the full enjoyment of desire and libidinal relationships. One of these problems is the disorder known as vaginismus..

Vaginismus: a sexual dysfunction

Vaginismus is a female sexual dysfunction.This type of dysfunction is a group of disorders produced by an alteration of the processes involved in the human sexual response or the presence of painful sensations during the act.

This type of disorder can be acquired from a specific moment in life or be present throughout life, and its causes can be psychological or a combination of organic and psychic variables. Moreover, they can occur both at a general level and in the presence of specific circumstances.

Main symptoms

The main symptom of this disorder is the presence of persistent and recurrent involuntary contractions of the vaginal musculature, especially of the pubic muscle, in a persistent and recurrent manner over time.and especially of the pubococcygeus muscle, which contracts and closes the entrance to the vagina.

In this way the entrance to the vagina is not accessible, which may prevent or simply hinder (because what is prevented is penetration) the performance of sexual practices. In addition to the maintenance of sexual intercourse, vaginismus can even affect the medical level, making gynecological examination very difficult.

The severity of vaginismus can be very variable, ranging from a mild contraction that may not cause great difficulties to produce generalized spasms and make completely impossible the insertion of any element into the vagina. Depending on the case, even the thought of inserting an object or being penetrated can provoke the muscular contraction characteristic of vaginismus. Attempting penetration in this state causes profound pain.

The fact of suffering from vaginismus does not imply that the woman who suffers from it does not get excited or enjoy the idea of having intercourse, it is not uncommon in cases where the woman in question has a sufficient level of excitement and is enjoying the sexual interaction. Thus, penetration is prevented, but other activities of a sexual nature are still viable.

Vaginismus tends to be chronic unless treated, and over time can lead to a real aversion to sex and the patient's avoidance of intimacy and the possibility of intercourse.

Possible causes of vaginismus

Vaginismus is a sexual dysfunction that can have different causes. In some cases it may be due to a medical condition, such as infection, surgery or in some cases even during menopause.

However, it is much more much more frequently, however, its origin is due to psychological and psychosocial circumstances, usually linked to experiences of sexual dysfunction.It is generally linked to experiences of fear and guilt.

1. Repressive education

The fact of having received a rigid and restrictive upbringing in relation to sexuality influences the influences the appearance of ideas of guilt, doubt and fear before the realization of the sexual act, which can provoke the contraction of the vaginal muscles.

2. Traumatic experiences

It is not uncommon for women with vaginismus to have undergone severe traumatic experiences related to sexuality.. People who during their childhood have suffered sexual abuse or seen it being committed, people coming from families with situations of gender violence or domestic violence or women who throughout their lives have suffered rape are more likely to suffer sexual dysfunctions such as vaginismus due to fear, pain and anxiety linked to the traumatic experience and associated with the performance of the sexual act.

3. Anxiety, guilt and self-doubt

As with erectile disorders in men, fear, guilt and anxiety in the face of sexual intercourse can also be a problem, fear, guilt and anxiety about the possibility of not being able to perform the act can lead to somatic symptoms of vaginitis. the symptoms of vaginismus.

Treatments and possible solutions

Vaginismus can be treated with a variety of therapies.. Some women consult with the idea of having surgery, but this method is not very useful unless the causes are organic, since it does not treat the problem itself and its underlying causes and in some cases may even worsen the situation.

Instead, the following treatments are often used, usually in combination.

1. Sex education

Taking into account that in many cases of vaginismus, the people who suffer from it have lived traumatic experiences or have had a very repressive education with female sexuality, psychoeducation and explanation of the processes considered normal within sexual relations is a useful tool to take into account and apply. to take into account and apply. Understanding and explaining their situation and the treatments to be applied can also be a great relief for women with this problem.

2. Stimulus exposure techniques

One of the problems that causes and maintains the disorder, as in most of the other sexual dysfunctions, is anxiety, fear and insecurity caused by the occurrence of a feared phenomenon, as in this case is penetration.as in this case is the penetration or the entrance of something inside the vagina. The most effective way to overcome this anxiety is the systematic exposure to the feared situation. This exposure must be done gradually, using techniques such as systematic desensitization. The objective is to recognize and overcome the fear step by step, until the performance of the act is neither aversive nor anxiogenic.

As we have said, the process must be gradual, starting with visual self-observation and continuing with the tactile exploration of the genital area, then the use of dilators, the spouse's hands and so on until the sexual act is performed.

3. Muscle training

One of the most common treatments for vaginismus is the following the realization of techniques of control of the pelvic muscles, learning to contract and relax them, increasing muscle tone and control of the pelvic muscles.This will increase muscle tone and control of the pelvic area. In this way the patient can also have a greater sense of control and undertake sexual activity with greater security.

Training the pubococcygeus muscle in Kegel exercises is usually the most common procedure.

4. Use of vaginal dilators

Another mechanism for coping with vaginismus is the use of vaginal dilators.. The use of these instruments, applied in a graduated manner, allows to decrease the fear and anxiety before penetration, while strengthening the pelvic muscles.

5. Involving the partner

Vaginismus is a disorder that can be a real source of psychological and physical suffering for those who suffer from it, limiting intimacy with the partner and ultimately the woman's self-esteem and self-concept. It is for this reason that is necessary that the person with whom the relationship is maintained, if it is an established partnerIf it is an established couple, be aware of the problem and receive some kind of advice on how to cope with the situation and help their loved one.

Bibliographical references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.

• Hawton, K. & Catalan, J. (1990). Sex therapy for vaginismus: characteristics of couples and treatment outcome. Sexual and Marital Therapy, 5, 39-48

• Labrador, F.J. (1994). Disfunciones sex uales. Madrid: Fundación Universidad Empresa

• Masters, W.H. y Johnson, V.E. (1970). Human sexual inadecuacy. Boston: Little Brown (Versión española: Intermédica, Madrid, 1976).

• Rosen, R.C. y Leiblum, S.R. (1995). Treatment of Sexual Disorders in the 1990s: An Integrated Approach. Journal of Consulting and Clinical Psychology, 63, 877-890.