Vaginismus means that the muscles surrounding the lower part of your vagina have gone into spasm making penetrative intercourse uncomfortable, painful or impossible depending on the degree of spasm.
Vaginismus can either be present on the first ever attempt at vaginal penetration, or it can develop later, after some emotional or physical traumatic event, even when there has been successful intercourse in the past.
Psychological upset
most commonly vaginismus is a bodily reaction to a psycho-emotional upset. A first attempt at penetration proves painful, and fear that this will happen again leads to an automatic protective reflex. The vaginal muscles tighten to prevent a recurrence of the pain
Any condition causing pain in the vulva or vagina
these include vulval infections, chemical irritation or allergy, a painful scar such as an episiotomy after childbirth, vaginal atrophy (thinning and dryness) after radiation or the menopause, pelvic inflammatory disease, adhesions from pelvic surgery or endometriosis.
As with so many sexual problems, vaginismus is a condition concerning the mind and the body, and so a mind-body approach is needed in its management.
Treatment approaches available
Sexual therapy is often the most important element of treatment. This combines elements of physical and medical therapies.
If there are any underlying medical conditions which have triggered vaginismus then medical treatment may be relevant. These may include antibiotics, emollients, creams or even local anaeasthetic gels. Very occasionally Botox® has been used.
Physical therapy can involve pelvic floor muscle training, biofeedback or desensitization, which may include the use of vaginal trainers.
Sometimes a woman has an anxiety or fear that her vagina is too small, too fragile or too rigid to be able to accept a penis. Sometimes a friend or a relative has said that sex will be painful the first time and this leads to anticipation of pain. Discussing such fears or anxieties with a trained doctor or nurse can often help. Sometimes women are not aware on a conscious level that they have such fears or anxieties until they talk about it at therapy. Holistic treatment such as stress management or relaxation therapy may also help.
Should you wish further psychosexual support we would be more than happy to refer you to our specialised services within Sandyford.
A list of accredited and registered sexual and relationship therapists is available from the following organisations:
COSRT (College of Sexual and Relationship Therapists)
PO Box 13686, London SW20 9ZH
Tel. 020 8543 2707 info@cosrt.org.uk
IPM (Institute of Psychosexual Medicine)
Building 3, Chiswick Park, 566 Chiswick High Road, London W4 5YA
Tel. 020 7580 0631 www.ipm.org.uk
Useful Contacts
Sexual Advice Association
Suite 301, Emblem House, London Bride Hospital, 27 Tooley Street, London SE1 2PR
Tel. 020 7486 7262 www.sexualadviceassociation.co.ukinfo@sexualadviceassociation.co.uk
This group is for women as well as men and helps deal with anumber of sexual issues including reduced libido, orgasm problems and vaginismus.
Vulval Pain Society www.vulvalpainsociety.org
If you wish advice on the menopause, please initially discuss with your practice nurse or GP
Helpful advice can also be found at www.menopausematters.co.uk
