[ad_1]
The social and cultural messages we receive about sex give the impression that everyone is “doing it” and it is always fun and enjoyable. But for many people, having sex is extremely painful or impossible. One of the main causes of painful sex is vaginismus.
Vaginismus is an extremely common condition, which can have a huge impact on women, their partners and relationships. Yet many of them feel lonely and hopeless as is rarely spoken.
But women don’t need to live with it – it’s easy to diagnose and it’s treatable.
Painful sex
Australian research shows that around 20% of women and 2% of men experience painful intercourse.
Male sexual problems, such as erectile dysfunction, have become publicly aware since the advent of the “little blue pill” – Viagra. But sexual difficulties in women are missing from the story.
Without the push from the pharmaceutical industries, awareness and knowledge of sexual difficulties in women (or people with vaginas who do not identify as women) have not progressed in the same way as men.
Read more: Gender and Diseases of Women: It is common and important to include men’s perspectives
A recent study, not yet published, found that in 2019, 57% of female patients who attended Monash Health Clinic participated because of painful sex. 60% of them had vaginismus. Nearly half of these women had experienced this for more than five years and it had occurred in about one in five of these women for ten or more years.
What is vaginismus?
Vaginismus occurs when someone has persistent or recurring difficulties in allowing a penis, finger, or any object to enter vaginally, despite their desire to do so.
Shutterstock
Some women experience fear, difficulty or pain the first time they try to insert something into their vagina and instead of getting better, it can get worse over time. This is called “primary vaginismus”.
Others may be fine for years and develop pain later. This is “secondary vaginismus”.
Vaginismus can be mild, moderate, or severe. The pain is often described as burning, cramping, or a feeling of tension. And for some, nothing can enter the vagina. Sufferers describe it as hitting a brick wall.
The impact of vaginismus
Those with undiagnosed vaginismus may feel embarrassed or abnormal, which can dissuade them from seeking help. And undiagnosed vaginismus can have a significant impact on self-esteem and lead to anxiety or depression.
Read more: “Is it normal to feel bad over there after sex?”
Those with vaginismus can avoid being sexual, as it can be a very painful experience. They can also avoid any intimacy for fear that it may lead to “sex”. This can have a significant impact on relationships, leading to distance and conflict.
Shutterstock
It can also inhibit single people from forming relationships. They may avoid socializing, dating and meeting new partners, feeling overwhelmed by a “shameful secret”.
Causes
When it comes to sex (and life), you can’t separate mind and body. Vaginismus is no exception. The underlying causes are highly variable and often influenced by multiple factors.
Read more: Health Check: What is normal vaginal discharge and what is not?
Sometimes there is no obvious cause, but common factors in the development of primary vaginismus include:
-
fear or anxiety: about pain, pregnancy or sexually transmitted infections. Generalized anxiety or other anxiety disorders can also cause vaginismus
-
taboo: cultural or religious taboos about sex or inner conflict about being sexual or not
-
sex without care: having sex when you really don’t want to
-
history of abuse: a history of physical, emotional or sexual trauma or abuse
-
unrealistic expectations: sex leading to the fear of not being “good enough”.
Secondary vaginismus can occur due to any of the above or after anything that leads to painful intercourse, such as:
-
relationship problems: leading to lack of libido or arousal
-
infections or skin problems: vaginal infections, such as thrush and dermatological (skin) problems of the vulvar or vulvodynia can cause vaginismus
-
gynecological problems: such as endometriosis, gynecological (or breast) cancer and its treatment or pelvic surgery
-
pregnancy: vaginismus can occur after pregnancy, childbirth, or as a new parent.
A normal reaction to any anxiety and fear is tightening of the muscles, and vaginismus occurs when this happens in the pelvic floor muscles. A strong pelvic floor is important, but we must also learn to relax it when we want it.
Read more: 1 in 10 women have endometriosis. So why does it take so long to diagnose?
Diagnosis
Vaginismus can usually be diagnosed by taking a careful medical history and looking at what factors might be causing it.
Shutterstock
Those who suspect they have vaginismus should initially seek help from family doctors, gynecologists, pelvic floor physiotherapists, sexologists, or psychotherapists who have experience with this condition.
Medical professionals experienced in treating the condition will perform an examination in a gentle and empowering way, only when the woman is ready, so as not to be distressed or traumatized in any way.
Learn more: Isolation could improve the way we think and orient about sex and relationships
Treatment
Women should be reassured that pelvic floor stiffness is an involuntary and protective response that they can learn to overcome with help.
A multidisciplinary management approach has proven more effective, this includes:
-
education on vaginismus, pelvic floor and sex
-
medical management of any underlying physical conditions
-
psychological management of any underlying concerns
-
Pelvic floor physiotherapy can help women learn to relax in general and in the pelvic floor
-
know what’s pleasurable, as careless sex is a common cause of painful sex.
The woman should also have the power to feel free to choose if, when and how to be sexual. Many women are forced to have sex or are complacent for the sake of their partner’s needs.
They need to be supported to recognize and express their needs and desires. Although women can continue to be sexual in any way they wish, it is vital to stop doing anything that hurts, like continuing to try penetrative sex, while treating vaginismus.
Source link
