Vaginismus

Symptoms | Treatments

What is

Symptoms

Causes and Risk Factors

Treatment

What is - Vaginismus

Vaginismus is a condition where there is involuntary tightness of the vagina during attempted intercourse. The tightness is actually caused by involuntary contractions of the muscles surrounding the vagina entrance and outer third of the vagina. Women are often not consciously squeezing the vagina muscles as it is an involuntary response.

Symptoms of Vaginismus

Burning, pain, or stinging occurs when an object such as the penis is attempting to enter the vagina canal due to involuntary contraction of the vagina muscles.
The severity of the condition varies in different women:
- Some are able to allow tampon or digital insertion but are not able to consummate the marriage.
- Other women are unable to tolerate any form of object entering the vagina at all.
The male partner may experience "something blocking" the entry of the penis and pain during attempted penetration. Over time, after repeated failed attempts at intercourse, this cou ld lead to premature ejaculation or inability to sustain an erection.

Types of Vaginismus

Primary Vaginismus
When a woman has never at any time been able to have pain-free intercourse due to this muscle spasm, her condition is known as primary vaginismus. Some women with primary vaginismus are unable to wear tampons and/ or undergo vagina examination. Many couples are unable to consummate their relationship due to primary vaginismus.

Secondary Vaginismus
Vaginismus can also develop later in life, even after many years of pleasurable intercourse. This type of condition, known as secondary vaginismus, can be precipitated by:

Medical conditions
Traumatic life events
Childbirth
Surgery
Life-changes (menopause)

Vaginismus - Causes and Risk Factors

The cause of vaginismus is not clearly known. It can be associated with:

Negative past sexual experiences or sexual abuse in the younger years of life.
Social upbringing, religious and cultural influences can affect views on masturbation and the sexual act which can give rise to anxiety and aversion to intimacy and sexuality.
Psychological factors include those such as the imagined fear of pain from something entering the vagina, tearing the hymen or that the penis is too big for the vagina.

Incidence
The incidence of vaginismus in Singaporean women is unknown but it is estimated that 1% of women seeking help for subfertility actually suffer from this condition. It is also estimated that for every woman who seeks help, tenfold suffer in silence.

Treatment for Vaginismus

Successful vaginismus treatment does not require drugs, surgery, hypnosis or any other complex invasive technique.

It would be advisable to see a doctor first to exclude medical conditions such as:
- Genital tract infections
- Anatomical genital tract anomalies such as a lack of vagina opening
First line measures such as education about the vagina structures, use of lubricants and ensuring adequate foreplay will be given.
If vaginismus still persists after medical issues have been addressed or if the patient does not respond to first line measures, intervention sessions with a Psychologist and/ or Physiotherapist can be considered.
A combination of the treatment approaches listed below may be used to optimise effectiveness:
Pelvic floor control exercises
Vagina insertion or dilation training
Pain elimination techniques
Transition steps
Exercises designed to help women identify, express and resolve any contributing emotional components through counselling and psychotherapy

Our healthcare providers will give an initial assessment with follow-up outpatient sessions. Between each treatment session, the woman will be encouraged to continue to work at her own pace in the privacy of her home.

Vaginismus is treatable
Vagina discomfort and penetration difficulties from vaginismus are treatable. With compliance to treatment, women experiencing difficulties with intercourse can overcome vaginismus and achieve pain-free, pleasurable intercourse.