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Vaginismus

Alternate Names

  • vaginal muscle spasms

Definition

Vaginismus is a painful, reflex muscle spasm of the vagina and leg muscles, which occurs when sexual intercourse is tried or anticipated.

What is going on in the body?

When a woman has vaginismus, muscle spasms cause the vagina and leg muscles to tighten reflexively. Putting a finger or penis in the vagina is quite painful. Often it cannot be done. Physical or psychological factors may be involved in causing this but because of the muscle spasm and build up of lactic acid in the muscles, the pain always is physical and not "in a woman's head"

Risks

What are the causes and risks of the condition?

Some contributing factors are:
  • infection of the glands at the outside of the vagina (vestibulitis)
  • muscle or nerve damage from childbirth or surgery
  • past sexual trauma, as a child, teen, or adult
  • sexual inhibition for religious, cultural or emotional reasons
  • pain with intercourse in the past

Prevention

What can be done to prevent the condition?

Diagnosed

How is the condition diagnosed?

A healthcare professional will take a medical history and ask about episodes of vaginismus. A pelvic exam will be done as well. During it, the examiner will try to gently insert a finger or fingers into the vagina to see if this causes a painful spasm of vaginal muscles and tightened leg muscles.

Long Term Effects

What are the long-term effects of the condition?

Because sexual activity is painful for a woman with vaginismus, relationships are often avoided, or marred by discord and dissatisfaction.

Other Risks

What are the risks to others?

A woman's partner may start to view himself as a sexual failure. Problems having an erection or impotence may result.

Treatments

What are the treatments for the condition?

If this reaction was triggered by an external skin or gland condition, the underlying problem must be treated first. This is done with pills or creams, or a combination of them. Even when the external cause is no longer present, the body remembers and reacts to protect itself from pain by tightening the muscles. Treatment may involve counseling for the psychological component of the vaginismus. Some experts use a program that slowly makes it easier to relax vaginal muscles so that the vagina opens up.

A reputable sex therapist or gynecologist familiar with the problem may suggest:
  • placing the woman's fingers or her partner's fingers in the vagina and learning to relax.
  • placing dilators of increasing size into the vagina daily. Over many weeks this helps open up the vagina and relax the muscles.
  • biofeedback or physical therapy
  • botox injections
  • seeking sex therapy with a goal of having intercourse and a healthy, satisfying sexual relationship.
Sessions may involve education about female and male anatomy, how sexual response works, and common myths about sex. If a phobia exists, hypnosis and relaxation techniques may also be useful. Success rates are high. Within 10 to 15 sessions, about 90% of women with vaginismus respond to therapy.

Side Effects

What are the side effects of the treatments?

Until a woman is able to relax her muscles, using dilators in the vagina may be uncomfortable and irritating. Therapy may uncover difficult issues that could trigger deep depression or anxiety.

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