What is vaginismus?
Vaginismus denotes a sexual disorder that consists of the involuntary spasm of the vaginal musculature, which hinders penetration: the woman suffering from vaginismus finds it difficult to accept the sexual act, despite the desire to do so.
More precisely, the actual pain of penetration is perfectly expressed by dyspareunia, which differs from vaginism because, in the latter case, the fear of pain is often unfounded and reflects only anticipatory phobias of the sexual act.
Incidence
It is estimated that vaginismus affects 1-2% of women of childbearing age: the percentage increases (15-17%) if the incidence index is focused only on women who undergo frequent clinical checks and who spontaneously declare disorder.
Unfortunately, however, it is not possible to accurately assess how many women are actually suffering from vaginismus, since, probably, the women who are affected are ashamed to even talk about it with their doctor.
Symptoms
Vaginismus is a disease and, for this reason, it should not be underestimated: we have seen that the phobia of sex and the spasm of the vaginal muscles are the two main characteristics that characterize vaginismus. Therefore, to assess the severity of the disorder, one must focus both on the intensity of the phobia (measured on an ideal scale of values: mild, moderate, severe), and on the intensity of the spasm. For example, we speak of a low degree of spasm severity when it disappears with simple verbal reassurance: in this case, penetration is generally possible. The next stage is characterized by a spasm that lasts over time, often characterized by a moderate pain during intercourse (dyspareunia). In higher gravity stages, penetration is very difficult, since the spasm is so tight that it prevents coitus; so much so that in the last level, the most serious, the woman also refuses her sight.
Based on the intertwined evaluation of these parameters it is possible to delineate the gravity of vaginismus.
Consequences
It is understandable that the rejection of the sexual act by the woman, caused by vaginismus, can also have consequences for the partner. The man feels inadequate, frustrated and unable to satisfy the desires of his own woman: the erectile maintenance deficit certainly represents the most immediate effect, which in the long run could reflect on sterility. Indeed, it is no coincidence that in a percentage varying from 5 to 7% of (improperly) "sterile" couples there is a lack of sexual relations.
Vaginismus causes a progressive (but inevitable) loss of sexual desire, associated with an incapacity for sexual arousal with the partner: erotic intimacy fails and the partner, unmotivated, dissatisfied and depressed, does not feel "up to par". If the woman affected by vaginismus is defined as "the one who induces the symptom", the man is "the one who carries the symptom", since the unfounded feeling of guilt causes him sexual dysfunctions such as erectile deficits, inability to maintain an erection, loss of desire and premature ejaculation.
Vaginismus holds the record of being the most frequent cause of an unused marriage .
Causes
Vaginismus is a rather complex condition, since the causes that cause it are often hidden and difficult to discover. The multimodal approach to vaginismus is indispensable for the treatment of the disease, in order to eliminate not only the phobia of the woman and the attached psychosomatic factors, but also to resolve the muscle spasm that develops at the moment of penetration.
The triggering factors, as can be guessed, have a psychological and physical nature.
We begin to analyze the psychological factors that affect vaginismus:
- The sexual act is associated with a negative factor, "something dirty" that must be avoided : this thought afflicts most women with vaginism, in particular young women who do not yet know sexual maturity;
- Many women who have suffered abuse / sexual violence interpret sex as danger and pain, sensations that perfectly reflect vaginismus: this condition is understandable following a harassment, but psychiatric sessions can solve the problem in a relatively short time;
- Even excessive attachment to parents could affect vaginismus, consequently the refusal of sex for fear of being judged;
- The fear (or, better said, the terror) of becoming pregnant and that "something goes wrong" could lead the woman to the progressive rejection of sex;
- Vaginismus could be linked to other neurobiological phobias (agoraphobia, claustrophobia, etc.), stress and anxiety: it is a hyperactivity of the fundamental command emotion of anxiety / fear, which is reflected with the fear of penetration [ Female special medical sexology, Jannini EA Lenzi A. Maggi M.].
If psychological factors have been the subject of in-depth studies and research by scholars, the factorialists who trigger vaginismus are still covered by an aura of uncertainty: often, the two categories of causal factors (psychological and physical, for the in fact) they overlap and one can be a consequence of the other. It has been estimated that only 1% of women with vaginismus suffer from this disorder from the beginning of their first sex approaches: a very rigid and fibrous hymen could be difficult to penetrate and create pain during intercourse. When attempts at penetration are in vain because they are particularly painful for the woman, then the structure of the hymen could be a first causal factor that predisposes to vaginismus.
The pain during intercourse could, however, be induced by surgery or trauma; even the terrible practice of infibulation, still performed by many African populations, could generate scarring in the female genital tract and cause pain during penetration: in this case, the physical factor (the closure of the vagina at half of the large lips, with possible removal of the clitoris) associated with psychological disorders (pain, fears) could act synergistically and trigger vaginismus.
Still, some serious pathologies, such as vaginal mullerian agenesis, could contribute to the formation of vaginismus: it is a malformation that foresees the lack of the vagina or of a part of it, typical of Rokitansky's syndrome .
Causes of vaginismus: psychological and physical factors | |
Psychological causative factors |
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Physical causal factors |
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Diagnosis and therapies
Obviously, the advice to change husband does not reflect the best solution to resolve vaginismus; women who often go to the doctor to complain about the disorder are underestimated, as many specialists cannot immediately diagnose vaginismus. The specialist must pick up the signals sent by the woman, focusing on the degree of phobia, on the gravity of the situation and on the hypertonicity of the anal levator muscles located around the vagina, which hinder penetration. The doctor, therefore, must evaluate the prognosis not only of the individual subject (woman), but of the couple, since the problem concerns both partners.
The most followed therapies concern psycho-sexological treatments, but endocrinological and urological analyzes are not lacking.
In some cases, vaginismus could be "resolved" surgically: episiotomy (or perineotomy), which consists of an incision with scissors in the thickness of the peritoneum (which coincides with the area between the rectum and the vagina). However, surgery is often useless for vaginismus.
Read also: All Remedies for Vaginism »
Conclusions
The healthy impetuosity and the balanced aggressiveness of the sexual relationship, an exquisitely natural and human act, should be fully experienced by both partners: fears, anxieties and worries related to vaginismus negatively affect the couple's intimacy, often even ruining simple interpersonal relationships. It would be useful to turn to a specialist, leaving aside the shame and embarrassment that could result from exposing one's phobias: the doctor must be able to listen to the couple's problems, interpret them and recommend a therapy to live completely sex life. The psychological approach is not always easy, but it is (perhaps) the only chance to resolve vaginismus and savor the couple's relationship without any type of anxiety.
Summary
Disorder | Vaginismus: sexual disorder caused by the involuntary spasm of the vaginal musculature, which hinders penetration |
Incidence | About 15-17% of women who undergo frequent gynecological examinations spontaneously declare the disorder; it is not possible to assess precisely how many women are actually affected |
Symptoms of vaginismus | Sex phobia, spasm of vaginal muscles, pain (dyspareunia) |
Consequences | The consequences are also reflected in the partner, who feels frustrated and unable to satisfy the woman: this leads to erectile deficits, an inability to maintain an erection, loss of desire and premature ejaculation |
Causes | Psychological factors (abuse, morbid attachment to parents, neurobiological phobias) and physical factors (infibulation, harassment, trauma, infections) |
Diagnosis | The specialist must focus on the degree of phobia, the severity of the situation and the hypertonicity of the anal levator muscles that surround the vagina and hinder penetration. Endocrinological and urological analyzes are also useful for diagnosing vaginismus |
Therapy | The psycho-sexual treatments represent the most recommended therapy by specialists to solve vaginismus. Surgery is not recommended |
