Vaginismus means a discomfort in the female sexual sphere.
It consists of reflex muscle contraction of the vagina and pelvic floor.
From the sexual point of view, vaginismus is strongly debilitating, as it "physically" hinders penetration (obviously necessary for coitus and gynecological examinations), which becomes difficult and painful (dyspareunia).
It is a real nervous "reflex" and its manifestation does not depend on the will of the person who is afflicted by it. It is classified into 4 severity levels. It is generally permanent and only rarely appears transient.
Vaginismus is NOT a form of frigidity; in fact the women who suffer from it maintain libido and the ability to reach orgasm with stimulation of the clitoris.
NB : Physical attraction towards the partner is not a cause of vaginismus.
Unfortunately, even reaching a balance between sexual needs, different problems can occur in the attempt to conceive.
What to do
- There is no effective preventive protocol against vaginismus; however, there are a number of errors to NOT commit. Being a discomfort of psychosomatic etiology, what hurts a subject could be totally harmless to others and vice versa.
- Objectively recognizing and evaluating the symptoms of vaginismus, without however convincing themselves that they are afflicted before receiving a medical diagnosis:
- Contraction of the perineum, vulva and vaginal orifice.
- Pain during penetration up to impossibility.
- Characteristics of sudden and involuntary onset.
- Understanding the causes of vaginismus: it can help the woman identify the disorder and assess its severity, reduce it, live with it or try to heal it:
- Psychological causes. They are based on one or more emotional traumas due to penetration:
- Failure or pain in the first penetration attempts.
- Experiences of sexual abuse.
- Subjective characteristics of women, especially concerning the history of sexual life.
- On the other hand, a good part of the female population does not complain of any negative experience and shows an individual predisposition. This concerns emotional management and the relationship with one's body. For example:
- Expression of one's adult femininity.
- In the educational phase, blaming sexuality.
- Conviction of a strong pain in the first relationship.
- Association of several factors (for example, conviction of severe pain and muscle stiffness at the first relationship, with real suffering).
- Entry into the menopause phase and related difficulties:
- Mood alteration.
- Libido reduction.
- Body modification (change of forms, increase in hair, etc.).
- Impairment of vaginal lubrication (dryness).
- Go to a specialist: the first reference figure is the gynecologist, who will check the total absence of pathological causes.
- With a concrete diagnosis of vaginismus, it is important to inform the partner.
- The male partner should support the woman's reaction to the problem. Any negative reactions would prove to be absolutely counterproductive.
- If possible, have fulfilling and regular sex without penetration.
- From the healing point of view, the possible treatments are:
- Sexological or psycho-sexual therapy. It consists in the association between psychotherapy and management training of muscular response. The means are:
- Induced and autogenic relaxation techniques.
- Management of psychophysiological mechanisms.
- Assignment of exercises (so to speak) to be performed privately (sex therapy). NB: if present, the participation of the partner is fundamental.
- Drug therapy: anxiolytics, antidepressants and muscle relaxants.
- In the event that the couple wishes a pregnancy, it is good practice not to exclude technological aids for conception. However, it is essential to avoid blaming the other half of the couple (on the one hand it could worsen vaginismus, on the other hand it can lead to problems with the male).
What NOT to do
- Convinced of having a vagina too narrow to cope with coitus: the vaginal dilatation capacity is very high for any woman and has no relevance to the onset of vaginismus.
- Ignore the symptoms of vaginismus.
- Do not inform and involve the partner.
- Unleashing yourself or your partner.
- Avoid the problem and close in on themselves.
- Find excuses to avoid contacting a specialist.
- Resign.
- Force coitus by experiencing pain and aggravating the situation.
- Impede the research (in therapy) of possible causes.
- Restrict yourself, limit yourself or not accept your sexuality.
- Refuse menopause and what it entails.
- For the male partner: exert psychological pressure, show significant distress, force a choice, become estranged, close the dialogue, force coitus, interrupt sexual relations and give primary importance to penetration.
- Do not perform or abandon early sexological or psycho-sexual therapy: in order to be effective it can last for several years.
- Refuse drug therapy.
- If sighed, abandon the idea of a pregnancy.
What to eat
There is no specific diet for the treatment of vaginismus. However, some tips may prove useful:
- Nutritional balance and good distribution of meals: a correct diet participates in regularizing the lifestyle. In turn, a regular lifestyle helps increase tranquility and reduce stress. We recommend:
- Consume 5 meals a day, 3 main and 2 secondary. The evening one MUST NOT be the most abundant.
- Spread the energy correctly, that is about: 45-60% carbohydrates, 25-30% lipids and the rest in proteins.
- Prefer fresh, partly raw and always good quality foods: they facilitate the achievement of the recommended rations for essential molecules (omega 3 and omega 6 fatty acids, essential amino acids, salts and vitamins).
- Cover the fiber and water requirements to prevent constipation: at least 30g / day. The consumption of probiotic foods can help.
- Consume meals that are not too abundant or late in anticipation of coitus: the sensation of gastric fullness can reduce libido, which is instead necessary during therapy for vaginismus.
- In the absence of a drug therapy, consuming an alcoholic unit (glass of wine or small bottle of beer) in the meal that precedes coitus can promote mental relaxation. ATTENTION not to overdo it!
What NOT to Eat
There are no foods less recommended than others. However, it is recommended to avoid:
- Monothematic diets.
- Vegan diet.
- Diet free of vegetables and vegetables.
- Diets based solely on:
- Cooked foods.
- Preserved foods.
- It is advisable to avoid alcohol abuse. In addition to compromising metabolism, intestinal absorption and health in general, it can cause drowsiness and decreased libido.
- It is necessary to consume the right amount of carbohydrates: diets too low in carbohydrates (especially when also lacking in fats) are responsible for a worsening of mood and a feeling of general malaise.
Natural Cures and Remedies
- All the activities that improve relaxation (no matter if they act by autosuggestion or thanks to real physiological mechanisms) are propedeutical to psycho-sexual therapy:
- Phytotherapy: based on the intake of plants capable of increasing relaxation levels and reducing stress levels, in particular: valerian, hawthorn, lemon balm and above all passion flower.
- Oligotherapy: based on the administration of minerals, in particular manganese and cobalt. The latter should be taken once a day for 3 weeks; then it is reduced to 2-3 doses a week. Can be supplemented with magnesium.
- Gemmotherapy: based on the administration of gems, in particular: Ficus carica (fig) and Tilia tormentosa (lime).
- Aromatherapy: based on the inhalation (or cutaneous absorption) of neurosedative volatile essential oils, in particular: lavender, lemon balm, chamomile and bitter orange.
- Yoga, pilates and any sport or hobby that has a positive effect on mood, reducing stress and "disconnecting the plug" from the thought of vaginismus.
Pharmacological care
- Serotonin reuptake inhibitors (SSRIs): help reduce anxiety.
- Diazepam: helps reduce muscle hypertonia.
- Muscle relaxants: to be used in the most serious cases. Some specialists suggest the use of injectable botulinum toxin.
Prevention
- The prevention of vaginismus is based fundamentally on reasonableness and logic:
- First of all, education: creating taboos, false beliefs, restrictions and fears is extremely predisposing to the onset of vaginismus.
- Aware of the occurrence of sexual abuse, seek psychological help immediately.
- Ensuring good fellowship and mutual understanding in the couple: selfish and unreasonable behavior on the part of the male partner is counterproductive, as is a lack of communication from the woman. Similar attitudes can be responsible for the onset of vaginismus even after many years of relationship, for example during the menopause phase or during emotionally difficult periods for the woman (mourning, separation from a child, etc.).
- Do not ignore relationship problems: overcoming certain obstacles and achieving emotional-sentimental tranquility favor the restoration of psychological balance. It is essential to consider any possibility and be willing to change, but without acting hastily. Some problems can be solved only by taking a long time (whether it is a change in behavior / attitude or breakdown of the relationship).
- Accepting one's sexual orientation and fantasies: vaginismus can also manifest itself in repressed homosexual or bisexual women.
Medical Treatments
- The only invasive medical treatment is localized injection of botulinum toxin. It is used as a powerful muscle relaxant, but it represents the "last resort" of curative treatment (generally in grade III and IV vaginismus). Botulinum toxin has a variable duration (several months), after which it should be repeated. It is injected mainly into the levator ani muscle, the one most responsible for the spasm typical of vaginismus.
