Vaginismus is a curable physical and emotional disorder that a small percentage
of women experience. A woman with vaginismus feels as though her vagina is tightening
before or during penetration. This sensation results from involuntary spasms
of the muscle surrounding the vaginal opening, making penetration painful or
impossible. Although intercourse becomes impossible, women who experience vaginismus
are capable of becoming sexually aroused and even of lubricating.
There are two types of vaginismus: primary and secondary. Primary vaginismus
refers to a condition in which a woman has never been able to engage in intercourse
without spastic muscle contractions. Secondary vaginismus is a condition which
emerges later in life, after a period in which a woman had been able to accept
penetration.
The first step a woman should take if she feels that she may have vaginismus
is to schedule a full pelvic exam with her gynecologist to identify any possible
physical causes. In most cases, vaginismus is traced to anxieties associated
with the act of penetration, and these may be linked with other causes, such
as past sexual trauma or control issues within the relationship.
Common treatments for psychologically rooted vaginismus include couples therapy,
Kegel exercises, a graded series of plastic dilators for muscle relaxation exercises,
and sensate focus exercises for the couple to do at home.
By attending couples therapy, partners can learn to communicate better to one
another. It can help the couple work out specific problems and encourage stronger
relationships. The female may be advised to engage in any or all of the techniques
mentioned above then later incorporate her partner. These exercises are intended
to foster self-awareness.
Many women begin their Kegel exercises by contracting the wrong muscles, so
it is important to first work with a professional in order to identify the correct
muscles, the PC muscles. You can also check yourself by placing a finger in
your vagina and applying pressure around it. When you feel pressure around your
finger that means you are tightening the PC muscle.
While doing the Kegel exercise, it is very important to make sure that all
other muscles are relaxed. Before beginning these exercises, a woman may want
to take a warm bath to try to become as relaxed as possible. To do the Kegel
exercises, you contract the PC muscle while counting to five and then relax
it on the count to six. Women with vaginismus need to concentrate on the feelings
of relaxation, so they can consciously make their PC muscle relax whenever they
want.
A set of graded vaginal dilators can also help a woman gradually learn to comfortably
accommodate a penis. These devices are available in various diameters and lengths,
and they are inserted in a way similar to tampons. By using progressively larger
vaginal dilators, a woman learns to keep her PC muscles relaxed even when the
vagina is penetrated.
A woman may then begin self-exploration, external genital stimulation, and
eventually insert a finger into the vagina. Later, a woman may be able to insert
more fingers attempting to replicate the sensation of a penis. Once the woman
has completed the previous steps, she may incorporate her partner into these
exercises. Together they may follow the same regimen she did alone. However,
instead of her own fingers, a penis will now be involved. Open communication
is a vital and necessary element to this progression. This approach requires
ongoing openness on the part of both partners with the woman being willing to
express her concerns and the man being receptive to them. At first, the couple
will remain motionless allowing the woman to get familiar with how it feels
to have a penis inside of her vagina. Movements will later be added when the
couple is comfortable enough. Fortunately, research shows those women who are
treated by a professional can expect an 80-100% improvement rate.
© - Reproduced with permission of SexInfo, University of California at Santa Barbara, 2007.