Vaginismus

According to Jacobson et al. (2022), vaginismus is the involuntary spasm of pelvic floor muscles, the muscles that surround the vagina. There are many causes for vaginismus, but it is considered a sexual issue. Some etiologies include sexual trauma, mental health, or the act of intercourse. The major symptom of vaginismus is pain on penetration during sex. The pain may be so great that penetration may not be possible at all (Jacobson et al., 2022).

According to Goodman (2022), there are two types of vaginismus, primary and secondary. Primary vaginismus is when a woman has pain every single time something penetrates the vagina (this includes the penis). It is known as “lifelong vaginismus.” Secondary vaginismus is when a woman has had painless sex before, but over time the sex becomes impossible or difficult. This is known as “acquired vaginismus.”

Diagnosis can be confirmed by a pelvic exam and medical history. Once confirmed, a treatment option can be to complete home exercises that teach a woman how to control and relax muscles that surround the vagina. This technique is known as progressive desensitization, which involves the following steps (Goodman, 2022):

1. Instruct the patient to complete at-home kegel exercises by squeezing muscles that are used to stop flow of pee and hold for 2-10 seconds and then release.

2. The above step is completed 20 times in one sitting, but can be done as many times a day as the patient wants. 

3. After a few days, the patient can insert a finger into the vagina while completing the exercise described in step 1. The patient should progressively work their way up to 3 fingers, but can stop if they feel uncomfortable. 

4. After a while of trying this, the patient should be able to place cone-shaped inserts into the vagina for about 15 min.

Citations:

Jacobson, J. D., Dugdale, D. C., & Conaway, B. (2022, April 19). Vaginismus. Mount Sinai Health System. Retrieved from https://www.mountsinai.org/health-library/diseases-conditions/vaginismus#:~:text=The%20main%20symptoms%20are%3A,intercourse%20or%20a%20pelvic%20exam

Goodman, B. (2022, March 4). Vaginismus: Types, causes, symptoms, and treatment. WebMD. Retrieved from https://www.webmd.com/women/guide/vaginismus-causes-symptoms-treatments