Vaginismus is a condition that affects thousands of women in the UK, and results in difficulties in being penetrated by any object such as a finger, tampon or allowing a partner to penetrate with their penis. Any such attempts or indeed vaginal touching or a suggestion of this, will lead to an involuntary spasm of the vaginal muscle that is not consciously controlled by the woman. This can be despite a woman's expressed wish for penetration to happen. Sometimes penetration is possible, however it is usually painful.
Some women with vaginismus have experienced this as a life-long issue and will never have had penetrative sex. They may have found tampons and smear tests difficult or been unable to co-operate with them being performed. For many women this is discovered when they present for a smear test. Other women may have been able to have penetrative sex and have used tampons in the past, but the condition develops later on, for example after a difficult vaginal delivery or other associated trauma. Sometimes there is no obvious cause. Vaginismus can be an extremely distressing sexual difficulty for both women and their partners.
The resulting stress and anxiety can lead to a fear of penetrative intercourse itself; due to an expectation of pain, and/or an assumption that there will be another "failed" attempt at penetration which can lead to feelings of guilt, shame and a sense of letting ones' partner down. Approaching each attempt at intercourse with all of these difficult feelings can inevitably cause tension.
It is very common to experience tightness in all of our muscles when we are feeling tense or nervous about something. When we consider that the vagina is actually a very strong muscle, it is perhaps little surprise to realise that in addition to the involuntary spasm that occurs with vaginismus, general tension and anxiety can contribute significantly to the condition and if penetration is possible, it can often be painful. Each difficult or negative experience of penetrative sex serves to reinforce the individual's fear and apprehension, resulting in a cycle of fear, pain and frustration.
Psychosexual therapy for vaginismus aims to understand the causes of the condition and to break this cycle. If the woman is in a relationship, an important aspect of the counselling is to attend to the impact of the condition on the relationship for both partners. If the woman is not in a relationship, therapy is still very effective at helping the individual to overcome this on their own.
This may involve educating the woman and her partner and providing them with information about the body and the condition. The therapist can help the individual or couple to explore any feelings of tension, fear and anxiety, and how they are linked to thought patterns which affect the behaviours of both partners (cognitive therapy).
Exercises are often set for the woman to complete alone or with a partner between the counselling sessions. These may involve the use of vaginal trainers - plastic, tube-shaped dilators which usually come in sets of five in graded sizes, ranging from very small to nearer the size of an erect penis. Combined with an individually tailored exercise to guide the individual/couple on how to use them, these can be very effective in helping a woman to very gradually start inserting objects into the vagina, allowing it to stretch sufficiently to eventually be able to accommodate a penis or dildo, for example.
Although women experiencing this condition can often feel isolated, it is important for them to realise that they are not alone and that it is very treatable.
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