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Understanding Vaginismus – What’s Occurring Down There?!

*** Content Warning: This article describes sexual violence related to medical conditions.

Do you have persistent vaginal pain and tension? It is hard for you to use tampons as well Menstrual cups? Is it almost impossible or incredibly painful for you to have penetrative sex?

If you answered yes to any or all of these questions, you may have vaginismus.

Vag-i-what-mus?

Yes, vaginismus. It is a real disorder that has a real impact on people’s lives.

Vaginismus is a condition that causes the muscles surrounding the entrance to the vagina to involuntarily contract, making it extremely difficult and uncomfortable to penetrate.

Some medical providers also refer to the condition as Genito-pelvic pain or penetration disorder, GPPD as well as sexual pain disorder.

While the exact number of people who experience symptoms of vaginismus is unknown, one is an estimated fifteen percent of women in North America have persistent pain during intercourse.

For some people with vaginismus, they may be able to use tampons without problems, but have difficulty and pain during penetrative sex. This roadblock to traffic can affect their ability to have healthy, flourishing relationships – although of course it can.

GPPD is most commonly diagnosed in people of early adulthood or their old age perimenopausal or postmenopausal Years.

It’s all in your head

Believe it or not, vaginismus is actually caused by dysregulation in the limbic system: the group of structures in your brain that regulate motivation, memory, and emotions.

In GPPD, the limbic system responds to the idea or act of penetration by involuntarily tightening the vaginal muscles to protect itself from possible damage or pain. Some studies show that people with vaginismus have structural abnormalities in the hippocampus and amygdala, two areas of the brain that help regulate anxiety.

Just because it starts in your head doesn’t mean that the pain, emotional distress, and other difficulties that arise with GPPD aren’t very real.

Symptoms of vaginismus (GPPD)

While symptoms can vary slightly from person to person, these are usually the most common:

  • Dyspareunia, also known as painful intercourse.
  • Reduced or no sexual desire.
  • Pain on penetration.
  • Vulvovaginal and pelvic pain during intercourse.
  • Fear and / or fear of intrusion.
  • Tension and tightening of the pelvic floor muscles during penetration.

Diagnosing vaginismus

Diagnosing GPPD is pretty straightforward. Someone who experiences the symptoms listed above that cause clinically significant distress for at least six months of persistent disease is most likely diagnosed with vaginismus.

Just because someone has been diagnosed with GPPD doesn’t mean treatment will be that simple. When diagnosing a person, the provider also takes into account the many compound factors that make the symptoms worse or cause them.

Providers will take note of any other factors that may cause discomfort during intercourse, such as: For example, those caused by severe relationship problems such as domestic violence or medication or other illness.

You will want to know the context of someone’s cultural and religious attitudes toward sex, as culturally embedded shame for sex can evoke a systemic limbic reaction that leads to vaginismus. Past mental disorders and traumatic events, including physical or emotional abuse, and poor body image can be causative factors. Has this patient experienced rape or some other form of sexual abuse / violence?

Other previous physical conditions can lead to vaginismus, such as vaginal infections and conditions in the genital and pelvic area, including Endometriosis. GPPD can also develop postpartum after someone has had a baby.

Vaginismus can be a lifelong or acquired disorder.

Treatment of vaginismus

Since this disorder involves exploring the mind-body connection, it may take multiple levels of treatment to find relief. Treatment also depends on the cause or causes of the individual case of a person.

With symptoms after pregnancy and childbirth, time and patience are two of the biggest factors. Some women can also be helped by Pelvic floor physiotherapy.

Regardless of the cause, people can find relief when they see a license sexological body worker. These practitioners use internal massage in the vaginal and anal areas, as well as communication and education, to provide holistic healing.

In people with vaginismus due to endometriosis or other gynecological disorder, surgery or treatment for the underlying condition can help relieve symptoms.

Using vaginal dilators can help people with GPPD gradually increase their comfort with different sized penetration objects. Hope and her, an organization that provides information and treatments for pelvic disease, has a vaginismus video series that helps people use dilators and other methods of home treatment.

Another tool for curing vaginismus is the use of a device like Intiminas KegalSmart, as well as Practice cones without device.

Regardless of the cause, vaginismus can be an incredibly emotionally distressing disorder, and patients may find the greatest relief when they combine treatments with treatments that help manage them psychologically as well. This can very likely mean seeing a licensed therapist or psychologist, especially if abuse or violence is one of the underlying factors.

Sex and vaginismus

As you can imagine or know from experience, vaginismus can cause someone to avoid sex and possibly romantic relationships altogether.

Therefore, it is important that someone who has a partner involves them in the healing process.

Going to a specialist such as a couples therapist or sex therapist can help a couple develop communication and understanding of the condition and navigate together.

Appropriate foreplay and stimulation can help the body empathize with the experience and produce enough lubricant to facilitate penetration. Using the right lubricant for your body can also help reduce discomfort.

Also, remember that no penetration is required to have sex or meaningful intimate experiences. Here are a lot of tips for getting sexy sans penetration.

Whatever your journey with vaginismus, we encourage you to seek professional help, listen to your physical intuition, and approach treatment from a holistic perspective.

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