Vaginismus

Vaginismus or difficulty to allow vaginal penetration for intercourse is a common cause of female sexual dysfunction. It is due to involuntary spasm of the muscles around the vaginal opening. These muscles go into spasm because of pain or fear of pain. Vaginismus is common in nonconsummated marriages and affects many women from different background. It causes many women to suffer in silence resulting in anxiety, isolation, stress, low self-esteem, and marital discord.

Vaginismus is usually not due to a physical abnormality of the genitals. Some women may wonder if their vagina is too small to fit a penis or they may have a rigid hymen or no vaginal opening at all. These concerns, however, are erroneous as the genital area is completely normal.

Majority of cases had psychological factors including the following:

• rape and past sexual abuse
• exposure as a child to shocking sexual imagery
• violence in the home
• painful intercourse
• overly strict or unbalanced religious teaching in the home
• rigid parenting
• inadequate sex education
• no known experience

Vaginismus is treatable. A full recovery from vaginismus can be expected with a treatment program that combines education and counseling with behavioral exercises. Proper understanding and discussion of the sexual anatomy, physiology, the sexual response cycle, and common myths about sex in details will helps to reduce anxiety.

Exercises include pelvic floor muscle contraction and relaxation (Kegel exercises) to improve voluntary control. Doing this regularly is very helpful. One does not know what relaxation feels like unless one knows what stress and tension feels like.

Vaginal dilation exercises are recommended using plastic dilators. This should be done under guidance starting out with the smallest dilator and slowly increasing in size. Treatment should involve the partner. This should gradually include more intimate contact, ultimately resulting in intercourse.

Pain-free and pleasurable intercourse is attainable for most couples.