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Vaginismus

Vaginismus is a condition which affects a woman's ability to have sexual intercourse, insert tampons and undergo gynaecological examinations. This is due to a conditioned muscle reflex in the PC muscle, they clamp shut making penetration either extremely painful or in many cases, impossible. The woman does not choose for this to happen; it is a learned reflex reaction. A comparison which is often made, is that of the eye shutting when an object comes towards it. This, like vaginismus is a reflex reaction designed to protect our bodies from pain. more...

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A woman with vaginismus expects pain to come with penetration and so her mind automatically sends a signal to her PC muscles to clamp shut, thus making penetration either impossible or very painful. The severity of vaginismus varies from woman to woman.

The condtioned reflex creates a vicious circle for vaginismic women. For example, if a teenage girl is told that the first time she has sex it will be very painful, she may develop vaginismus because she expects pain. If she then attempts to have sexual intercourse, her muscles will spasm and clamp shut which will make sex painful. This then confirms her fear of pain as does each further attempt at intercourse. Every time the fear is confirmed, the brain is being "shown" that sex does hurt and that the reflex reaction of the PC muscles is needed. This is why it is important that if a woman suspects she has vaginismus, she stops attempting to have sexual intercourse. This does not mean women with vaginismus can not partake in other sexual activities, as long as penetration is avoided. It is a common misconception that these women do not want to have sex as a lot of the time, they desperately do.

There is no one reason that a woman may have vaginismus and in fact, there are a variety of factors that can contribute. These may be psychological or physiological and the treatment required will usually depend on the reason why the woman has the condition. Some examples of causes of vaginimus include sexual abuse, strict religious upbringing, being taught that sex is dirty or wrong or simply the fear of pain associated with penetration, and in particular, losing your virginity. These are just some of the reported reasons behind vaginismus and there are many, many more. It is a very personal condition and so each case must be looked at individually as causes and treatment can not be generalised to all women with vaginismus.

Most women who suffer from vaginismus do not realise they have it until they try to insert a tampon or have sex for the first time and so it may come as quite a shock to them. Whether they choose to treat the problem or not is entirely their choice and they should never be led to believe that vaginismus must be treated. It is not an illness or a dysfunction and therefore the only physical effect it will have on a woman is making penetration painful or impossible. It will not get worse or more serious if left untreated unless the woman is continuing to have sex/use tampons despite feeling pain on penetration.

Primary vaginismus

Primary vaginismus occurs when a woman has never been able to have sexual intercourse or achieve any other kind of penetration. It is commonly discovered in teenagers and women in their early twenties as this is when the majority of women will attempt to use tampons, have sexual intercourse or complete a pap smear for the first time. It can often be very confusing for a woman when she discovers she has vaginismus as we are led to believe that sex is something that comes naturally to us. It can be even more confusing if the woman does not know why she has the condition, as is true for many women.

Read more at Wikipedia.org

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Dr. Hilda Hutcherson addresses your most intimate concerns
From Essence, 7/1/04 by Hilda Hutcherson

The last time my boyfriend and I had sex, he told me my vagina was so stretched out he felt it was swallowing him. I was hurt, but it's true that my muscles are not as tight as they used to be. I'm not sure why--I don't have kids. But I've gained 20 pounds; could that be the problem? How can I tighten my vaginal muscles?

Sisterfriend, why do you assume he's right? Your vagina is perfect exactly the way it is. The problem is just as likely his. For instance, if he can't produce a strong erection, he will float around in anyone's vagina. Many men begin to have occasional erection difficulty after age 40, and a few as early as their twenties. And if, in addition, he's on the small side, he may be unable to create much friction in the vagina.

A 20-pound weight gain will not increase the size of your vagina. The muscle that supports the vagina, the pubococcygeal (PC) muscle, may become more lax with age as well as with childbirth. You can strengthen your PC muscle with Kegel exercises. But you must do at least 100 contractions each day, and it may take up to three months before you see a change. To learn how to perform Kegels, sit on the toilet, legs spread. Begin to urinate, then squeeze your pelvic-floor muscle to stop the flow of urine. You have now identified the PC muscle and can squeeze and release it anytime. Add a Kegelcisor, or vaginal barbell, to your routine to speed up your progress. The Kegelcisor is a long, narrow metal weight. By placing half of it inside your vagina and using your vaginal muscles to lift the remaining half, you strengthen your PC muscles. You can purchase a Kegelcisor at an adult store or online.

You should also take a close look at your relationship. I suspect that this isn't the first time your boyfriend has said something hurtful to you. When people care about each other, they find a sensitive way to talk about sex. Before you invest more energy into this relationship, have a heart-to-heart with your guy. It just may be time to find a new partner.

For the past few years I've been experiencing a great deal of pain when I have intercourse. Is this normal?

Painful sex is common, occurring in approximately 15 percent of women. But that doesn't mean you have to grit your teeth and bear it. Sex should be mutually enjoyable. To determine the cause of your pain, you'll need to answer a few questions: Does the pain start with penetration or only with deep thrusting? Does it last throughout the encounter? Do you feel the pain in your vagina or deep in your pelvis? The most common cause of painful sex is vaginal dryness. As a result of increasing age, use of such medications as birth-control pills or anti-histamines, or excessive douching, the vagina may not produce as much lubricating secretions as it used to. Another cause of dryness is inadequate foreplay. It takes time for most women to warm up and lubricate. If your partner rushes to intercourse before you're ready you'll have two dry surfaces rubbing together, producing friction and heat--and pain. Deep penetration will cause his penis bump against your cervix, leading to more pain.

Relieve this pain by using a water-based lubricant, such as Astroglide, during sex. Pain that occurs only with deep penetration usually indicates a problem in the pelvis--fibroids, ovarian cysts or adhesions, among others. A vaginal infection caused by yeast, herpes, genital warts, vulvodynia (painful vulva) or vaginismus (spasms of the vaginal muscle) may also make intercourse painful.

Pain that is not relieved with lubricants should be evaluated by a doctor.

Happy lovemaking!

Hilda Hutcherson, M.D., is the author of What Your Mother Never Told You About S-e-x (Perigee).

Have a sexual-health question? Write to Sexual Matters, ESSENCE, 1500 Broadway, New York NY 10036 or E-mail sexualmatters@essence.com

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