Why does vaginismus happen?
Vaginismus is a condition in which the muscles around the vagina contract involuntarily, closing the entrance of the vaginal opening and making penetration painful and difficult. It is primarily a psychological condition, where fear (often subconscious) of penetration during intercourse, tampon or menstrual cup insertion, or a gynecological exam leads to a reaction in the pelvic floor muscles.
Vaginismus can occur due to a variety of reasons. From a psychological perspective, fear of sexual intercourse, distress of past sexual abuse, fear of the vaginal opening being too small, negative self-image, and growing up in a conservative environment with limited discussion around around sex or intimacy are all factors that can play a role in vaginismus. Physical changes and trauma can also affect what’s happening at the pelvic floor muscles. This can include previous pain with intercourse, pelvic injuries (childbirth is included!), painful menstrual cycles, urinary or vaginal infections, and thinning of the vaginal tissue during menopause.
Generally, a cycle of fear of pain begins when a person expects pain with penetration or they have had a history of bad/painful touch. This leads to a guarding response, where you’re likely to tighten your pelvic floor muscles in anticipation of pain. When penetration is attempted, that guarding response makes it harder to penetrate, which then causes pain. This sends signals back to your brain, reinforcing your belief that penetration is painful. When penetration is attempted again, the pelvic floor goes back to the guarding response due to the history of pain.
How to check if you have Vaginismus?
Currently, there is no evidenced based assessment to determine if someone has Vaginismus. However here at Proactive for Her, we’ve come up with an extensive screening tool which helps us diagnose patients with vaginismus in an evidence based manner.
When attempting penetration, you might feel like you don’t have control over your vaginal opening, and/or that there’s a wall in your pelvis you’re hitting. You might feel pain when penetration is attempted or have pushed your partner away due to fear of pain. You might even feel like your vaginal canal is too small and that nothing will fit inside.
Vaginismus can affect you emotionally, causing anxiety, panic, sleep disturbances, low mood or self esteem, and chronic pain in other areas of the body.
If you’ve experienced any of these thoughts or felt this pain, you may have vaginismus and it’s important to visit a non-judgemental gynecologist or physiotherapist to confirm your diagnosis.
Is it ideal to treat vaginismus at home?
Vaginismus is considered a psychological condition, which is why treatment usually begins with a mental health expert. Evidence states that a holistic approach where treatment includes addressing the physical symptoms alongside mental health counseling is the best.
Our Online Vaginismus Program at Proactive For Her is extremely effective and you have the ease of getting treatment for vaginismus from home. The program includes one-on-one sessions with a vaginismus coach, pelvic floor relaxation sessions, women’s support group sessions, pleasure coaching workshops, a set of silicone dilators, and partner support sessions if needed. For people who want individual pelvic health physiotherapy sessions, these are also offered via an online portal, so you can get treatment for vaginismus from home.
Part of the program includes participating in breathing and exercises for the treatment of vaginismus at home, along with dilation. What’s important to remember throughout this, is that there is support and guidance at every step of the way. Treating vaginismus at home is possible, but you need to make sure you have someone with experience and knowledge guiding you towards healing. One should not try to treat vaginismus alone.
Best options to treat vaginismus
The best treatment for vaginismus involves utilizing the expertise of a mental health counselor along with a pelvic health physiotherapist. Treating both the psychological and physical aspects of vaginismus is essential for healing. Here are some aspects of treatment of vaginismus from home that we utilize at Proactive for Her:
- Psychotherapy - The focus is on first understanding your experiences and beliefs, and then working to connect what you’re feeling mentally to how it’s expressing itself in your body physically.
- Physiotherapy- Pelvic Health Physiotherapists are skilled in evaluating and treating vulva and pelvic pain. They work on breath techniques, stretching, and desensitization to teach your brain that not all penetration is painful. They can also help to release painful tension points that can occur from years of anxiety and stress.
- Dilator therapy- Think of dilators as a foam roller or gentle stretcher for your vaginal canal. They help you understand that there is plenty of space in your vaginal canal, and help to stretch muscles in your pelvic floor that may be shortened after time spent under tension. Psychologically, they teach your brain that penetration is not something to be fearful of, and it can be pain free. They are made up of plastic, silicone or glass. We recommend silicone dilators as they are most comfortable and realistic.
- Pleasure coaching and partner counseling - These help couples improve their intimacy, communication, and understand each other’s sexual needs for a more pleasurable and enjoyable experience.
Conclusion
The WHO defines sexual health as something that is “fundamental to the overall health and well being of individuals, couples and families, and to the social and economic development of communities and countries”.
Vaginismus is more common than we think it is, however women are dealing with it in silence, so the statistics are not very clear. There are several options for treating this condition, and self-diagnosis and treatment is not something that is recommended. At Proactive for Her, we’re trying to educate and inform people that there is a treatment and solution to this condition.
We offer an evidence based, non-judgemental, collaborative treatment approach, where you can access all the necessary practitioners under one roof. If you feel you may have Vaginismus, we offer multiple solutions for your healing.