Vaginismus

Proactive for her

What are vaginal dilators?Vaginal dilators are a cylindrical shaped medical device, made to mimic something that may be inserted into the vagina such as a penis or vagina. Dilators can be plastic, silicone, or glass. Some might describe vaginal dilators as a foam roller for the vaginal canal, stretching muscles to release tension, and restore the width and depth of the vaginal canal. The aim of the vaginal dilator is to maintain flexibility of the vaginal opening and canal. Vaginal dilators can also help the muscles coordinate better, learning how to relax when something is inserted into the canal. Vaginal dilators are essential in desensitising the pelvic floor muscles in order to make penetrative intercourse less painful.&nbsp;&nbsp;&nbsp;How might you benefit from using vaginal dilators?&nbsp;The main aim of using vaginal dilators is to address pain with penetrative sexual intercourse, which can occur through various stages in life.&nbsp;For people who might be experiencing vaginismus or vulvodynia, the dilators help to&nbsp; decrease sensitivity both around the vulva and in the vagina. They also release tension in the muscles that come from a guarding response that occurs when there is fear of penetration or history of painful intercourse. Dilators help to decrease the fear associated with penetration.&nbsp;&nbsp;Endometriosis is a condition where tissues that grow inside the uterus start growing outside the uterus. One of the symptoms associated with endometriosis is pain with urination and sexual intercourse. This pain can cause the muscles and tissues around the uterus and vagina to become very sensitive and tight. Vaginal dilators help to decrease the sensitivity and pain response, subsequently relaxing the muscles so intercourse and urination is no longer painful. They can also help address symptoms of constipation.&nbsp;Childbirth and radiation or chemotherapy are extremely traumatic experiences for the vaginal canal and abdomen. Scarring at the vaginal canal or the abdomen (due to a c-section) can contribute to women experiencing pain with intercourse. Vaginal dilators can help stretch the scar tissue, keeping the tissues more flexible. They’re also used to help decrease the sensitivity to pain, making inserting a tampon, gynac exams, and sexual intercourse easier.&nbsp;Vaginal dilators are utilised frequently after gender affirming surgery when the muscles and tissues need help keeping the vaginal opening flexible and open.&nbsp;&nbsp;Hormonal changes such as decreased estrogen during perimenopause and menopause cause dryness and decreased elasticity in tissues around the vagina, which can lead to pain with intercourse. Dilators with the use of lubricant can be very helpful in maintaining flexibility as well as help apply topical estrogen if warranted.&nbsp; &nbsp;How to choose the correct vaginal dilatorThe first step in choosing the correct vaginal dilator is to speak to a pelvic floor physiotherapist. They’ll provide you with options, as well as discuss how appropriate it is to start using dilators. When choosing vaginal dilators, it’s important to keep in mind the variety of sizes a kit offers (the more the better), the price point, if you’re able to keep it inserted without using your hands, and the texture that suits your body best. Read on to learn more about silicone and plastic vaginal dilators.&nbsp; Silicone Vaginal Dilators vs Plastic Vaginal DilatorsSilicone dilators are generally described as safer for the body, because some types of plastic dilators can be made with BPA, which can be harmful to the body if used at high levels. They also have a more natural feel, firm with some flexibility - similar to that of a penis. They can often feel less intimidating to a person. Another benefit of silicone dilators is that they have the ability to change temperatures, whether chilling in the fridge or heating it with warm water.&nbsp; <a href="https://proactiveforher.com/care-packages/sexual-health/dilator-package/">Click here</a> to order a set of silicone dilators made specifically for Proactive for Her.&nbsp; &nbsp;How to use a vaginal dilator?After purchasing dilators, speaking to a pelvic health physiotherapist is essential.&nbsp; Using vaginal dilators is not as simple as just inserting them. It’s very important to incorporate breathing techniques, body movement, and pain management strategies, so the correct signals are being sent to the brain. Prior to using dilators, a pelvic health physiotherapist can help assess how the pelvic floor muscles are functioning, create specifically tailored exercises, and provide 1:1 guidance to help progress faster.&nbsp;&nbsp;Here are some tips to get started:&nbsp;<ul><li>Create an environment that feels safe.&nbsp;</li><li>Make sure to wash the dilators with soap and water both before and after use</li><li>Start with inserting your own finger to get a sense of how the vaginal canal feels</li><li>Go slow and don’t try to push past pain or the “block” you might feel.&nbsp;</li><li>Stay consistent. Dilating everyday even for 5 minutes helps to progress</li></ul> <a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=online&amp;clinic=0&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability%2F&amp;Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=broad&amp;C1=leadgen&amp;Prod=physio&amp;gad_source=1&amp;gclid=CjwKCAjwwr6wBhBcEiwAfMEQsyJtHmpH3tQabcAWyYI4t360g30dzX69K8WbmtIIIjdxdZZ1ey9h5xoCA4UQAvD_BwE">Click here</a> to make an appointment with one of our expert pelvic health physiotherapists at Proactive for Her.&nbsp; Benefits of using vaginal dilatorsThere are many benefits of using vaginal dilators, the primary one being that they help to decrease pain with intercourse. Dilators help to decrease muscle spasms, teach women how to control their pelvic floor muscles, as well as actively relax them. They’re also great tools to help warm up the vagina before sexual intercourse. Dilators are great at gently stretching the vaginal canal, allowing the person who’s using them full control.&nbsp;&nbsp;Importance of keeping in touch with your doctorWhile using your dilators, it’s important to keep in touch with a pelvic health physiotherapist. They’ll be able to track progress, provide information on how long to keep it in for, and reassure any fears or apprehension associated with it. Pelvic health physiotherapists also help to set a routine and tell you when you’re ready to progress to the next size. From there, you will need to follow your doctor or physiotherapist’s instructions closely. They will tell you how long you should leave your dilator in for at a time, and how often you should train with it inside you. Make sure to speak to your gynecologist if you notice any signs of infection.&nbsp;&nbsp;ConclusionUsing vaginal dilators can feel intimidating, however they’re extremely helpful in addressing pain around the vagina and with sexual intercourse. It’s important to use the guidance of your pelvic health physiotherapist during your dilation journey. Here at Proactive for Her, you can purchase both&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/dilator-package/">body-safe silicone dilators</a>, as well as work with one of our&nbsp;<a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=online&amp;clinic=0&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability%2F&amp;Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=broad&amp;C1=leadgen&amp;Prod=physio&amp;gad_source=1&amp;gclid=CjwKCAjwwr6wBhBcEiwAfMEQsyJtHmpH3tQabcAWyYI4t360g30dzX69K8WbmtIIIjdxdZZ1ey9h5xoCA4UQAvD_BwE">expert pelvic health physiotherapists</a> to make your dilation journey much smoother and enjoyable!

Vaginal dilators are used to help address pain with intercourse. They're also beneficial for people who have had radiation to the vagina or gender affirming surgeries. Read on to learn more about them!

Everything you need to know about vaginal dilators for vaginismus

How is childbirth associated with secondary vaginismus?Childbirth is a significant event that can be associated with secondary vaginismus for some women. While primary vaginismus refers to when a woman has always experienced a condition of involuntary tightening of the vaginal muscles, making penetration difficult or impossible and can even cause pain, secondary vaginismus develops after a period of painless intercourse/penetration and can be triggered by various factors, including childbirth.&nbsp;&nbsp;Here's how childbirth is linked to secondary vaginismus:Physical TraumaChildbirth, especially if it involves complications, can result in physical trauma to the vaginal and abdominal area. This can include perineal tears (natural tearing of the area below the vaginal opening up to the anus), an episiotomy (a surgical cut made at the opening of the vagina during childbirth), and a cesaeran (a cut through the abdomen). Such physical trauma can lead to pain and discomfort, which might trigger a protective or fear-based tightening of the pelvic floor muscles in response to anticipated pain, leading to secondary vaginismus.&nbsp;&nbsp;Psychological FactorsThe experience of childbirth can be emotionally intense and, for some, a traumatic event. Anxiety, fear, or trauma related to childbirth can contribute to the development of secondary vaginismus. The anticipation of pain during sexual intercourse after childbirth, memories of the pain during delivery, or a general increase in anxiety levels can condition the body to respond by involuntarily tightening the vaginal muscles, leading to painful sex. &nbsp;Hormonal ChangesAfter childbirth, hormonal changes can affect vaginal lubrication and elasticity. Decreased estrogen levels, especially during breastfeeding, can lead to vaginal dryness, thinning and weakening of the vaginal walls. This can make sexual activity painful. This pain can lead to the development of secondary vaginismus as the body's way of avoiding the anticipated discomfort.&nbsp;Emotional trauma could lead to vaginismusChildbirth can be an intense and physically demanding experience, often accompanied by emotional stress and trauma. The emotional trauma of childbirth can contribute to secondary vaginismus in several ways:<ul><li>Fear and Anxiety- The experience of childbirth, especially if it was difficult or traumatic, can lead to a heightened fear and anxiety related to vaginal penetration. Women may subconsciously associate the pain and trauma of childbirth with penetration, triggering a fear response that leads to muscle tension and spasms.</li><li>PTSD (Post-Traumatic Stress Disorder) - Childbirth can be traumatic for some women, leading to symptoms of PTSD. Flashbacks, nightmares, and hypervigilance associated with PTSD can intensify anxiety and fear related to sexual activity, including vaginal penetration, which may contribute to the development of secondary vaginismus.</li><li>Changes in Body Image and Self-Esteem- The physical changes that occur during and after childbirth, such as weight gain, stretch marks, and changes in genital appearance, can impact a woman's body image and self-esteem. Feelings of insecurity or dissatisfaction with one's body may contribute to anxiety or avoidance of sexual activity, further intensifying vaginismus symptoms.</li></ul>&nbsp;&nbsp;Consult a doctor to find the root causeIt's important for individuals experiencing symptoms of vaginismus to seek support from healthcare professionals, such as gynaecologists or therapists specialising in sexual health, to address both the physical and emotional aspects of the condition. Seeking professional help ensures an accurate diagnosis and assessment of underlying physical and psychological factors contributing to the condition. A&nbsp;<a href="https://blrclinic.proactiveforher.com/gynaec/?Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=phrase&amp;C1=purchasepage&amp;Prod=gynae&amp;utm_source=google&amp;utm_medium=cpc&amp;utm_campaign=gynae&amp;gad_source=1&amp;gclid=Cj0KCQjwq86wBhDiARIsAJhuphmV4fM68EjlKThY4w-f-O39F21V8f4ymlN9NPG7dbEZmOG06EJVlbgaAkpREALw_wcB">gynecologist</a> can provide medical management and reassurance in regards to any changes that have occurred. A&nbsp;<a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=online&amp;clinic=0&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability%2F&amp;Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=broad&amp;C1=leadgen&amp;Prod=physio&amp;gad_source=1&amp;gclid=Cj0KCQjwq86wBhDiARIsAJhuphn_EHyWf27ME3aE0o2-9EbjtTnkf-Q7EW5RuH2Q0_WAHmRpvS-EHjEaAkP9EALw_wcB">pelvic health physiotherapist</a> can address physical changes such as prolonged pain, strength deficits, decreased muscle coordination and sensation, and scar tissue management. A&nbsp;<a href="https://proactiveforher.com/experts/?specialization=psychology&amp;page=1&amp;sort=availability&amp;mode=online&amp;clinic=0">mental health therapist</a> can offer invaluable support in processing emotions, managing anxiety, and developing coping strategies. Additionally, healthcare professionals can educate individuals about vaginismus, provide resources for support, and collaborate on a holistic treatment plan tailored to their specific needs. Timely intervention can prevent potential complications and improve long-term outcomes, ultimately enhancing sexual health, intimate relationships, and overall well-being. ConclusionOverall, the emotional trauma of childbirth does have a significant impact on a woman's psychological and physical well-being, potentially leading to the development or exacerbation of secondary vaginismus, highlighting the intricate link between psychological and physical well-being and sexual health. The fear, anxiety, and possible PTSD symptoms stemming from a traumatic childbirth experience can contribute to involuntary pelvic floor muscle spasms, making sexual intercourse painful or impossible. This condition not only affects physical health but also impacts intimate relationships and overall quality of life. Recognizing and addressing the emotional roots of secondary vaginismus through medical and psychological support is crucial. At Proactive for Her, we offer individualised, holistic&nbsp; treatment, focusing on addressing both the physical components with&nbsp;<a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=online&amp;clinic=0&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability%2F&amp;Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=broad&amp;C1=leadgen&amp;Prod=physio&amp;gad_source=1&amp;gclid=Cj0KCQjwq86wBhDiARIsAJhuphn_EHyWf27ME3aE0o2-9EbjtTnkf-Q7EW5RuH2Q0_WAHmRpvS-EHjEaAkP9EALw_wcB">our expert pelvic health physiotherapists</a>, as well as the psychological aspects of postpartum with&nbsp;<a href="https://proactiveforher.com/experts/?specialization=psychology&amp;page=1&amp;sort=availability&amp;mode=online&amp;clinic=0">our expert mental health therapists</a>.&nbsp; By acknowledging the profound impact of childbirth trauma, one can seek the necessary care and support to heal both physically and emotionally, paving the way for a recovery which involves the entirety of a person's well-being. &nbsp;

Childbirth is a traumatic experience for a woman, and this can lead to secondary vaginismus. The good news is, that just like primary vaginismus, secondary vaginismus is completely curable! Read on to learn more. 

Can childbirth trauma cause vaginismus?

Vaginal muscles are just like any other muscle in the body, which contract and relax. If the vaginal muscles develop tightness or are continuously in a contracted state, the vaginal opening can become narrower, creating challenges with penetration for women.&nbsp; It can even be difficult for women to insert their own finger,a tampon or menstrual cup, or go through a&nbsp; gynaecological exam!&nbsp;What causes vaginal muscle tension?Vaginal muscle tension can happen due to a number of reasons, including both physical and psychological causes.&nbsp;<ul><li>Fear of insertion during intercourse can be a big reason for muscles around the vagina to tense up. This fear can be due to previous unpleasant sexual experiences, inadequate knowledge about our own body,&nbsp; cultural factors, and the myth that intercourse is always painful.</li><li>Postpartum, women can be anxious when resuming intercourse. They might be fearful of changes in how they experience intercourse, especially after going through physical trauma of a vaginal or caesarean delivery.&nbsp;&nbsp;</li><li>Conditions such as endometriosis, vulvodynia, vaginal infections, urinary tract infections can cause pain in the genital or pelvic/abdominal area. This can lead the muscles around the vagina to have a guarding response, creating more tension.&nbsp;</li><li>&nbsp;Vaginal muscles can contract and stay that way, in order to&nbsp; compensate for weakness elsewhere in the body, like weak hip muscles and/or weak abdominal muscles.&nbsp;</li><li>Prolonged sitting is known to slow down the circulation in the muscles and decrease flexibility.&nbsp;</li><li>Hormonal changes during menopause can also cause vaginal dryness and decreased flexibility or increased tension in the area.&nbsp; &nbsp;</li></ul>Vaginal muscle tension interferes with the normal sexual function, takes away the&nbsp; option of using insertable products during menstruation, and also makes the internal gynaecological exam difficult. It’s important to identify the cause of the tension, and more importantly work on releasing the tension, to decrease discomfort and challenges with penetration.&nbsp;&nbsp;How to relax the vaginal muscles?Once the tension&nbsp; in vaginal muscles is identified, the next step is to work on relaxing them. A&nbsp;Pelvic floor physiotherapist&nbsp; is the ideal person to help identify tension areas, causes, and provide solutions. Here are some strategies to help relax the muscles around the vagina:&nbsp;<ul><li>Ensuring a correct breathing pattern is crucial.&nbsp; With every inhalation the vaginal muscles should relax &amp; lengthen and should come back to their normal resting state with the exhalation. A pelvic floor therapist will monitor the breathing pattern and subtle movement of vaginal muscles through observation and guide the person towards the correct pattern.</li><li>Various stretching exercises can help with opening up the vaginal area and hence relaxing the tense muscles.</li><li>Identifying weak musculature in the body and strengthening them will automatically help reduce tension in the vaginal muscles.</li><li>Addressing underlying psychological causes such as fear of penetration with the help of a mental health expert is important. This will help to alleviate the root cause of the tension.&nbsp;</li><li>Calming down the nervous system through meditation and guided relaxation techniques.</li><li>Taking frequent&nbsp; breaks from prolonged sitting and moving around throughout the day helps to improve circulation through the vaginal muscles and reduces the tension.</li><li>Using vaginal dilators to open up and relax the vaginal canal.</li><li>Manual therapy both internally and externally by a pelvic floor therapist can help release tension points in the muscles. The therapist should also teach the individual strategies on how to release tension points themselves.&nbsp;</li></ul> &nbsp;ConclusionMany women report increased tension in the muscles surrounding the vagina, making penetration very challenging for them. Decreasing tension and relaxing the vaginal muscles is the most holistic way to address this. Pelvic Floor Physiotherapy plays a very important role in educating females about their body, creating awareness around their pelvic floor, and making the mind muscle connection, which is essential to improve the flexibility of the vaginal muscles. This helps women experience pain free penetration! If you feel like you may be experiencing tension in the muscles around your vagina, make an appointment to see one of our&nbsp;<a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=online&amp;clinic=0&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability%2F&amp;Source=google&amp;Acq=inorganic&amp;Med1=ad&amp;Med2=landingpage&amp;Int=visit&amp;C3=&amp;C2=broad&amp;C1=leadgen&amp;Prod=physio&amp;gad_source=1&amp;gclid=Cj0KCQjwk6SwBhDPARIsAJ59GwdRC32bh16QDfw_fAbz1h6g5a2M282dSnNwxtx1xSVXnwYfNkr0kwkaAoKGEALw_wcB">expert pelvic health physiotherapists</a> at Proactive for Her.&nbsp;

Vaginal muscle tension can occur due to various reasons. What's important is that a pelvic health physiotherapist can assist in teaching  you how to relax the muscles around your vagina. Read on to learn more!

How to relax your vaginal muscles

What is Vaginismus?Vaginismus involves recurrent or persistent involuntary spasms of the vagina’s outer muscles, preventing the penetration of any object (penis, finger, tampon, menstrual cup, gynaecologist’s speculum etc.),&nbsp;despite the person's definite desire to do so.&nbsp;It is understood as the body’s protective response that causes an involuntary contraction of the pelvic floor muscles, causing the entrance of the vagina to close. It is an uncontrollable response generally rooted in fear. It does not necessarily affect one’s ability to get aroused or enjoy other types of sexual contact.&nbsp;Vaginismus is classified as primary or secondary. It is&nbsp;primary vaginismus if it’s a lifelong condition i.e. if the individual has never been able to have penetration of any kind, despite desiring so. This is often discovered during one’s first attempt at penetrative sex, inserting a tampon, or the first time a pelvic examination is attempted by a doctor. It is&nbsp;secondary vaginismus if painless intercourse has been experienced in the past but the individual is no longer able to have it. This can be triggered by particularly stressful life events, emotional distance created by marital conflicts, childbirth trauma and injuries, or health conditions such as pelvic inflammatory diseases, infections, endometriosis etc.It has been associated with high levels of disturbance for those affected and can have a profound impact on how a woman feels about herself, on her partner, and on their relationship.&nbsp;&nbsp;Vaginismus as a Phobic or Fear ResponseA phobia can be simply described as an excessive and irrational fear reaction. One may experience a deep sense of dress or panic when they encounter the specific source of fear.&nbsp;Pelvic floor reactions such as an involuntary spasm of the pelvic floor has been observed as a part of the body’s wider defence reaction to threat and stress, in individuals both with and without vaginismus. Vaginismus is a phobic, involuntary, and reflexive response to protect the individual against actual, perceived, or anticipated harm from vaginal penetration - of any kind. Fear of pain is the most significant factor observed in women coming to Proactive For Her for&nbsp;<a href="https://proactiveforher.com/vaginismus/">vaginismus treatment.</a> The root of this fear may be in having heard stories of and expecting penetration to be painful, inaccurate sex education, excessive and unbalanced exposure to stories of sexual assault etc. This can result in hyper-vigilance, negative perception of any sexual cues, and avoidance of sex. Hence, the phobia for some individuals is not due to the experience of actual pain but in the anticipation of pain.&nbsp;Women who experience high stress or perceive to have high levels of stress are considered vulnerable to vaginismus. Anxiety and being prone to anxiety has also been identified as a risk factor for vaginismus. Women with vaginismus may also report specific phobias related to bleeding, bodily injury, childbirth and show an unwillingness to engage in penetration if even the possibility of pain presents itself.&nbsp;Some women with vaginismus have also been found to respond to sexual stimuli with more disgust and show increased pelvic floor tension. This response could possibly be due to beliefs around sex and masturbation being shameful or wrong. This conditioning is often seen in women who have grown up with overly restrictive upbringing (in which sexuality was considered a taboo subject), restrictive religious teaching resulting in unhealthy or sex negative messages, and inadequate or incorrect sex education. Hence, in such cases, the underlying fear may not be of the pain but of the resultant shame or consequence arising out of penetration.&nbsp;Vaginismus must not be confused with the fear, phobia or anxiety around and of sex as it is a fear response to penetration of any object and is characterised by the desire to insert it but not being able to due to the muscle spasm experienced at the time. Beliefs around sex and sexual intercourse can contribute to underlying beliefs of vaginismus that can get triggered at the time of attempting penetration.&nbsp;Vaginismus and the muscle spasm must not be understood purely as a dysfunctional response but should be normalised as a healthy functional response to the threat that protects the individual from real or perceived potential harm.&nbsp;&nbsp;Vaginismus as a Psychological and Mental Health ConcernVaginismus is a psychosomatic condition, which means that it is borne out of an interaction between the mind and the body. Traditionally, vaginismus was understood as a physical concern characterised by the vaginal spasm. With new research, studies have found that it’s actually affected by multiple factors, beyond just the physical symptoms. It’s important to focus on deeper cognitive (mental) and emotional meanings behind the physical symptoms. The factors that contribute to vaginismus are understood to lie on a spectrum and are understood as a combination of physical to psychological, influenced by relationships and one’s cultural context. Different blends of these factors will contribute to it in unique ways to each set of partners experiencing vaginismus.&nbsp;&nbsp;Some of these factors include:&nbsp;<ul><li>Beliefs around penetrative sex being painful or underlying fears about tissue damage or the hymen being torn, due to misinformation about the body and acts of sex</li><li>Beliefs around sex and masturbation being shameful or wrong including overly restrictive upbringing (in which sexuality was considered a taboo subject), repressive religious teaching resulting in unhealthy or sex negative messages, and inadequate sex education,</li><li>Negative beliefs around sexual organs including the vagina being too small or having a penis aversion</li><li>Excessive fears around negative consequences of sex including painful childbirth, unwanted pregnancy, sexually transmitted diseases etc.&nbsp;</li><li>Experiences of pain around genitals including painful periods, vaginal injuries or surgeries&nbsp;</li><li>Painful first sexual experiences&nbsp;</li><li>Traumatic events including past emotional, physical and sexual abuse or being a witness of violence or abuse, or exposure to unsafe touch experiences, or excessive exposure to stories of sexual assault&nbsp;</li><li>Having a general anxiety disorder that is characterised by hyper-vigilance, catastrophic thinking and an excessive need for control as well as development of perfectionism</li><li>Relationship dynamics, particularly a lack of emotional safety with one’s partner (due to mistrust, lack of commitment or emotional detachment) which could create anxiety about being vulnerable. As the aforementioned factors underlying vaginismus are primarily psychological, emotional, relational, and cultural in nature, it makes vaginismus a mental health or psychological concern as well.&nbsp;</li></ul>&nbsp;Moving Forward&nbsp;One shouldn’t have to live out their life in perpetual fear of pain, threat or the consequence of sex. Every individual has a right to a safe, protected, respectful, pain-free, and pleasurable sexual experience. Unfortunately, vaginismus remains enveloped in taboo, shame, embarrassment, or sheer ignorance, leaving women often without a name for their experiences, resigned to endure their condition silently. Vaginismus is a treatable condition provided a holistic and well-rounded approach is applied. The essential components of an effective vaginismus treatment plan are the following:&nbsp;<ul><li>Psycho-sexual therapy to address the underlying psychological and mental health factors of vaginismus. In the presence of a trauma-informed mental health expert, one must gain insight into the excessive fear and phobia that may be contributing to vaginismus as well as heal their related past trauma.&nbsp;</li><li>Mind and body relaxation&nbsp;done through mindfulness, breathing, and exercises as advised by a trained yoga professional to ease their stress and anxiety.&nbsp;</li><li>Pelvic floor exercises&nbsp;as advised by a trained&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapist</a> to target the pelvic floor muscles to gain better control of them and their general movement. It also helps to ease the tension in the pelvic floor. This also aids with vaginal training or dilation wherein the movement and stretching would decrease the pain and allow the muscles to relax.&nbsp;</li><li>Vaginal training&nbsp;using vaginal dilators can be extremely helpful for the mental, visual, and physical adaptation to penetration and to refute the belief that penetration is painful. Dilators are cylindrical shaped devices which come in various sizes. They are used to help open and stretch the tissues in the vaginal canal and release pain points, along with building the mental and emotional threshold to accept penetration.&nbsp;</li><li>Partner relationship and intimacy&nbsp;to build better communication and understanding between partners, provide a space for them to vent and feel supported, along with initiating partnered physical exercises aimed at improving emotional and physical connection. In some cases, couples counselling may be needed to address some deeper running issues.&nbsp;</li><li>Support network with other women with vaginismus&nbsp;to address feelings of isolation that come with the condition, experience empathy and support.&nbsp;</li></ul> &nbsp;ConclusionVaginismus is a lot more common than we all think. Proactive For Her’s award winning, multi-faceted <a href="https://proactiveforher.com/vaginismus/">Vaginismus Healing Program</a> has a multidisciplinary team to treat vaginismus holistically and supportively. If you suspect someone you know might be dealing with vaginismus, reach out to us to schedule an&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/online-vaginismus-screening/">initial screening</a> call and gain more information.&nbsp;

A phobia is considered an excessive fear reaction, and when this fear happens in response to vaginal penetration, it's called vaginismus. Understanding what vaginismus is, why it's a psychological concern, and how to treat it is extremely important. Read on to learn more! 

Fear of Painful Sex: Understanding Vaginismus as a Phobia Response

What is Vaginismus?Vaginismus involves recurrent or persistent involuntary spasms of the vagina’s outer muscles, preventing the penetration of any object (penis, finger, tampon, menstrual cup, gynaecologist’s speculum etc.), despite the person's definite desire to do so. It is understood as the body’s protective response that causes an involuntary contraction of the pelvic floor muscles, causing the entrance of the vagina to close. It is an uncontrollable response generally rooted in fear. It does not necessarily affect one’s ability to get aroused or enjoy other types of sexual contact.&nbsp;Vaginismus is classified as primary or secondary. It is&nbsp;primary vaginismus if it’s a lifelong condition i.e. if the individual has never been able to have penetration of any kind, despite desiring so. This is often discovered during one’s first attempt at penetrative sex, inserting a tampon, or the first time a pelvic examination is attempted by a doctor. It is&nbsp;secondary vaginismus if painless intercourse has been experienced in the past but the individual is no longer able to have it. This can be triggered by particularly stressful life events, emotional distance created by marital conflicts, childbirth trauma and injuries, or health conditions such as pelvic inflammatory diseases, infections, endometriosis etc.It has been associated with high levels of disturbance for those affected and can have a profound impact on how a woman feels about herself, on her partner, and on their relationship.&nbsp;&nbsp;Why is Vaginismus a Mental Health or Psychological Concern?&nbsp;Vaginismus is a psychosomatic condition, which means that it is borne out of an interaction between the mind and the body. Traditionally, vaginismus was understood as a physical concern characterised by the vaginal spasm. However, a multi diagnostic framework was needed to understand it beyond the physical diagnostic markers to focus on deeper cognitive and emotional meanings behind the physical symptoms. The factors that contribute to vaginismus are understood to lie on a spectrum and are understood as a combination of physical to psychological, influenced by relationships and one’s cultural context. Different blends of these factors will contribute to it in unique ways to each set of partners experiencing vaginismus. Some of these factors include:&nbsp;<ul><li>Beliefs around penetrative sex being painful or underlying fears about tissue damage or the hymen being torn, due to misinformation about the body and acts of sex</li><li>Beliefs around sex and masturbation being shameful or wrong including overly restrictive upbringing (in which sexuality was considered a taboo subject), repressive religious teaching resulting in unhealthy or sex negative messages, and inadequate sex education,</li><li>Negative beliefs around sexual organs including the vagina being too small or having a penis aversion</li><li>Excessive fears around negative consequences of sex including painful childbirth, unwanted pregnancy, sexually transmitted diseases etc.&nbsp;</li><li>Experiences of pain around genitals including painful periods, vaginal injuries or surgeries&nbsp;</li><li>Painful first sexual experiences&nbsp;</li><li>Traumatic events including past emotional, physical and sexual abuse or being a witness of violence or abuse, or exposure to unsafe touch experiences, or excessive exposure to stories of sexual assault&nbsp;</li><li>Having a general anxiety disorder that is characterised by hyper-vigilance, catastrophic thinking and an excessive need for control as well as development of perfectionism</li><li>Relationship dynamics, particularly a lack of emotional safety with one’s partner (due to mistrust, lack of commitment or emotional detachment) which could create anxiety about being vulnerable.</li></ul>As the aforementioned factors underlying vaginismus are primarily psychological, emotional, relational, and cultural in nature, it makes vaginismus a mental health or psychological concern as well.&nbsp;&nbsp;How to Spot if You Have Vaginismus and How is it Diagnosed?Paying attention to one’s body and symptoms during penetration of any kind can help to know whether it is vaginismus. Given below are some of the signs that point towards vaginismus:&nbsp;<ul><li>Feeling like there is a “wall” down there, blocking anything from penetrating.&nbsp;</li><li>Painful vaginal penetration, including during sexual intersource, tampon insertion or a medical examination.&nbsp;</li><li>Fear or anxiety around penetration, which can make one avoid penetration, sexual activity, or push the partner away in anticipation of sexual activity and/or pain.&nbsp;</li><li>Feeling like the vaginal opening is too small for anything to penetrate.&nbsp;</li></ul>The condition can be extremely difficult to talk about as there can be shame and taboo surrounding matters of sexual health. However, vaginismus is more common than one thinks and it is curable, when approached with a multi-faceted, well-rounded treatment plan. It is advised to consult with a non-judgemental and trauma-informed medical expert to accurately examine the symptoms, diagnose, and suggest evidence-based treatment options.&nbsp;&nbsp;Can a Gynaecologist Provide the Ideal Treatment for Vaginismus?Often, a gynaecologist is a woman’s first point of contact when challenges related to sex or the genital region may appear. It is advised to consult with a&nbsp;<a href="https://proactiveforher.com/experts/?specialization=gynaecology&amp;page=1&amp;sort=availability&amp;mode=offline&amp;clinic=78b9e873-ce70-4f06-b39a-8c4ae448a37d">non-judgemental and trauma-informed gynaecologist</a> to accurately examine the symptoms and diagnose vaginismus. However, since vaginismus is a combination of a physical, psychological, mental health, and relational symptoms and factors, the ideal treatment for vaginismus must also be holistic and address these multiple components. These include:&nbsp;<ul><li>Psycho-sexual therapy to address the underlying psychological and mental health factors of vaginismus. In the presence of a trauma-informed mental health expert, one must gain insight into the negative beliefs and stressors that may be contributing to vaginismus as well as heal their related past trauma.&nbsp;</li><li>Mind and body relaxation&nbsp;done through mindfulness, breathing, and exercises as advised by a trained yoga professional.&nbsp;</li><li>Pelvic floor exercises&nbsp;as advised by a trained&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapist</a> to target the pelvic floor muscles to gain better control of them and general movement. This also aids with vaginal training or dilation wherein the movement and stretching would decrease the pain and allow the muscles to relax.&nbsp;</li><li>Vaginal training&nbsp;using vaginal dilators can be extremely helpful for the mental, visual, and physical adaptation to penetration and to refute negative beliefs around penetration being painful. Dilators are cylindrical shaped devices which come in various sizes. They are used to help open and stretch the tissues in the vaginal canal and release pain points, along with building the mental and emotional threshold to accept penetration. Oftentimes, women are just given a set of dilators to practise with on their own and it can be an overwhelming experience to go through alone. It’s important for a trained pelvic health physiotherapist or professional to guide you as you get started with dilation.&nbsp;</li><li>Partner relationship and intimacy&nbsp;to build better communication and understanding between partners, provide a space for them to vent and feel supported, along with initiating partnered physical exercises aimed at improving emotional and physical connection. In some cases, couples counselling may be needed to address some deeper running issues.&nbsp;</li><li>Support network with other women with vaginismus&nbsp;to address feelings of isolation that come with the condition, experience empathy and support.&nbsp;</li></ul> ConclusionThere is a need for widening of the perspective on vaginismus as from beyond a physical condition to a multi-faceted condition with psychological roots. Proactive For Her’s award winning, multi-faceted&nbsp;<a href="https://proactiveforher.com/vaginismus/">Vaginismus Healing Program</a> has a multidisciplinary team to treat vaginismus holistically and supportively. If you suspect someone you know might be dealing with vaginismus, reach out to us to schedule an&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/online-vaginismus-screening/">initial screening</a> call and gain more information.&nbsp;

Although vaginismus has physical symptoms, it's actually a psychological condition, related to how a person's brain is reacting to the thought or attempt at penetration. Treatment involves treating both the psychological aspect as well as the physical symptoms that come with them. Read on to learn more! 

Vaginismus is a mental health concern - Here's why

What is vaginismus and why does it happen?Vaginismus is a condition in which the muscles of the vagina involuntarily contract upon any kind of penetration. This contraction makes penetration extremely painful and uncomfortable.&nbsp;Vaginismus primarily has psychological roots, and often results from fear of penetration, and at times from the taboos associated with sex and intimacy. The precursors of vaginismus often develop during childhood and early adulthood (as in the case of primary vaginismus), and these may be in the form of extreme stress during childhood, instances of childhood trauma, or conditions in which one may have felt unsafe or vulnerable. The feeling of ‘unsafety’ often plays a key role in the development of vaginismus, in which the body tries to protect itself by resisting and avoiding penetration.&nbsp; Can vaginismus regress?Can vaginismus come back after I have healed from it? This is a question that women may have after they have had successful attempts of penetrative and pleasurable intercourse. The answer is that it depends on a lot of factors. Women may notice regression of vaginismus when experiencing any pain, discomfort, or muscle contraction during penetration.&nbsp;Some symptoms of vaginismus regression include:&nbsp;<ul><li>Pain or discomfort during penetration</li><li>Involuntary muscle contractions during or before intercourse</li><li>Feeling of tension or clenching in pelvic region</li><li>Lack of interest in sex or foreplay</li><li>Avoidance of emotional or physical intimacy</li></ul> What can cause vaginismus to regress?As we understand, muscle contractions in vaginismus are often involuntary, and they tend to be the body’s way of protecting itself. Regression of vaginismus may happen due to:<ul><li>Experiencing high levels of stress or distressing incidents</li><li>Unsafety in the relationship or marriage</li><li>Unhealed or unresolved incidents from the past</li><li>Experience of pain near the vulva, pelvic region, or on other parts of the body</li><li>Other factors that make one feel vulnerable or stressed</li></ul>However, these factors don’t always necessarily lead to vaginismus regression, especially in the presence of protective (preventative) factors. Having a healthy support system, personal resilience, and healthy stress-coping skills can help prevent vaginismus regression. It is also important to remember that vaginismus regression can be treated and healed, and exercises and therapy may greatly help with it.&nbsp;&nbsp;&nbsp;What does treatment look like?Healing vaginismus or vaginismus regression involves addressing specific issues that may have led to the regression, while also helping the mind and body adapt to penetration painlessly. Treatment usually entails:&nbsp;<ul><li>Psychological therapy: Therapy in healing vaginismus regression focuses on helping identify and address issues or triggers that may have led to the regression. This involves learning healthy stress-management skills, healthy conflict-management skills, and resolving any past trauma, pain, or distress that still lingers.&nbsp;</li><li>Physiotherapy and vaginal-training exercises: Working with the body is very important in treating vaginismus regression to help the body re-adapt to penetration while experiencing comfort and pleasure during it. This involves relaxing breath-work, pelvic-floor exercises, and vaginal-training using dilators.</li><li>Self-work and lifestyle changes. Lifestyle changes in the present are important to make and are encouraged. It is important to actively make healthy lifestyle choices which maximize on feelings of safety and comfort.</li></ul>&nbsp;How can I ensure that I have healthy and pleasurable sex after healing vaginismus?Here are some things which can be done to ensure healthy sex lives while also preventing vaginismus regression:&nbsp;<ul><li>Spend time with your partner building on safety and intimacy in your relationship.&nbsp;</li><li>Engage in safe and healthy foreplay while focusing on mutual pleasure and comfort. Sharing intimate sexual experiences during foreplay creates healthy associates with sex, and can also help partners to explore their bodies together.&nbsp;</li><li>Focus on maintaining healthy mental and physical well being. Engage in healthy stress-coping activities such as meditation, breath-work, and connecting with supportive people. It is also helpful to address any unresolved emotional issues through therapy.</li><li>Celebrate yourself and your personal resilience. Acknowledge and celebrate your effort and dedication in overcoming vaginismus and recognize the progress you have made. Positive affirmations and a healthy self-image can play a great role in maintaining a positive attitude towards intimacy.</li></ul> To sum it up, vaginismus regression is possible after healing vaginismus completely. It usually happens when one is going through high levels of stress, or is experiencing emotional or physical stress. However, vaginismus regression can be prevented and addressed by following healthy practices and exercises such as meditation, building on safety in the relationship, open communication, and maintaining healthy mental and physical wellbeing.&nbsp;If you notice any signs of regression or if challenges arise, please don't hesitate to seek professional support from our team at Proactive For Her that specialises in <a href="https://proactiveforher.com/vaginismus/">healing vaginismus.&nbsp;</a>

Yes it's possible, but there are certain strategies and practices you can implement in order to prevent it from happening! Read on to learn more on how to keep it at bay!

Can vaginismus come back once it is treated?

What is vaginismus?Vaginismus is a condition where the muscles around the vagina tighten involuntarily, making it very painful or even impossible to insert anything into the vagina, such as a tampon, finger, or penis for penetration. It can make sexual intercourse difficult or uncomfortable, and it can affect a person's relationships and quality of life. Think of it like this: imagine the muscles around your vagina are like a tight fist. When someone with vaginismus tries to insert something into their vagina, these muscles clench up tightly, making it feel like a barrier or a blockage. This can cause pain, discomfort, or even make it impossible to have penetrative sex.Now, what causes this tightening? It can be due to a variety of reasons. Sometimes it's because of fear or anxiety about sex or penetration. It can also be linked to past traumatic experiences, such as sexual abuse or painful medical procedures involving the genitals. Why is vaginismus misunderstood?Vaginismus is often misunderstood for several reasons, including societal taboos around sexuality, limited awareness among the general public, and the complex nature of the condition itself. Many societies have deeply ingrained taboos surrounding the topic of sexuality and discussing issues related to genitals or sexual function openly. This stigma can lead to a lack of education and awareness about conditions like vaginismus. People affected by vaginismus may feel embarrassed or ashamed to talk about their symptoms, therefore further contributing to the slack of discussion and understanding surrounding the condition.&nbsp;Vaginismus is also not as well-known or understood as other sexual health conditions. It can present with a wide range of symptoms and severity levels, making it challenging to recognize and diagnose, which can only be done by medical professionals and sex therapists. Some individuals may experience mild discomfort or pain during penetration, while others may find it completely impossible to insert anything into the vagina. Additionally, vaginismus can be triggered by various factors, including psychological, emotional, and physical causes.There are many misconceptions surrounding sexuality and sexual dysfunction. Some people may inaccurately believe that painful sex is normal or unavoidable, leading to a normalisation of symptoms associated with vaginismus. Others may also incorrectly assume that vaginismus is solely psychological or that it can be easily overcome with will power alone, negating the physical aspects of the condition. It must be known that the contraction experienced in the vagina by the individual, is involuntary therefore needs attention in a physical as well as psychological manner.&nbsp;Another point to note regarding why vaginismus is misunderstood, is that the whole topic is rarely depicted or discussed in mainstream media or literature. The lack of representation can contribute to feelings of isolation and alienation among individuals affected by the condition, as well as evolve misconceptions and stereotypes about sexual health and dysfunction. In order to accurately understand vaginismus, addressing these barriers requires increased education, awareness, and de-stigmatization of sexual health issues, as well as improved training for healthcare professionals in recognizing and treating vaginismus effectively. How social factors could impact your sexual life?Vaginismus has a lot to do with the lack of understanding or exposure to one’s own sexual life. Social factors can have a significant impact on a person's sexual life in various ways, influencing their attitudes, behaviours, and experiences related to sexuality. Here are several ways in which social factors can affect sexual life:<ul><li>Cultural Norms and Values: Cultural norms and values play a crucial role in shaping beliefs and attitudes about sexuality. Different cultures may have varying perspectives on sexual expression, gender roles, sexual practices, and acceptable behaviour. These cultural norms can influence individuals' comfort levels with their sexuality, as well as their willingness to explore and express their desires.</li><li>Family and Upbringing: Family attitudes and upbringing can profoundly influence an individual's sexual development. Messages received from parents or caregivers about sex, relationships, and gender roles can impact self-esteem, body image, and beliefs about sexual behaviour. If there is open communication and positive parental guidance, this can foster healthy attitudes towards sexuality, while stigma or shame surrounding sex can lead to feelings of guilt or confusion.</li><li>Religious Beliefs: Religious beliefs and teachings often shape individuals' views on sexuality and sexual behaviour. Some religions promote abstinence before marriage, prescribe specific sexual practices, or impose strict guidelines regarding sexual morality. For individuals who adhere to these beliefs, navigating sexual relationships and desires may involve balancing religious teachings with personal values and desires, making it quite difficult to dwell deep into their sexual side.&nbsp;</li><li>Peer Influence: Peers and social networks can also influence sexual attitudes and behaviours. Adolescents and young adults, in particular, may be influenced by peer pressure, social norms, and cultural expectations regarding sex. The desire for acceptance or conformity within peer groups can impact decisions related to sexual activity, contraception use, and relationship dynamics.</li><li>Media and Entertainment: Media portrayals of sex and relationships can shape perceptions and expectations surrounding sexuality. Television shows, movies, music, and advertising often present idealised or unrealistic depictions of sex, which can create pressure to conform to certain standards or norms. Additionally, the prevalence of sexualized imagery in the media can influence body image and self-esteem, particularly among young people.</li><li>Social Stigma and Discrimination: Stigma and discrimination related to sexuality, gender identity, and sexual orientation can have detrimental effects on individuals' sexual well-being. Fear of judgement, rejection, or violence may lead some individuals to conceal their sexual orientation or engage in risky sexual behaviours. Discriminatory attitudes and policies can also limit access to sexual health resources, education, and support services for marginalised communities.</li><li>Socioeconomic Factors: Socioeconomic factors such as income, education, and access to healthcare can impact sexual health outcomes. Individuals facing economic hardship or social inequality may experience higher levels of stress, which can affect sexual desire, arousal, and satisfaction. Limited access to sexual health resources, contraception, and reproductive healthcare services can also contribute to disparities in sexual health outcomes.</li></ul>&nbsp;Vaginismus and cultural and religious factors&nbsp;Culture and religion do play a huge role in the lack of discussion and awareness around sexuality, and therefore vaginismus and its treatment. It's essential to recognize that attitudes towards sexuality, gender roles, and health care vary widely across different cultures and religious beliefs. In some cultures, there may be strong taboos surrounding discussions of sexual health and dysfunction, making it challenging for individuals to seek help or support for vaginismus. Cultures that prioritise modesty and sexual purity may view discussions of sexual problems as shameful or inappropriate, leading to stigma and reluctance to seek treatment.Likewise, gender roles and expectations can influence experiences of vaginismus. In patriarchal societies, there may be pressure on women to fulfil traditional roles as wives and mothers, including performing sexually without experiencing pain or discomfort. This pressure can increase feelings of inadequacy or failure for individuals with vaginismus and may impact their willingness to seek help.Religious beliefs and teachings can shape attitudes towards sexuality and health care, including the treatment of conditions like vaginismus, therefore, seeking treatment for vaginismus may raise questions about religious morality, marital duties, and personal piety.In some cultures, there may be barriers to accessing sexual health education, gynecological care, and mental health support due to cultural taboos, gender segregation, or limited availability of services. Religious beliefs regarding modesty and privacy may also impact individuals' comfort levels with seeking medical treatment for sexual health concerns. It is also important to note that supportive communities may provide acceptance, understanding, and encouragement for seeking treatment, while communities that stigmatise sexual health issues may perpetuate shame and silence surrounding vaginismus. Understanding the cultural and religious norms within a community can help one tailor their support networks to meet the needs of individuals with vaginismus. &nbsp;ConclusionIn addressing vaginismus within cultural and religious contexts, it's essential to approach treatment with sensitivity, respect, and cultural competence. At Proactive for Her, we strive to create a safe and non-judgmental environment for individuals to discuss their experiences and concerns, while also acknowledging and respecting diverse cultural and religious perspectives on sexuality and health. If you or a loved one know or suspect you have vaginismus, please don’t hesitate to schedule a&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/online-vaginismus-screening/">screening call</a> with us.&nbsp;

Here at Proactive for Her, we treat (and heal!) many women who are suffering from vaginismus. Social factors in women's lives (such as religion and the environment they grew up) often contribute to vaginismus. Read on to learn more! 

Vaginismus through a social microscope

If you are reading this, it is possible that you have encountered painful intercourse firsthand. Alternatively, you may have a loved one confiding in you about an experience, and are here to better understand this. Understanding the underlying causes of painful intercourse can help one decide the best possible treatment option.&nbsp;&nbsp;Does sex usually hurt?Intercourse does not have to be painful for either partner. When engaged in healthy practices of sex (with plenty of foreplay and safety-creation!), it can be entirely painless and pleasurable.&nbsp;However, certain conditions and underlying issues can cause intercourse to be painful and these often require professional and specialised interventions to heal.&nbsp;What can lead to painful intercourse?Pain during intercourse,&nbsp; or&nbsp;‘Dyspareunia’&nbsp; may vary in intensity, sensations, and locations. For some, this may feel like general discomfort, pressure, or tightness in the pelvic region. For others, they may experience sharp pain, or a dull persistent ache. There are various potential causes for Dyspareunia, including psychological and physical causes.&nbsp;&nbsp;Psychological causes&nbsp;of painful intercourse often include deep seated fear, discomfort, or aversion to sex, which cause physical pain and tightness in the vagina. This often manifests in a condition called&nbsp;‘Vaginismus’&nbsp;in which the muscles of the vagina involuntarily contract upon any kind of penetration. This contraction makes penetration extremely painful and uncomfortable.&nbsp;&nbsp;Physical causes of painful intercourse include:&nbsp;<ul><li>Anatomical causes:&nbsp;This includes dysfunction involving anatomical structures (including muscles and organs) that may lead to the sensation of pain.&nbsp;</li><li>Hormonal causes:&nbsp;Imbalances or decrease in certain hormones may also lead to underlying conditions causing dyspareunia. This includes decreased estrogen, and endometriosis.&nbsp;</li><li>Inflammatory conditions:&nbsp;These may include cysts, recurrent vaginal and pelvic infections, and other inflammatory conditions in the vaginal canal and the pelvic region.&nbsp;</li><li>Physical injury:&nbsp;Physical injury, especially when unhealed, may lead to increased pain and discomfort during intercourse. This may involve perineal tearing during childbirth,, scarring due to C-sections or surgery, and the effects of radiation therapy.&nbsp;</li><li>Other causes:&nbsp;Pain during intercourse may at times be due to other causes such as bowel issues, overall ill health, and other conditions involving pain around the vagina or pelvic region.&nbsp;</li></ul>&nbsp;When should I seek help for painful intercourse?It is always a good idea to seek professional support when experiencing pain during intercourse. This is especially important when one notices the following:&nbsp;<ul><li>Pain is persistent and prolonged&nbsp;</li><li>Pain is increased in intensity.&nbsp;</li><li>Physical symptoms of abnormal bleeding, pelvic pain, or urinary symptoms</li><li>There is a general unease and fear of sex</li><li>Significant impact on daily life and self-confidence</li><li>Significant impact on intimate relationship</li></ul>&nbsp;What can I expect when seeking help?It is important to seek professional medical support from a health care provider specialising in treating dyspareunia. Professionals may administer tests and assessments to diagnose and identify the underlying causes of painful intercourse, after which appropriate treatment would be administered.&nbsp;Treatment for dyspareunia depends on the nature of the underlying causes. Psychological causes are treated with psychological interventions which focus on addressing fears, healing unresolved conflicts, and creating safety and confidence. At Proactive for Her, we have a team of&nbsp;<a href="https://proactiveforher.com/experts/?specialization=psychology&amp;page=1&amp;sort=availability&amp;mode=online&amp;clinic=0">mental health professionals&nbsp;</a>who are experts in treating this condition. Pelvic health physiotherapists address the physical symptoms accompanying painful sex, which includes body and vaginal training to help the body slowly adapt to penetration while experiencing comfort. We have expert&nbsp;<a href="https://proactiveforher.com/experts/regular-physiotherapy/?mode=offline&amp;clinic=78b9e873-ce70-4f06-b39a-8c4ae448a37d&amp;tag=regular-physiotherapy&amp;utm_source=website&amp;utm_medium=internal&amp;utm_campaign=schedule_flow&amp;utm_content=navigation_bar&amp;specialization=all&amp;page=1&amp;sort=availability">pelvic health physiotherapists</a> who specialise in helping women who are having challenges with penetrative intercourse.&nbsp;&nbsp;&nbsp;Is healing possible? What is the ideal solution?Healing and painless sex is definitely possible! It is important to remember that the journey to healing looks different for each individual, and your health provider may suggest an approach that is tailored for your condition. It’s important that you have a multidisciplinary team working together to optimize your health. Your gynecologist can help to identify any hormonal or medical conditions which may be contributing, your<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic"> pelvic health physiotherapist </a>will help address the physical symptoms, and your mental health therapist will help to address any fear or negative thoughts. Once successfully healed, intercourse can become entirely painless and pleasurable.&nbsp;To summarise, painful intercourse, or dyspareunia, involves the experience of persistent and intense pain during sex. This may be caused by a number of factors which may be physical or psychological in nature. Treatment involves assessments to ascertain exact causes, and administering appropriate interventions, including medications, psychotherapy, and vaginal-training. Successful healing and treatment can lead to pleasurable and painless intercourse.&nbsp;If you are experiencing any signs of painful intercourse, please do not hesitate to seek professional support from our team at Proactive For Her that specialises in treating dyspareunia.&nbsp;&nbsp;

Sexual intercourse should be pain free and pleasurable. However that's not the case for many women. Challenges with intercourse can be due to psychological or physical reasons, and it's important to remember that there is a solution! Read on to learn more. 

Are you facing painful sex? Here's what you should know

What is Vulvodynia?Vulvodynia is characterised by persistent and unexplained pain in the vulva, another word for the area made up of a person’s external female genitalia. The pain could be localised (just around a single point in the vulva) or generalised (in different locations in the vulva). Vulvodynia is a neurologic condition, where there is an increased sensitivity in the vulvar tissue.Studies suggest that Provoked Vulvodynia (caused by direct touch of any kind) seems to be the most common cause of pain with sex in women of reproductive age between 20 to 40 years of age.&nbsp;What are some symptoms of VulvodyniaBurning and aching painPain could be present in the entire vulva and may even radiate to the thighs, buttocks, and into the abdomen. The pain could be present all of the time and might interfere with daily activities such as wearing clothing, walking, sitting for long periods, and while sleeping. Women who report burning with urination are at increased risk of developing vulvodynia. Itching and IrritationThe skin at the vulva gets sensitive and irritated due to friction and exposure to things like perfumes, dyes, clothing, or harsh soaps. People experiencing vulvodynia have nerves in the vulva which are very sensitive, and this could lead to itching, burning and/or tingling when exposed to various irritants. Infections in the urinary tract or yeast infections can cause itching, burning, and irritation in the vulva as well, and this sensation can stay on even after the infection has been treated. Stinging and stabbingThe nerves in the vulva have a tendency to get irritated and sensitive, which leads to an increase in the sensory nerves that eventually cause too much pain. Direct injury to the vulva from childbirth and indirect injury from the back, hip, and pelvic floor muscles could cause a stabbing or stinging type of pain in the vulva. Rawness and TendernessWith chronic irritation or itching, a sense of feeling raw or tender at the area can occur. In turn, this can create a burning sensation or the feeling of increased heat around the area. People with vulvodynia who experience these symptoms will report feeling better once they remove any clothes around the area or sit under a fan. Increased sweating with exercise or hot weather might exacerbate this pain.&nbsp;&nbsp; &nbsp;What could cause Vulvodynia?Vulvodynia is a condition in which the cause is still unknown. One thing we do know is that&nbsp; there are multiple contributing factors which could cause vulvodynia. Chronic vulvar pain can occur without any cause and it’s often linked to women who are experiencing frustration, anxiety, chronic stress, and depression. One theory is that some women can have an increase in the number of nerve endings in the vulva which could make the area hypersensitive. Pain is then triggered or worsened by touch, pressure, friction (during penetration), sitting for long periods, or wearing tight clothing. Stress and anxiety are other factors that contribute to the pain in vulvodynia. Chronic stress and anxiety or history of having anxiety and depression can cause a fourfold increased chance of developing vulvodynia in women.&nbsp; Hormonal changes that occur during a person’s menstrual cycle, pregnancy, postpartum or during menopause can affect the tissue around the vulva. Fluctuating estrogen levels may affect vaginal lubrication, tissue elasticity, and the vulvar skin that contribute to pain and discomfort. Vulvodynia can also be caused by infections (such as urinary tract, yeast, or sexually transmitted), inflammatory disorders (such as lichen sclerosus), and neurological conditions like nerve compression or chronic pain. &nbsp;Difference between vulvodynia and vaginismusVaginismus is a psychological condition with physical symptoms. It’s characterised by involuntary muscle spasms in the pelvic floor muscles, specifically the muscles surrounding the vagina. These spasms can make vaginal penetration painful or near impossible, impacting sexual intercourse, inserting a tampon or menstrual cup, or even going through a gynaecological exam. It's often linked to psychological factors like fear or anxiety related to sex or penetration and even traumatic experiences. When we say psychological, we mean that your pelvic muscles are working to protect you from what they think might be&nbsp; dangerous.&nbsp; If a person has previously encountered pain with insertion, has had a strict cultural background around sexuality, or has had a sexual traumatic experience, it’s common for them to anticipate pain or have anxiety around penetration. They expereince a protective reflexive response, causing the muscle to tense and spasm.&nbsp; Vulvodynia is a chronic (&gt;3 months duration), persistent pain in the vulva or external female genitelia. The pain is often unexplained or could be caused by various factors. The most common symptoms are: burning, itchiness, soreness, and rawness. The pain could be intermittent or constant and worsened by touch, pressure, friction, sitting for long periods of time, or wearing tight clothing.&nbsp;&nbsp;<figure class="table"><table><tbody><tr><td>Vaginismus</td><td>Vulvodynia</td></tr><tr><td>Considered a psychological condition&nbsp;</td><td>Considered a condition affecting the nerves with a psychological component</td></tr><tr><td>Generally caused due to fear and anxiety around penetration&nbsp;</td><td>No specific cause</td></tr><tr><td>People report feeling a “block or wall”, making penetration impossible</td><td>People report burning and pain around the outer vulva, however penetration is often possible&nbsp;</td></tr></tbody></table></figure> &nbsp;Treatment for Vulvodynia and VaginismusAlthough vaginismus and vulvodynia are different, treatment for both conditions are very similar.&nbsp;Here are some key components of treatment for both:Pelvic floor assessment and treatment: Visiting a&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapist</a> involves assessing the pelvic floor and surrounding muscles for sensation, strength, muscle coordination, and if there are areas of tension which might contribute to the pain and burning. Tension points in the pelvic floor muscles can happen just like in other muscles in the body. They’re released through breathing exercises, gentle massage, and strengthening other areas of the body to offload the pelvic floor muscles. Relaxation techniques: Various breathing techniques can reduce muscle tension and relax the pelvic floor and surrounding muscles. It’s important that you’re guided by an expert and practise this regularly. Lifestyle modifications: Sitting for long periods of time and certain postures can decrease the amount of blood flow and oxygen to your pelvic floor muscles, which can then lead to pain. Increasing physical activity throughout your day and maintaining an active lifestyle can help decrease pain around the vulva.&nbsp;&nbsp;Mental Health Therapy:&nbsp; Counsellors help with managing anxiety and depression that is present with vulvodynia and vaginismus. ConclusionVulvodynia and Vaginismus are two different conditions, with similar treatment methods. Both multifactorial causes require a multi-disciplinary approach to treatment. If you feel you have vulvodynia or vaginismus, consult our experts at Proactive for Her for a&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/online-vaginismus-screening/">screening</a>. We offer an evidence based, non-judgementalm and collaborative treatment approach, which involves multidisciplinary care. We offer&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapy</a> both in person and online. At Proactive for Her we also have a leading an&nbsp;<a href="https://proactiveforher.com/vaginismus/">Online Vaginismus Healing Program&nbsp;</a>that encompasses all the aspects of a multicentric treatment approach. Over &gt; 250 women have been healed through the Online Vaginismus Healing Program.&nbsp;

Vulvodynia and Vaginimus are two different conditions, with similar treatment methods. Both of multifactorial causes requiring a multi-disciplinary approach to treatment.

Vulvodynia & Vaginismus: What's the difference?

What are the reasons for a tight vagina?At Proactive for Her, we don’t love using the term “tight vagina”. When people are talking about a “tight vagina”, they’re usually referring to the fact that penetration in the vagina is difficult. This can be penetration in regards to intercourse, the use of a sex toy or vibrator, inserting a tampon or menstrual cup, or even undergoing a gynecology exam! The “tight vagina” that is being referred to, can happen due to a variety of reasons, some of which aren’t often spoken about! Read on to learn more.&nbsp; VaginismusVaginismus is a condition where women experience an involuntary contraction or muscle spasm at their vagina in response to penetration or the thought of penetration. It’s considered a primarily psychological condition with physical symptoms. Over time, muscles in the pelvic floor including the ones surrounding the vagina can start to have tension points due to constant spasming. Women who have vaginismus often feel like they have a “tight vagina” because penetration is difficult. In actuality, it’s the combination of spasms and tension points that make the opening of the vaginal wall smaller. This doesn’t have to be permanent! It also doesn’t need surgery to resolve. Muscles surrounding your vaginal wall and pelvic floor are similar to that of muscles anywhere else in the body - if a person works on stretching, sending blood and oxygen to the area, and connecting with it, they’re able to relax and lengthen! Vaginismus is considered a psychological condition, so it’s important to address the root cause of why someone is experiencing this block in response to penetration.At Proactive for Her, we offer a comprehensive online&nbsp;<a href="https://proactiveforher.com/vaginismus/">Vaginismus Program</a>, which helps address the mental and physical symptoms associated with vaginismus or feelings of a “tight vagina”. We also offer in-person and online<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic"> pelvic health physiotherapy</a> sessions to help guide you on how to relax your vaginal muscles with tools such as dilators.&nbsp;&nbsp;InfectionsVaginal or urinary infections can be a source of significant pain and discomfort. When the body experiences pain, especially around a specific area, the muscles around it begin to tense up - what we call a guarding response. When someone experiences an infection around the pelvic floor, the muscles around the vagina can start to contract and create tension, especially because the urinary tract and vaginal canal are so close together. An infection in one area causes muscles around the other openings to tighten as well.&nbsp; &nbsp;The pelvic floor houses a lot of nerves, all of which are great at remembering. Even when the infection has cleared, the nerves still remember the pain they experienced and will often fire (causing muscles to contract) in response to even the thought of the infection or anything touching the area. Constant contraction can lead to tension and trigger points in the pelvic floor muscles. This is why people who have experienced infections around the uterus, bladder, rectum, anus, vagina, or urinary tract might feel like they have a “tight vagina”.&nbsp; &nbsp;<figure class="image"><img src="https://lh7-us.googleusercontent.com/hInPjO2oSXqHi1mK24Gmn75SAHia7iYwztBWoPufpfD_Pvp9RtfgaiFMd7Yt6bMLNl1pdOucoJcXPWsUKDih_Iwk26iMa0erbdYYr4UW4E29fT636_hVH3KyZGbCBdjthRSLwAZY5kMyfgP-Y5V3AVE"></figure>If you feel like you might be experiencing tension around your vagina due to a previous infection, we offer one-on-one,&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">personalised physiotherapy care</a> (both in-person and online) at Proactive for Her. Our physiotherapists are trained in helping your muscles relax and teach the brain how to decipher what actual danger is (another infection, harmful penetration), so it’s able to maintain a relaxed state. If you feel like it’s impossible to even penetrate your own finger due to the pain or fear of pain, set up a&nbsp;<a href="https://proactiveforher.com/care-packages/sexual-health/online-vaginismus-screening/">screening call</a> with one of our gynecologists or physiotherapists so they can assess what’s the best suited treatment for you.&nbsp; &nbsp;DyspareuniaThe term dyspareunia means “pain with intercourse”. Having a “tight vagina” or decreased flexibility in the pelvic floor muscles is a reason why someone might be experiencing pain with intercourse. On the other hand, an experience (or multiple experiences) of pain with intercourse is a reason why a person might experience tension around the vagina and pelvic floor muscles. Remember, the nerves around the pelvic floor and its organs act as bodyguards, protecting us from pain and any other situation we perceive as dangerous. So if someone has experienced painful intercourse in the past, the next time they attempt to have intercourse or penetrate into the vaginal opening, the nerves will send signals to the muscles telling them to tighten or close off the vagina, in order to protect it. To the person, this can feel like tightness in the vagina.&nbsp;If you’re experiencing pain with intercourse or feelings of tension around your vagina when attempting intercourse, consult with one of our&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapy</a> experts who can help you address your tension and improve your experience with intercourse!&nbsp;Injuries or Trauma (including Childbirth)Injury to ANY area in the pelvis -&nbsp; which can include your urethra (where urine comes out), vagina, anus, rectum, uterus, bladder, large intestine, hips, low back, and tailbone, can lead to increased tension in the pelvic floor muscles. Once again, this can be interpreted as a “tight vagina”. Delivering a baby, whether vaginally or through a caesarean is considered to be an injury! Similar to how the nerves in the pelvic floor react to pain, when trauma happens, the nerves once again store the memory of the pain and negative feelings that came with the trauma. After a traumatic event or injury, a person’s mind tends to become very sensitive to anything that might be dangerous. Often, the mind starts interpreting situations, people, and objects as danger, even though they might not be. When the mind is in a constant state of “guarding” or stress, the body starts to experience an increase in tension as a result of this. A simple example is that of your upper back and neck muscles. This is a common area for people to experience tension points and pain, especially when they are stressed. Similarly, a person’s pelvic floor muscles are also known to hold tension when the mind is stressed, which can be interpreted as a “tight vagina”. This happens because the opening feels smaller due to the increased muscle tension.&nbsp;If you have experienced trauma or injury anywhere around the pelvis, including your urethra, vagina, anus, rectum, uterus, bladder, hips, low back, abdomen, tailbone, or gut, and you’re feeling an increase in tension, pain, or the feeling of tightness around the area, it’s important you consult a&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapist</a>.&nbsp;&nbsp;MenopauseDuring menopause, a woman’s body goes through hormonal changes, especially a decrease in estrogen. Estrogen helps the vagina stay lubricated, keep infections away, and make sure the muscles and skin around the vagina are flexible. When there is a decrease in estrogen, the vaginal canal starts to experience dryness, it’s more susceptible to infections, and the flexibility of the muscles and tissues in the pelvic floor goes down. This can make women feel like they have “tightness” in their vaginal opening, but in fact it has more to do with the mobility in muscles, not the actual size of the vaginal opening or canal. It’s important to use research backed treatment for the lack of flexibility in the vaginal tissues, which includes using topical estrogen creams and&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapy.</a>&nbsp;If you’re going through perimenopause or menopause and are experiencing pain or difficulty with intercourse and penetration, it’s important you consult both your gynecologist and pelvic health physiotherapist. At Proactive for Her, we have experts in both fields who can help improve your quality of life!&nbsp; &nbsp;ConclusionThe anxiety and shame that comes with feeling like you have a “tight vagina” can cast a strong negative shadow on your life. It’s important to start by first changing the terminology to reflect what’s actually happening in the body. There is tension and restriction in the muscles of the pelvic floor which may feel like the opening or canal of the vagina don’t have enough space for penetration. This is different from a true lack of size in the structures. Our muscles and tissues are flexible, sometimes we just need some guidance to improve flexibility. If you feel like there isn’t enough space in your vagina, you’re not sure how to relax at your vagina, or there’s some type of block when you’re attempting penetration, it’s important to seek help. At Proactive for Her, we offer one-on-one specialised&nbsp;<a href="https://proactiveforher.com/consults/physio-therapist/?clinic=indiranagar-clinic">pelvic health physiotherapy</a>, as well as a&nbsp;<a href="https://proactiveforher.com/vaginismus/">Vaginismus Online Healing Program</a>. We offer non-judgemental, evidence-based, holistic treatment focused on improving pain and quality of life.&nbsp;

The term "tight vagina" has a very negative conotation. People experience tension around their vaginal canal due to a variety of reasons, and the good news is that this can be addressed! 

It’s good to stay curious about things.

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