VAGINISMUS (PART 2)

Last week, we started a topic on Vaginismus. We discussed the types, causes, signs and symptoms of vaginismus. This week, we will conclude with its diagnosis and treatment.

DIAGNOSIS OF VAGINISMUS

The clinician will ask about your symptoms and take a medical and sexual history to diagnose Vaginismus. Following that, a pelvic examination will be performed to rule out any other medical conditions that may be causing the pain. Before treating the vaginismus, the clinician may need to rule out any underlying causes, such as an infection. The clinician will move slowly and gently so that you may understand what they are doing.

A person must have one or more of the following symptoms for at least six (6) months and be in significant distress to receive a diagnosis:

• Vaginal difficulties during sexual intercourse
• Vaginal or pelvic pain during penetrative sexual intercourse or penetration attempts
• Tightening or tensing of the pelvic floor muscles during penetrative sexual intercourse or penetration attempts
• Fear or anxiety about experiencing vulvovaginal or pelvic pain as a result of vaginal penetration

TREATMENT OF VAGINISMUS

Treatment may involve a variety of specialists, depending on the cause. In general, vaginismus treatment aims to reduce the automatic tightening of the muscles, eliminate the fear of pain, and help ease any other fears associated with the problem.

Treatments typically focus on managing your feelings around penetration and exercises to gradually get accustomed to it, which may include:

·       Psychosexual Therapy: A type of talking therapy aimed at assisting, understanding and changing your feelings about your body and sex. Educating people about the sexual anatomy and how sexual response cycle may help them understand their pain and the processes their bodies are going through.

• Vaginal Dilation Exercises: Vaginal dilators are tapered devices that may be used to relax and gently stretch the muscles around the vaginal entrance. They come in graduated sizes, making the process slow and painless. Vaginal dilators can help desensitize the area and make you more comfortable with touch over time, which is ideal for those who have sex phobias. If a plastic dilator can be inserted without causing pain, the next step is to leave it in place for 10-15 minutes to allow the muscles to become accustomed to the pressure. They can then use a larger insert and teach their partner how to apply the insert. When the individual is comfortable with this, they can allow their partner to place their penis near but not inside the vagina. When they are completely at ease with this, the couple can resume intercourse
• Relaxation Techniques: Mindfulness, breathing, and gentle touching exercises will assist in learning to relax the vaginal muscles. This therapy entails gradually exposing a person to penetration. It can start by encouraging someone to touch an area as close to the vaginal opening as possible without causing pain. They will get closer to the vaginal opening every day. They will be encouraged to touch and open the vaginal lips, or labia, once they are able to touch the area around the vagina.
• Pelvic floor exercises: Squeezing and releasing exercises to strengthen the vaginal muscles. These include muscle contraction and relaxation activities, or Kegel exercises, to improve pelvic floor muscle control. Kegels are pelvic floor exercises that target the pubococcygeal muscle, which is responsible for supporting the pelvic floor. They are performed by isolating and tightening the muscles used to stop the flow of urine. Kegel exercises can not only help with vaginismus and increase sexual pleasure, but they can also help prevent urinary incontinence (loss of bladder control) as you age.
• Surgery: This is extremely rare and is usually only required when there is a vaginal problem that mimics the symptoms of vaginismus.

Initially, treatment is carried out under the supervision of specialized therapists. After that, you will be expected to practice some of the exercises at home. You can choose to involve your partner if you are in a relationship. Fortunately, the majority of women who undergo these treatments can find relief and reclaim their sexual lives. While treatment can be beneficial, it is important to note that some women with vaginismus have very intimate, loving relationships without engaging in sex.

CONCLUSION

Experiencing this pain or shame during sexual intercourse is not something to be embarrassed about. Talk to a clinician, you do not need to keep suffering. Women who have vaginismus and keep to themselves frequently have disrupted sex lives, which can cause distress, loss of confidence, and relationship problems. It may prevent some women from pursuing intimate relationships or starting a family, worsening their problems.

Many issues, including vaginismus, can result in painful intercourse. Almost all of these issues are curable. Many people report significant improvements in their sex lives and mental health following vaginismus treatments. Vaginismus can be treated and even cured. Treatment typically entails diagnosing and treating any underlying physical issues, as well as undergoing psychological therapy, performing pelvic exercises, and using vaginal dilators to gradually improve tolerance of penetration.

Treatment, however, will be determined by the underlying cause, which could be physical, psychological, or a combination of the two. The longer treatment may take, the more complex the cause or the severity of the symptoms.