Difference between revisions of "Cope with Vaginismus"

[[Category: Women’s Health]]

#Take painful sex seriously. The first and most disturbing symptom of vaginismus is pain during attempted sexual intercourse.<ref name="rf1">https://www.vaginismus.com/</ref> Different women experience this pain differently--it may feel like burning, stinging, tightening, tearing, or as if your partner is “hitting a wall.” In many cases, the pain and the involuntary muscle contractions are severe enough to prevent sexual intercourse entirely.

#*Many women discover this problem the very first time they attempt to have sex. This is called ''primary vaginismus''<ref name="rf2">https://www.vaginismus.com/faqs/vaginismus-questions/primary-and-secondary-vaginismus-differences</ref>

#Note other problems with vaginal penetration. In addition to pain during sexual intercourse, women with vaginismus may have trouble with other kinds of penetration, including tampon insertion and pelvic exams. Other symptoms also include:<ref name="rf3">https://www.vaginismus.com/vaginismus-symptoms</ref>

#Pay attention to other muscle spasms.<ref name="rf3" />Vaginal muscle contractions and spasms are the hallmarks of vaginismus, but some women also experience spasms in the legs or lower back. These spasms occur most frequently during attempts at sexual intercourse.

#Evaluate your avoidance of sex.<ref name="rf4">https://www.vaginismus.com/vaginismus-causes</ref> Many women with vaginismus fall into a pattern of avoiding sexual situations. Avoiding sexual activity or romantic relationships because of pain or embarrassment about your symptoms is a clear sign that medical help should be sought.

#*The vaginismus may have an obvious physical cause, like an infection, injury, or hypersensitive nerves at the opening of the vagina (provoked vulvodynia).<ref name="rf5">http://www.nhs.uk/Conditions/Vaginismus/Pages/Diagnosis.aspx</ref>

#Get a diagnosis. If all other potential causes of your symptoms are ruled out, your doctor may diagnose you with either primary or secondary vaginismus. Additionally, your doctor may describe your condition as ''global'', if it occurs in all situations involving insertion or ''situational'', if it occurs only in certain situations (like attempted sexual activity).<ref name="rf2" />

#*Other possible diagnoses are apareunia, a general term for inability to have sexual intercourse (of which vaginismus is one type), and dyspareunia, which refers broadly to pain during sexual intercourse.<ref name="rf2" />

#Consider the role of anxiety. Many women with vaginismus can trace their symptoms to feelings of anxiety, fear, and stress. These can be more deeply rooted, or simply related to current factors of life, like lack of sleep and excessive work-related stress.<ref name="rf6">http://patient.info/doctor/vaginismus-and-orgasmic-problems-in-women</ref>  

#Recognize underlying beliefs about sex and sexuality. Women with vaginismus are more likely than others to have deeply ingrained negativity about sex and sexuality.<ref name="rf7">http://www.researchgate.net/profile/Rhonda_Amsel/publication/10957434_Etiological_correlates_of_vaginismus_sexual_and_physical_abuse_sexual_knowledge_sexual_self-schema_and_relationship_adjustment/links/53ff77f60cf2194bc29a8264.pdf#page=72</ref> These feelings may date back to childhood, or they may be related to a particularly traumatic event.

#Understand the role of past experiences. It is estimated that women with vaginismus are twice as likely to have a history of childhood sexual interference as non-sufferers.<ref name="rf7" /> Events thought to contribute range from mild to severe traumas, and include the following:<ref name="rf6" />

#Acknowledge the potential role of reproductive milestones.<ref name="rf8">http://www.nhs.uk/Conditions/Vaginismus/Pages/Causes.aspx</ref> For many women, the onset of secondary vaginismus is related to childbirth. This is more likely if it was very difficult or resulted in injuries to the sexual organs. Other women have vaginismus from the hormonal changes and dryness that usually occurs during menopause.

#*Secondary vaginismus can also result from a fear of having children or going through childbirth.<ref name="rf8" />

#*Some research even suggests that symptoms of vaginismus are part of general defense mechanisms that are triggered in threatening situations. This suggests that it need not always be viewed as a primarily sexual dysfunction.<ref name="rf9">http://link.springer.com/article/10.1007/s001920170035</ref>  

#Try counseling. A therapist can be helpful whether or not your vaginismus is caused by emotional or psychological issues. This is because awareness of the condition itself often produces fear and anxiety before intercourse, starting a vicious cycle that exacerbates symptoms.<ref name="rf4" /> Feelings of depression, isolation, and lower self-esteem are also common effects of the stigma of sexual dysfunction.

#*Treatment outcomes are much more positive when the woman and her sexual partner are motivated, cooperative, and resolve to lessen relationship conflicts. So, a couple's psychological evaluation is a great beginning to treatment.<ref name="rf10">http://psycnet.apa.org/psycinfo/2000-08960-006</ref>

#*One particular type of therapy, cognitive behavioral therapy (CBT), can be especially helpful to some women. CBT focuses on the relationship between thoughts and behaviors, and a cognitive behavioral therapist can help you change your thoughts and behaviors regarding avoidance of sexual intercourse<ref name="rf11">http://www.nhs.uk/conditions/Vaginismus/Pages/Introduction.aspx</ref>.

#Ask about exposure therapy. One treatment for vaginismus is called exposure therapy, or flooding, and it involves gradual desensitization to penetration.<ref name="rf12">http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001760/abstract</ref> Therapist-aided exposure to penetration is an effective treatment, even for women with lifelong vaginismus.<ref name="rf13">http://psycnet.apa.org/journals/ccp/77/1/149/</ref> The techniques for exposure usually involve vaginal penetration exercises using dilators.  

#*This is the same method used for self-treatment, with the addition of a guide who can help you continue on your own with confidence and success.<ref name="rf13" />

#Find a physical therapist. Ask your doctor to refer you to a physical therapist who has experience dealing with vaginismus and other forms of female sexual dysfunction. Because the muscles of the pelvic floor play such a major role in vaginismus, physical therapy is one of the best treatment options. Your physical therapist might:<ref name="rf14">pelvic floor muscle contraction</ref>

#Do Kegel exercises.<ref name="rf15">http://www.nlm.nih.gov/medlineplus/ency/article/001487.htm</ref> Kegel exercises are designed to help you control the muscles of your pelvic floor. To do a Kegel exercise, you simply contract the muscles you would use to stop the flow of urine, hold for a few seconds, then relax. Aim to do about 20 contractions at a time, as many times a day as you can.

#*When you begin using the dilators, leave them in for 10 to 15 minutes. The vaginal muscles will become used to the pressure.<ref name="rf16">http://www.merckmanuals.com/home/women-s-health-issues/sexual-dysfunction-in-women/vaginismus</ref>

#*If you have a spouse or partner, you may want to ask this person to help you insert the dilators.<ref name="rf16" />

#*Doctors typically suggest that women hold the penetrative object and place it partially or completely in their vagina as they have done with vaginal dilators. This applies equally to penises, dildos, and vibrators.<ref name="rf16" />