What is Vaginismus?
Vaginismus is the problem that sexual intercourse becomes impossible or painful as a result of the contraction of the muscles surrounding the outer part of the vagina during sexual intercourse. The contraction in the vagina may be accompanied by contractions in other parts of the body. Panicked by the severity of the contractions and fear, the woman may push her partner during intercourse or close herself completely to intercourse. These behaviors may be perceived by her partner as if she does not want intercourse or consciously closes herself to intercourse. However, the contractions are completely involuntary and it is not in the woman's hands to relax.
The muscle group involved in vaginismus is called PC (Pubococcygeus) muscle group. These muscles draw a line from the urethra to the anus and play a role in many bodily functions from urination to birth. Under normal conditions, these muscles are quite stretchable during sexual intercourse. If the person is not experiencing fear and anxiety, if the desire and stimulation are sufficient, the muscles stretch according to the size of the penis and sexual intercourse takes place easily. In women with vaginismus, an involuntary vaginal reflex occurs and spasms narrow the entrance to the vagina.
Although vaginismus is included in sexual pain disorders in the classification of sexual problems, it is not necessary to have pain to diagnose vaginismus. Vaginismus problem varies from woman to woman. Some women can undergo a gynecological examination or take a tampon into the vagina but cannot take the penis inside. Others can partially insert the penis, but the process is very painful.
Women with vaginismus think that their vagina is too small to accommodate a penis, or that there is no vaginal opening, or that the hymen is too thick and that they will have great difficulty in attempting sexual intercourse. These are erroneous thoughts caused by the vaginal muscles in a state of spasm, making it appear as if the entrance is closed. In reality, women with vaginismus have no physical obstacles in their body to experience sexuality; their genitals are completely normal.
Women with vaginismus have sexual desire for acts other than intercourse, can experience arousal and enjoy sexual intimacy. However, if vaginismus persists for a long time, they may lose interest in sex altogether.
Types of vaginismus
Vaginismus can be primary or secondary.
Primary vaginismus: It is a condition in which a woman has never had painless intercourse due to spasm of the PC muscle groups, it is detected during the first sexual intercourse attempt or gynecological examination.
Secondary vaginismus: This is the occurrence of contractions in a woman who has previously had painless intercourse. This often occurs after a trauma or surgical intervention.
What causes vaginismus?
Vaginismus is a psychological problem except in very rare cases.
Erroneous thoughts and negative conditioning in the subconscious lead to this problem. Lack of information or hearsay leads to erroneous beliefs and the perception of sexual intercourse as frightening and painful.
The negative feelings and thoughts involved in vaginismus are often not easily visible, so they need to be investigated in detail.
Inadequate sexual education, being raised with strict moral value judgments, perceiving sexuality as something shameful, sinful, dirty, being under the influence of hearsay misinformation about the hymen or sexual intercourse, high anxiety level, fear of conception, negative sexual experiences, bad childhood experience or problematic parental relationship, over-controlled personality traits, emotional attachment difficulties, lack of trust and communication problems with the partner are among the common causes.
How to approach the problem of vaginismus?
- If you are experiencing vaginismus, you should not think that it only happens to you.
- Although vaginismus is also seen in western societies, it is a common and actually the easiest female sexual function problem to solve due to traditional reasons in our society.
- Vaginismus should not be confused with the fear of the first night and should not be left alone by saying "it will pass anyway, we will overcome this problem".
- The contractions are completely involuntary and it is not in the woman's hands to relax and require treatment. For this reason, approaches such as "it is in your hands, you can do it if you want, you are not pushing yourself hard enough" should be avoided. This approach can lead to a feeling of not being understood or feelings of guilt and helplessness.
- The earlier treatment is started, the easier it is to get results. If it is late, the problem grows; in addition to depression, loss of self-confidence and communication problems between spouses, premature ejaculation, erectile dysfunction and sexual reluctance may occur in time in the spouses of women with vaginismus.
- The most important step in the solution of vaginismus is to "decide" to overcome this problem. But this should not be a forced decision with the pressure and insistence of the partner or the environment. The person's belief that he/she will solve the problem and his/her determination to continue the practices are important in treatment.
Common malpractices: Alcohol, using muscle relaxants or sedative drugs, applying local anesthetic pomades, surgical removal of the hymen, attempts to have intercourse while asleep or under hypnosis or under office conditions, trying to have in vitro fertilization with the idea that it will pass after having a child or losing hope of having sexual intercourse, etc. do not solve the problem and cause it to grow.
Vaginismus is a problem of the couple, not the woman!
Vaginismus should not be seen as a problem experienced only by women. The man also has an important role in the experience and treatment of the problem. For this reason, the man should not leave his wife alone and the spouses should participate in the treatment together. In the beginning, since the treatment will focus on the woman, the man may not need to attend all sessions. What is important in terms of treatment is that the cooperation and harmony between the spouses continues.
VAGINISMUS TREATMENT and PRACTICES IN OUR CLINIC
- Vaginismus is treated with "sexual therapy" which includes cognitive-behavioral methods.
- It is not possible to treat it with any medication or operation.
- Hypnosis is thought to be a solution sought by people with this problem with the expectation of immediate solution and definite benefit, but it is not a proven method in the treatment of vaginismus.
- Effective treatment of vaginismus is possible by addressing both the mind and the body. It is aimed to purify the mind from negative conditioning and anxiety towards sexuality and to make the body to accept and enjoy vaginal entry.
SEXUAL THERAPY
- At the beginning of the Sexual Therapy process, a detailed assessment interview is conducted. The person's/couple's lack of sexual knowledge and erroneous learnings are identified and first of all, it is aimed to eliminate them.
- Sexual and non-sexual relationships and interactions between spouses are understood and approaches are made to ensure cooperation and harmony between them.
- The woman experiencing vaginismus is taught to relax in general and to recognize and control the autonomic reactions in her body, as well as to recognize and gradually relax the vagin muscles with computer support.
- In our center, biofeedback method, a scientifically proven method, is used for this learning process.
What does Vaginal Biofeedback Application provide?
The practices that the woman will do to recognize her own bodily sensations and stretch her vaginal muscles constitute an important part of the treatment. In traditional treatments, these practices are left to the individual as homework to be evaluated later in the sessions. However, disruptions in the practices constitute a major obstacle to the treatment and often lead to the treatment being left unfinished. When vaginal practices are given as homework, it is seen that the avoidance/avoidance behaviors and postponements caused by the fear and anxiety experienced by the woman come into play and the treatment motivation, which was full at the beginning, is gradually depleted. Again, according to our observations; even if the practices (homework) are done, it is seen that people cannot analyze their bodily sensations correctly due to the fear affecting their perceptions and they cannot know how far they have progressed.
Working on the feedback of vaginal contractions (biofeedback) with computer-assisted method in a special section prepared for this purpose in our clinic removes a great burden on women and eliminates all these difficulties in treatment.
The duration of treatment can generally last from a few sessions to 8-10 sessions depending on the type and severity of the problem. Vaginal biofeedback applications shorten this period considerably. When the therapy is continued at regular intervals as one or two sessions per week, progress is made faster.
It should not be forgotten that the effectiveness of the treatment depends on the motivation and determination of the person to solve the problem in addition to the methods and techniques applied. In addition to the belief that the person will solve the problem and patiently continuing the applications, the support and support of the man to make his wife feel that he is with her is an important factor in the success of the treatment.
Click here for the brochure "Neurotheraphy", a new method in vaginismus and its treatment
