Science of Sex: Vaginismus

September 15th, 2018

Welcome to this month’s edition of Science of Sex. This topic was suggested by one of my readers in my recent blog giveaway (thanks Courtney!). Vaginismus is a condition that you might never have heard of if you haven’t struggled with it (or known someone who has). And it seems like medical professionals don’t always take claims of pain as seriously as they should. It’s a shame because vaginismus is quite treatable as you’ll learn below.

Check out the rest of the Science of Sex posts here.

Vaginismus science of sex

Some people suffer from a condition known as vaginismus, which is characterized by involuntary contractions of the vagina that make sex painful or even impossible. It’s not uncommon for people who have this — or their partners — to describe it like hitting a wall.

There are two types of vaginismus: primary (lifelong) and secondary (developed).

A similar problem is dyspareunia or painful sex; although, vaginismus is a specific condition and patients with this condition have fewer issues with desire and self-lubrication than those whth dyspareunia.

Vaginismus is interested because it’s certainly tied to emotions, especially fear and anxiety. One survey found that people who suffer from vaginismus had a significantly higher phobia of sex while another found that over half of participants with vaginismus qualified as alexithymic (the inability to name their emotions).

While a past trauma such as sexual assault may potentially be one factor in vaginismus, people who have never engaged in any form of sexual activity can also suffer from this. And pain may be present in non-sexual situations like using a tampon or getting a Pap smear.

But there is doubt whether the emotional state causes vaginismus or whether pain leads to anxiety. Vaginismus is definitely a vicious cycle.

Researchers have looked for differences in brain and genital response in people with this condition. Interestingly, there are no differences in how the brain responds. Furthermore, while women with vaginismus report less mental arousal to erotic content, they don’t necessarily have decreased genital arousal. This is known as arousal non-concordance, and is a common theme of female sexual dysfunction.

Because of the emotional/mental aspects of vaginismus, many of the treatment options are psychological. Mindfulness, for example, can be an effective treatment.

Touching exercises are a common treatment for this condition. Patients are instructed to touch themselves progressively closer to their vagina until their can do so with less or no pain. Insertion begins with a single finger, then moves to devices (dilators) that become progressively larger.

Coping with vaginismus can be difficult for couples. Some professionals recommend erection-enabling medications if partners find it difficult to remain erect or to engage in penetration after dealing with vaginismus. Becoming accustomed to touch helps to desensitize people.

Treatment can allow for successful intercourse in as little as two weeks.

Medicine interventions have been explored, and botox may be one option for treating vaginismus. Surgery is also occasionally a solution. A hymenectomy (removal/reduction of the hymen) to make sex possible and pleasurable.

Although most people think of vaginismus in terms of sex, it can also affect childbirth and labor. Specifically, women with vaginismus are more likely to have C-sections and to suffer from perineal laceration (tears of the perineum, the skin between the anus an vagina) during vaginal deliveries. It stands to reason that fear of pain and muscle contractions or tension could make this area more vulnerable.

Further Reading


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