Hey there synners,
It’s Supper CJ, Your favourite online doctor.
Welcome to my column! Today, you’ll learn about Vaginismus, a “self-barricading” vagina.
“You may now kiss the bride,” said the priest. And his pink lips embraced hers in a warm kiss. It was quick, and brief, but long enough to turn on the water works, and she felt the breaking of the dam between her legs.
Throughout the reception, the only thing that preoccupied her mind was thoughts of the unimaginable pleasure that lay ahead. An experience she fervently prayed would worth the wait.
She had been brought up in a Christian home where sexual immorality was frowned upon. So frowned upon that she never had “the talk” with her mother, at the insistence of her father.
The vagina– her vagina, was spoken of with code words, and in abstract terms — so abstract that sometimes she felt as if it was a stranger in her body. “Don’t ever touch IT, don’t ever let anyone near IT;” something she was told even before she developed breast buds.
The first time she experienced her menses, she had ran to her Mom and said, “IT is bleeding.” That day everything changed. She had become a woman. And “it” was under constant scrutiny. A thing her Mom did every month, while making a face of disgust.
She was still a virgin. Well, technically; except for that time that an uncle forcefully tried to gain access to “It.” Something Father warned her never to mention to anyone.
The little she knew of sex was snippets she eavesdropped during those wild nights when her hostel mates discussed their sexcapades. And from romantic novels, and movies, which often made “It” shade tears in sympathy, just like it did when hubby kissed her in the Church, following the priest’s “you may now kiss the bride” prompting.
” Tonight, yes tonight…” She thought, while dancing with hubby.
Everything had started well. Candle light dinner. Slow-dance to J Holidae’s “Bed.” Kissing. Gentle caresses. Undressing. His mouth on her nipples. His head down below, on the knob, sending jitters down her spine, and making “It” swim in its own fluid.
Then he removed his boxers, and she saw his raging members, and snapped. Uncle was suddenly in his place. Mother was whispering “don’t touch it, don’t ever let anyone touch it,” into her ears. And her heart was racing.
When the husband thrusted, it felt like “It” was a rock, and he was hitting at it with a hammer. Few more attempts, and shouts of intense pain, left them both frustrated and exhausted. Hubby tried to insert a finger, and met the same wall. He had “disvirgined” someone before he said, and it felt nothing like this one!
What Is Vaginismus ?
Vaginismus is a form of female sexual dysfunction characterized by INVOLUNTARY spasms of perineal and pelvic muscles, following an attempt at penetration, making it extremely difficult, or outrightly impossible.
It is important to note that Vaginismus is not the same thing as “Frigidity” [failure of a woman to respond to sexual stimulus], neither does it have anything to do with libido. In fact most of such women still get aroused, and enjoy NON-PENETRATIVE sex, as can be seen from the above scenario.
It is a form of PHOBIA, entrenched by past negative experiences with any form of penetration, which may be actual or imagined, leading to anxiety following the approach of a penetrating object, or mere anticipation of such, with the resultant psychosomatic manifestation of vaginal muscle spasms. Liken this to the blink response; what happens when the eyes are approached with something perceived to be harmful.
Vaginismus, the actual snapping shut of the vagina, can be experienced, not just with a penis as the object attempting penetration, but also with dildos, fingers, tampons, and even medical instrument [during an examination], as the penetrating object! So, it is not necessarily a function of WHAT is being inserted, or WHO is inserting it.
Types Of Vaginismus
There are two type of Vaginismus; Primary and Secondary.
? In PRIMARY VAGINISMUS,the sufferer has never been able to have penetrative sex, or any form of vaginal penetration, without great difficulty and pain, or finding it totally impossible. It is commoner in adolescent females, and young adult females.
? In SECONDARY VAGINISMUS, the sufferer had initially been able to have normal, penetrative vaginal sex, or any other form of penetration, before the onset of symptoms. This is commoner in adults, and may have an identifiable physical cause, like an infection, or vaginal trauma [example; during child birth].
In terms of aetiology, Vaginismus, to a large extent, is poorly understood. It is difficult to say, sometimes, which is risk factor, and which is cause.
Many schools of thought are divided as to what constitutes a risk factor, what is an outright cause, and what is neither of the two.
To avoid the confusion, I have decided to lump both together.
Physiological Risk Factors/Causes
– Fear of pain.
– Anxiety disorder.
– Self-consciousness, about body image, and viewing the vagina as “ugly” and “dirty.”
– Previous history of rape, and sexual molestation, or witnessing of such.
– Parental factor– a critical, domineering, moralistic, and chastising father.
– Domestic violence
– Lack of, or inadequate, sex education.
– Previous history of painful rectal procedures [example enemas], or traumatic urethral catheterization.
– Sexual dysfunction in male partner
– A passive, unassertive, and overtly “nice” male partner.
– Relationship problems.
– Religious factors– high expectations of morality, the propagation of the belief that sex is sinful,wrong, and shameful; and the accompanying guilt.
– Sexuality crises; Vaginismus, in some cases, is someone’s body’s way of protesting a yet undiscovered, or denied, sexual preference.
Physical Risk Factors/Causes
Generally speaking, any painful vaginal, vulval, or pelvic condition, can lead to Vaginismus. Anticipation of worsening of such pain, by penetration, breeds fear and anxiousness, and may lead to INVOLUNTARY vaginal spasms.
Physical/organic risks/causes include;
– Vaginal trauma
– Vulvar vestibulitis syndrome
– Hymenal abnormalities
– Vaginal adhesions from use of caustic substances [Acquired gynaetresia]
– Chronic pelvic pain
Symptom And Severity
The principal symptoms are;
1. Pain. Which may be due to the primary cause, or from forceful penetration against a tightly shut vaginal setting.
2. Difficulty penetrating the vagina. This is often described to be like “hitting a wall.”
Severity defers. In some cases, the vaginismic reflex is only experienced against a penis. In others, it is experienced against virtually everything, including tampons, fingers, dildos, and medical instruments.
Also, while partial penetration is possible, but extremely difficult, in some, in severe cases, penetration is totally impossible. In more severe cases, attempt at penetration may even be accompanied by involuntary adduction of the thighs [bringing the thighs together, forcefully], and arching of the back.
There are various modalities of treatment. These include: Psychotherapy, Physical therapy, and use of medications.
Considering the myriad of psychological risk factors, Psychotherapy is very beneficial. Due to the sensitivity of such factors, this must be done by a trained person.
– Kergel’s exercise has been found beneficial, as it enables the sufferer to have some degree of conscious control over her pelvic muscles.
– Progressive desensitization. This is the mainstay of physical therapy. It involves progressively getting the sufferer used to being touched around her genitals.
She starts by touching the skin of her vulva daily. Over time, she progresses to separating her labia, and touching her introitus. Then she progresses to inserting a lubricated finger into her vagina. Then two fingers. Three. And so on.
When she’s comfortable going all the way in, and without pain, nor resistance, she progresses to inserting her partner’s penis, by HERSELF. Initially the tip. Then a little bit longer. And so on.
Alternatively, this could be done using different sizes of Hegars’s dilator.
– Anxiolytics can be used to quell the resulting, or rather accompanying, anxiety.
– Botox has been proven to help in the relaxation of the vaginal muscles, allowing for easier penetration.
This is defined as excessive pain experienced during penetrative, vaginal sexual intercourse.
While some degree of reflex spasms may be associated with dypaurenia, chronic dypaurenia may lead to vaginismus; the major difference between the two is that, in dyspaurania, penetration, while painful, is neither difficult, nor impossible.