In this part of female sexual health, we will discuss vaginismus, which acts as a "silent scream" and affects the woman herself and her relationship with her partner, even if it is not expressed.
What is and what is not Vaginismus?
It is the condition where sexual intercourse becomes impossible due to the involuntary contraction of the muscles in and around the vagina. This situation also appears as a problem that makes gynecological examination or the use of tampons impossible.
How common is Vaginismus?
Unfortunately, the exact answer to this question is not known. However, cases with vaginismus need to know one thing very well: "You are not the only one experiencing this problem!"
What are the complaints and symptoms of Vaginismus?
The most important complaint regarding vaginismus is the inability to have sexual intercourse. Mostly, it is not desired to be expressed as a complaint because society's expectation from marriage makes the woman feel wounded, as if "the woman's duty (!)" has not been fulfilled.
The inability to have sexual intercourse can manifest in various degrees. Sometimes it occurs as a contraction when the penis touches the vulva in any way, and sometimes it occurs when the penis slightly enters the vagina. It is often described as "there is a wall, a narrowness where the penis would enter the vagina." The contraction also causes pain to be felt in the lower area.
Sometimes vaginismus cases may get used to having the vaginal entrance touched even though they do not allow the penis into the vagina, and thus they try to meet their sexual need for orgasm through friction, also called "padding." After a while, couples "get used to living like this." Eventually, even erectile dysfunction may occur in the man after a long period.
Who gets Vaginismus and how many types are there?
Vaginismus can be seen in anyone who is in a position to have a sexual experience. Vaginismus is generally divided into 2 types:
- Primary (If there is no underlying organic cause)
- Secondary (If there is an underlying organic cause, for example, dryness and narrowing due to hormone withdrawal after menopause)
What should NOT be done in Vaginismus treatment?
People with vaginismus should -unfortunately- not be told that this situation "is all in the head," that they should take "alcohol to relax" or "sedative" medication, or that it is like this "because they are always obsessed with it." Such an approach further reduces the person's self-confidence and makes them feel the accusation of "failing to do their duty." Misleading directions can be given, such as suggesting that the problem can be solved by intercourse under anesthesia (while asleep), or that "no problem will remain if the hymen is opened." Please, these should not be credited.
How is Vaginismus treatment performed?
Important points in vaginismus treatment can be listed as follows;
- The woman should come to the treatment together with her husband (partner).
- She must be evaluated psychologically by experts, and this part of the treatment should not be neglected; on the contrary, it should be given importance.
- She should know that no examination etc. will be performed during the check-up without her knowledge.
- In treatment, exercises are provided for the person to be able to control their lower muscles. The treatment duration can vary from person to person.
- During the treatment period, importance should be given to having no sexual intercourse at all (including orgasm with friction).
Vaginismus is a treatable condition; it "should not be ignored" if it exists.
Wishing you healthy and happy days...
Prof. Dr. Ümit İNCEBOZ / Obstetrician and Gynecologist / İRENBE