Vaginism is an extended or recurring muscle contraction of the pelvic floor muscles surrounding the opening of the vagina

Vaginism is an extended or recurring muscle contraction of the pelvic floor muscles surrounding the opening of the vagina.

This reflex, involuntary and uncontrollable action, persistent prevents any desired vaginal penetration, even by a finger or a hygienic stamp when vaginism is total.

It can also be partial or situational when contraction occurs only in certain attempts at penetration (penis penetration).

An attempt at penetration despite vaginism can lead to severe pain (dyspareunia) that will often exacerbate it.

Vaginism is qualified, as the case may be:

Primary: occurring from the first sexual intercourse, leading to failure of any attempt at penetration;

secondary school: it can occur after prolonged period of sex without problem. Secondary vaginism usually occurs after trauma, physical or psychic (bad experience), of all kinds. We’re talking more about ′′ dyspareunies ", that is, vaginal pain during sex. Dyspareunias are not diseases in itself, rather symptoms that need to be sought for.

Vaginism can be total or partial.

It is total when the introduction of any body or object into the vagina is impossible (hygienic stamp, finger…), it is partial or situational when penetration is difficult and often painful (this case is mainly seen during attempts to penetrate the penis, while the introduction of other objects such as hygienic pads is possible and does not necessarily generate pain).

A dyspareunia (pain) often appears if penetration is still company despite the observed contractions theoretically making penetration impossible or very difficult.

Vaginism has many physical and psychological causes, including:

abuse, rape or sexual assault or their attempt;

a fear or phobia of getting pregnant;

a more closed attitude towards sexuality is more commonly found in people suffering from vaginism;

a central neurological cause can be found in some cases without a local explanation;

a birth;

Sexual identity problems, especially for situation vaginisms and not total;

a vaginal infection;

Insufficient lubrication;

Following treatment of cervical cancer or rectum by radiation or curious therapy;

a non-elastic hymen clogging the vagina entrance.

Alleged vaginism can also be an unmissed manifestation of spouse’s powerlessness, which can be solved by the latter’s medical treatment.

A vaginism with no rules (amenorrhea) can also be a sign of a too small vagina - a few inches (Rokitansky syndrome), which is treated very well as the diagnosis is properly done.

Vaginal pain during the report and / or fear reflexing preventing penetration have in common the setting up of a vicious circle where the possible anticipation of pain, and avoidance strategies reinforce blocking and lead to a sense of guilt in the person suffering from vaginism.

The consequences of vaginism can be dramatic for couples’s sexual and emotional balance. Vaginism sometimes leads to a transient loss of excitement, resulting in reducing the erection of the partner (s). However, it’s the clitoris the erectile organ not the vagina. If the partner encounters a blockage during penetration, it is that you have to change your method and forget the penetration.

The absence of vaginism costs can lead to difficulties getting pregnant.

Vaginism can also prevent a gynecological examination and the conduct of certain medical acts, such as a screening smear.

Gynecological check is necessary, in order to rule out any physical abnormality or infectious disease.

Due to the taboo often surrounding problems related to sexuality, vaginism and dyspareunias are still very little known while they are very well treated in motivated patients as the diagnosis has been properly diagnosed.

Rehab with vaginal dilators (also called ′′ candles ′′) can be useful in any case with regular and progressive expansion exercises. These exercises are focused on body discovery and contact acceptance.

Cognitive-behavioral psychotherapy could be relatively effective as well as sexology consultations. Similarly, muscle relaxation therapies can help, as well as biofeedback techniques. Hypnosis can also be used during medical hypnotherapy sessions.

If the purpose of the application is a desire for pregnancy, a medically assisted procreation can be proposed.

Local injection of botulum toxin leads to muscle relaxation after several days, which can last a few months. Preliminary results are encouraging.

The very occasional partial penetrations suggesting some people with vaginism that the problem is solved, so they delay consultation. This unlock is often partial and punctual because avoidance strategies are reopened from the following sexual intercourse, and only adapted treatment ensures a real chance of success in treating vaginism over time.