Vaginismus is an involuntary contraction of muscles surrounding the vaginal opening in women having no abnormalities in the genital organs. This tight muscle contraction may make penetration impossible or painful. All of this may result in a low sex drive. Although women with vaginismus and low sex drive have similar symptoms, they are different conditions. But, yes, low sex desire and vaginismus may co-exist and results in a chicken-egg kind of situation

If you face pain during sexual intercourse, it is best to consult a doctor. They will help you understand whether it is due to vaginismus or other conditions. Your doctor will also offer treatment for low sex desire.

Overview

While the exact prevalence of vaginismus is unknown, it is estimated to affect 5% – 17% of the women. Low sex drive is also a widespread condition. A study suggested that about 40% of Canadian women have a low sex drive.

Vaginismus is a condition where the vaginal muscles contract persistently or involuntary during vaginal penetration. These contractions can make sexual intercourse painful or prevent sexual intercourse.

This can happen:

  • During a sexual intercourse
  • While inserting a tampon
  • When being touched near the vaginal area

While the contractions do not affect sexual arousal, it can prevent penetration. To confirm the diagnosis, your doctor will run a pelvic checkup, and there are no physical abnormalities contributing to the problem.

But the good news is that vaginismus can usually be treated. And it would be best if you also remember that it is not your fault and it can happen to anyone. If not attended, it may interfere with your quality of life or relationships.

Read more about Low Sex Drive and Vaginal Dryness here.

Types of Vaginismus

Vaginismus is mainly of two types:

  • Primary vaginismus: A condition when vaginal penetration has never been achieved
  • Secondary vaginismus: Here, penetration is achieved once but is not possible now due to factors such as trauma, surgery, or radiation.

For many women, vaginismus develops after menopause. Low estrogen levels, lack of vaginal lubrication, and reduced elasticity make sex stressful, painful, or impossible, resulting in vaginismus.

Causes

While there might not always be a reason for vaginismus, some common factors include:

  • Past painful intercourse
  • Past sexual trauma or abuse
  • Emotional factors

Along with a physical exam, your doctor may ask about your sexual and medical history, which will help them find a cause for your problem.

Symptoms

Vaginal constriction is the primary symptom of vaginismus, but the severity differs for every female. But in all cases, muscle contractions make penetration impossible or difficult.

Symptoms include:

  • Impossible of difficult penetration
  • Involuntary contractions, meaning you cannot manage to stop these contractions
  • Fear of vaginal penetration
  • Decrease sexual desire related to penetration
  • A stinging or burning pain after inserting anything into the vagina

However, this does not mean that you won’t be able to enjoy sexual activities. Women with vaginismus can still crave and feel sexual pleasure and enjoy orgasms.

You can enjoy sexual activities that do not involve penetration, such as massage, oral sex, and masturbation.

Effects

Vaginismus can negatively affect your emotional or physical well-being. Besides, as vaginismus affects penetration, it may significantly reduce your sex drive. This, in turn, may affect your relationship and marriage.

Fortunately, vaginismus is treatable. 

So, being proactive and consulting your doctor can help manage your problem and save your relationship or marriage. It is essential to understand that there is nothing to be ashamed of. Communicating with your partner about your fears and feelings about intercourse can help you feel relaxed.

Your doctor can also help you with many treatment options to manage vaginismus. Many women recover and enjoy and happy and healthy sexual life.

Diagnosis

To begin with, your doctor will ask you to describe your symptoms. They may also ask you the following questions:

  • Frequency of symptoms
  • Duration of symptoms
  • What triggers your problem

They may also enquire about your sexual history, including a history of sexual abuse or trauma. To confirm the diagnosis, your doctor will carry out a pelvic examination.

During the examination, it is common to be fearful or nervous about the examination, making your condition worse. If you feel you are anxious about the examination, you can discuss the same with your doctor. They will help you with ways to make the physical checkup as comfortable for you as possible.

The doctor will rule out scarring or an underlying infection. 

In vaginismus, there is no physical cause responsible for the contraction of the vaginal muscles. Meaning, if you have vaginismus, the doctor will not find any other reason for your condition or symptoms.

Treatment

According to the American College of Obstetricians and Gynecologists (ACOG), vaginismus can be managed through emotional and physical therapies.

Treatment options include counseling, education, dilators, and exercises.

Sex Counseling and Education

Education involves learning about your body and what happens during intercourse and sexual arousal. Your doctor will also explain the muscles involved in vaginismus. 

This will help you understand how your body works and how your body responds. 

You can choose to attend the counseling alone or with your partner. A counselor specializing in sexual disorders can be an excellent choice. Hypnosis and relaxation techniques also promote relaxation and allow you to feel more comfortable with sexual intercourse.

Vaginal dilators

Your therapist or doctor may also recommend using a vaginal dilator. But it is important to understand that they should be used under your doctor’s supervision.

To use them, the cone-shaped dilator is to be placed in your vagina. You can use progressively bigger dilators. Over time, they stretch the vaginal muscles and make them flexible.

Alternatively, you can also tell your partner to insert the dilators. This will help you to improve intimacy with your partner. After using a set of dilators, you and your partner may be able to have normal sexual intercourse.

Physical therapy

If you find it challenging to use dilators on your own, you can take the help of a physical therapist, especially one who specializes in the pelvic floor. They can help you learn about deep relaxation techniques and how you can use the dilators.

Other Treatment Options

If you have a low sex drive, your doctor may advise the following:

  • Lubricants or moisturizers if you have vaginal dryness
  • Medicine to improve sexual drive, such as Bremelanotide and Flibanserin
  • Estrogen therapy available in the form of gels, sprays, patches, and sprays
  • Dehydroepiandrosterone (DHEA), which is available as a vaginal insert

Besides, the following lifestyle changes may also help to boost your sexual drive:

  • Regular exercise 
  • Manage stress level through yoga or meditation
  • Communicate openly with your partner
  • Set time for cuddling and intimacy
  • Add spice to your sex life by trying different sex positions or a different location for sex
  • Ditch bad habits of smoking, excess alcohol consumption, and illegal drug

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