Tightening of the pelvic floor – Vaginismus

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Vaginismus is an involuntary contraction, or reflex muscle tightening, of the pelvic floor muscles that generally occur when an attempt is made to insert an object (tampon, penis, speculum used for a Pap test) into the vagina. This muscle tightening causes pain; which range from mild discomfort to severe burning and aching. It does not interfere with sexual arousal, but it can prevent penetration.

Sexual dysfunction can occur in both males and females and can usually be treated. It’s not your fault, and it’s nothing to be ashamed of. Nevertheless, these disorders can interfere with your relationships and your quality of life.

Types

Primary vaginismus: when vaginal penetration has never been achieved.

Secondary vaginismus: when vaginal penetration was once achieved, but is no longer possible. This may be due to factors such as gynecologic surgery or radiation. Some women develop vaginismus after menopause. When estrogen levels drop, a lack of vaginal lubrication and elasticity makes intercourse painful, stressful, or impossible. This can lead to vaginismus in some women. Dyspareunia is often confused with vaginismus, but dyspareunia could be due to cysts, pelvic inflammatory disease, or vaginal atrophy.

Causes
Past sexual abuse or trauma Previous painful intercourse Emotional factors

Diagnosis
The doctor will do a physical examination and ask about your medical and sexual history. These histories can help give clues to the underlying cause of the contractions.

Treatment Options
This disorder is treatable. Treatment usually includes education, counseling, and exercises. Sex Therapy & Counseling Education: this typically involves learning about your anatomy and what happens during sexual arousal and intercourse. Seek information about the muscles involved in vaginismus too. This can help you understand how the parts of the body work and how your body is responding.

Counseling: it involves you alone or with your partner. Working with a counselor who specializes in sexual disorders may be helpful. Relaxation techniques and hypnosis may also promote relaxation and help you feel more comfortable with intercourse.

Vaginal Dilators: your doctor or counselor may recommend learning to use vaginal dilators under the supervision of a professional. Place the cone-shaped dilators in your vagina. The dilators will get progressively bigger. This helps the vaginal muscles stretch and become flexible. To increase intimacy, have your partner help you insert the dilators. After completing the course of treatment with a set of dilators, you and your partner can try to have intercourse again.

Kegel Exercises: this involves repeatedly tighten and relax your pelvic floor muscles, which control your vagina, rectum, and bladder. You can locate these muscles when you are urinating. After you begin to urinate, stop the stream. You’re using your pelvic floor muscles to do this. You may feel them tighten and move. These muscles move as a group, so they all contract and relax at the same time. Practicing these exercises helps you control when your muscles contract and relax.
Follow these steps: Empty your bladder. Contract your pelvic floor muscles, and count to 10. Relax your muscles, and count to 10. Repeat this cycle 10 times, three times a day. To successfully strengthen your pelvic floor muscles, do not engage the muscles of your abdomen, buttocks, or thighs when doing these exercises.