The exact cause of Vaginismus remains unknown and unclear. It is usually not the result of sexual abuse but occasionally we see vaginismus in patients who have suffered from abuse.
The treatment we use at Maze involves determining the degree of vaginismus a patient has. We use a gradual vaginal dilation program with a series of dilators that increase in size weekly or every other week. We often prescribe vaginal medication to help with tight muscles in the vagina; we sometimes recommend Pelvic Floor Physical therapy to help massage tight vaginal muscles. In severe cases, we offer Vaginismus Treatment Under Anesthesia which works wonders on patients.
At Maze, we try and include partners as deemed appropriate by our patients. Unfortunately most primary care providers do not really know or understand vaginismus. Hopefully this will soon change as more people are becoming educated about Vaginismus.
It’s unlikely that Vaginismus would go away on its own. Vaginismus is an involuntary tightness of muscles in the vagina. Since it is involuntary, Vaginismus can only be treated with dilation and Pelvic floor physical therapy. With the right treatment, it can nearly always be helped. It doesn’t just “fix itself”
The best way to incorporate your partner in treatment is to educate them on vaginismus. Many of our patients bring their partners to a few of their visits here at Maze so we can educate and answer any questions they may have. We find when the patients get comfortable dilating themselves they can then allow their partner to help them dilate. At first we tell patients to dilate in front of their partners. When they are comfortable with this, we advise allowing their partners to insert the dilators.
It is so difficult to come face to face with Vaginismus. By educating yourself and knowing that you are not suffering alone you are better able to accept the diagnosis. I think it is vital to be kind to yourself and not judge.
Once patients are aware of the many other patients who are managing Vaginismus, they then feel empowered to seek help. Questioning then accepting are the very first steps in overcoming Vaginismus.
One can easily avoid sex when they are suffering from Vaginismus. There are many other types of intimacy that do not involve intercourse. I think that becoming a sexual person starts with the self. Masturbating and using vibrators can be both pleasurable and help while going through the treatment of Vaginismus. Eventually you can transition from self to partnered sex when you feel comfortable doing so.
“Pregnancy and Vaginismus” is a topic we regularly receive questions about here at Maze. I think it is vital to overcome vaginismus before attempting pregnancy if this is an option for you. Pregnancy involves multiple trips to the obstetrician to assess both maternal and fetal well-being. Although some visits do not involve internal exams as the obstetrician is just listening to the baby’s heartbeat, measuring maternal vital signs, and measuring the size of the uterus to make sure the baby is growing well, many visits do.
In the beginning of pregnancy, an internal vaginal sonogram is standard in order to measure size and dates to confirm a due date and to check for fetal viability. If you have vaginismus, this internal sonogram can be difficult and potentially cause a good deal of pain and emotional trauma.
As patients head into the last few weeks of their pregnancy, weekly internal exams are sometimes necessary to check for cervical dilation and fetal position.
If Vaginismus is impeding your ability to get pregnant, you can opt for IVF or IUI but these are still difficult to do and very costly.
When a patient has gone through the necessary steps to cure vaginismus we find that pregnancy and childbirth are not very difficult. We do think that patients should probably continue dilation throughout their pregnancy unless dilation is medically contraindicated.
We do not think that Vaginismus is hereditary, although we do sometimes see it occurring in mothers and daughters. However, this might be due to high levels of anxiety in the family. We just don’t know.
Vaginismus is not a form of anxiety. It is defined as the involuntary tightening of vaginal muscles. With that being said, many patients with Vaginismus do suffer from some form of anxiety. Whether the Vaginismus has caused the anxiety is often discussed.
At Maze our patients have a very thorough psychosocial intake before meeting with the medical providers. Patients can have a history of sexual and emotional abuse in conjunction with Vaginismus.
The majority of our patients present without any history of abuse and just have tight muscles which causes Vaginismus.
Sex for the first time can be both exciting and scary. We suggest dilating before having intercourse.
We also recommend 2 positions for the first few attempts because they simulate the insertion of dilators. Lie on the bed with your legs apart and your feet propped up on chairs with your partner standing between your legs. Have your partner insert the largest dilator so that he can adequately gauge the appropriate angle. Then using his or your hands, slowly insert his penis into your vagina.
Another position is the missionary position. Have your partner kneel between your legs as you are lying on your back. Again have your partner insert the largest dilator so he can adequately gauge the appropriate angle. Then using his or your hands insert his penis.
Once your partner is fully inside and you are relaxed enough and you are not experiencing any pain, let him start to move slowly and gently.
Remember to use adequate lubricant to make insertion easier.
At Maze, we treat every degree of vaginismus. We begin with a gentle dilation program. We often prescribe vaginal muscle relaxant suppositories to help relax tight muscles and we offer a ton of encouragement every step of the way.
If we are not successful with dilation we do offer Vaginismus Treatment Under Anesthesia. You are not alone and we can help you.
There are birth control that are available to you that do not involve a pap smear. Your age determines whether or not a pap smear is necessary.
The only form of birth control which could be difficult for a patient with uncured vaginismus is an IUD as it needs to be inserted into the uterus in your gynecologist’s office.
As far as birth control, there are many options. You can take birth control pills, get the depoprovera shot, use the orthoevra patch, or use male or female condoms. Condoms prevent Sexually transmitted diseases and do not require a prescription.
In terms of discussing Vaginismus with your Gynecologist, this can be tricky as many gynecologists do not know how to counsel women regarding Vaginismus.
I suggest finding a gynecologist who does treat female sexual dysfunction. These gynecologists are generally well versed in vaginismus and can see you through a pap smear. If you are already dilating, I suggest dilating before the gynecology visit and Pap smear.
Many gynecologists are not trained in vaginismus during both medical school and residency. This is a major problem in terms of the training that they receive. We are hopeful that this will change in the near future as Vaginismus is no longer a condition that is not talked about by both the media and by patients themselves.