This blog will discuss the condition of vaginismus or severe pelvic pain which makes it difficult and often impossible for a woman to engage in pleasurable sexual intimacy. I will also discuss some of the common treatment options for this condition.
Vaginismus is caused by contraction of the muscles around the vagina making penetration difficult or impossible. Often the problem is caused by anxiety or worsened by the anticipation of pelvic pain. If a woman focuses on pelvic pain, her ability to concentrate on the pleasurable sensations of sexual intimacy may be affected, and often her sex drive will decline. This will perpetuate her pain, as decreased sexual excitement may lead to less vaginal lubrication and tight, contracted vaginal muscles, all of which may increase the unpleasant friction in the vagina during sexual intimacy. Emotional anxiety, which often results from painful sex, may have a negative impact on the sexual relationship. Sexual pain creates a vicious cycle, which needs to be addressed from multiple perspectives in order to be resolved.
Treatment often requires a referral to a physical therapist. Physical therapists are trained to provide treatment to restore function, facilitate movement, and most importantly, to relieve pain. Pelvic floor physical therapy is often helpful in the treatment of sexual problems in women.
A physical therapist may prescribe vaginal dilators to help overcome penetration anxiety and also to help gradually stretch the vaginal opening. Dilators are usually provided in a gradual manner starting with the smallest dilator that does not cause the woman any pain or discomfort.
Another treatment option is pelvic floor biofeedback. This involves the insertion of probe into the vagina. The probe measures the activity of the pelvic floor muscles and displays the activity on a computer monitor. The woman is able to visualize the activity of her vaginal muscles and learn to relax them as well as strengthen, stabilize, and coordinate the muscles that are used during sexual intimacy.
Finally electrical stimulation with a low voltage current can be useful to teach coordinated contraction of vaginal and pelvic musculature, and is useful in providing pain relief.
Bottom Line: Vaginismus is a terrible condition that results in loss of enjoyment in sexual intimacy, can impair a relationship between a woman and her partner, and can even lead to depression. Speak to your doctor and consider a referral to a physical therapist to help put the zing back into your bedroom.