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There may be a variety of psychological causes that may be triggers for this condition, and which cause the fear and anxiety which arise in the expectation of penetration. Issues relating to past traumas, such as rape and sexual abuse in childhood can leave a persistent fear in the victim, resulting in vaginismus developing over time as a defence mechanism. Other issues that can be cause for experiencing this disorder are relationship issues, anxiety surrounding the issue of sex and sexual intercourse, misconceptions and false beliefs about the vagina and sex, fear of pregnancy and childbirth, and misinformation/incorrect education that sex is painful, wrong and shameful. It could also be due to a bad sexual experience in the past or believing that your vagina is too small, or even an unpleasant medical examination (Munasinghe, T., Goonaratna, C., & De Silva, 2004).

Women who struggle with vaginismus go through a lot of different emotions. Many women feel embarrassed and ashamed about their disorder, and feel uncomfortable talking about openly. There is also an element of frustration and disappointment, as many women believe they are not sexually pleasing their partner as much as they should be.

The therapy and treatment available for vaginismus generally has a good outcome. In a study in conducted by the Department of Physiology, Faculty of Medicine, Colombo, Sri Lanka, fifty six couples, in which the woman had vaginismus, were treated with CBT therapy and the results of the therapy were recorded. From this study, it resulted that 80.3% of the women managed to have penetrative sex with their partners after receiving therapy (Munasinghe, Goonaratna & De Silva, 2004).

Vaginismus is usually treated with a combination of talking therapy (with a professional therapist experienced in the area), as well as a set of exercises to be practiced at home using what are known as vaginal dilators.  Vaginal dilators are instruments that are used by clients so that they can get gradually accustomed to having something inserted into their vagina. The sizes vary, starting from a small size to the size of an average penis (Pacik, 2014).

The exercises used to treat vaginismus help women to gradually penetrate and stretch the vagina, and slowly become comfortable with penetration at their own pace. Relaxation and breathing techniques are also practiced, and are encouraged to be used in combination when carrying out the vaginal dilator exercises. These techniques will eventually prove very useful when sexual intercourse is attempted (“Vaginismus”, 2018).

Talking therapy for vaginismus will help to manage and work through any feelings of fear, anxiety or negative feelings a woman might have about penetration. Breaking the mental barriers helps the person to start making sense of the cause for their issue, and help them gain more control of the situation. This is essential to really improve the progress with using the vaginal dilators. At home, clients can use all that has been learnt through therapy while carrying out the exercises in safety and comfort, without any pressure from others, and at their own pace. This way, both the physical limitations of vaginismus, as well as the psychological blockages may be overcome.


References:

Munasinghe, T., Goonaratna, C., & De Silva, P. (2004). Couple characteristics and outcome of therapy in vaginismus. Ceylon Medical Journal49(2), 54. doi: 10.4038/cmj.v49i2.3262

Pacik, P. (2014). Understanding and treating vaginismus: a multimodal approach. International Urogynecology Journal25(12), 1613-1620. doi: 10.1007/s00192-014-2421-y

Vaginismus. (2018). Retrieved 27 January 2020, from https://www.nhs.uk/conditions/vaginismus/

Becky Faenza is one of the Triage Officers that form part of the Triage Team with Willingness. She is a University graduate, with a B.A Degree in Philosophy and Psychology, and also a Higher Diploma in Psychology (H.DIP).