WHAT IS VAGINISMUS?

Vaginismus refers to intense painful contractions (shortenings and/or increased tension) of the outer third of the vaginal muscles. Because these muscles surround the vagina near the vaginal opening, the muscle contractions tightly close the vagina. As a result, sexual intercourse is either impossible or very difficult. For those of you who do not know, the vagina is an opening in the female's body that is part of the reproductive system. It is located behind the stomach area and in from of the rectum (rear end). In some individuals, contractions also occur to muscles in the rear end, inner thigh, and abdomen (the belly area).

A simple way to think of vaginismus is that it is like an eye blink. Much like how blinking of the eyelid helps protect the eye from a foreign object, the muscle contractions in vaginismus help protect the vagina from a foreign object. The big difference between an eye blink and vaginismus (besides where they occur) is that an eye blink is not painful, whereas vaginismus is painful. Although vaginismus is painful, it protects the vagina from anticipated harm and is thus reinforcing. The perceived avoidance of harm that occurs as a result of vaginismus makes the condition likely to occur again in the future.

IS THERE A PSYCHOLOGICAL COMPONENT TO VAGINISMUS?

Vaginismus is thought to have a psychological component to it as well as a physical component. The condition typically occurs when the female is expecting sexual intercourse or any object being placed in the vagina to be painful. Vaginismus can even occur when an object is placed near, but not in, the vaginal area.

ARE THERE DIFFERENT TYPES OF VAGINISMUS?

There are several types of vaginismus. One type of vaginismus is called "consistent," because it occurs every time vaginal penetration is attempted. Another type of vaginismus is called "global," because it happens in many types of circumstances. A third type of vaginismus is called "recent onset," because it starts recently in the female's life. Recent onset vaginismus is also known as "secondary" vaginismus because it is the result of (or secondary to) something that recently caused it to occur. A common cause of recent onset vaginismus is something causing pain in the vaginal area such as rape, dryness in the vagina, a mismatch in genital size, or vaginal surgery. Women with recent onset vaginismus typically had sexual intercourse without discomfort before the onset of this condition.

The fourth type of vaginismus is called "lifelong," because it has been occurring for a very long time or for the female's entire "sexual life." Lifelong vaginismus is also known as "primary vaginismus", as opposed to secondary vaginismus, because it has been occurring for a long time and does not have a recent cause. This does not mean there is not a cause of primary vaginismus. It just means that the cause of primary vaginismus is not recent. For example, some women with this condition believe themselves to be sexually inadequate and/or have life histories in which they were taught that sex is disgusting and evil. Thus, vaginismus does not need to be caused by a physical trauma, but can be due to psychological trauma early in life. Most women with lifelong vaginismus have never been able to experience vaginal penetration without significant pain or discomfort.

WHEN IS VAGINISMUS ABNORMAL?

Vaginismus is considered abnormal when there are no genital lesions present and when the female wants to partake in sexual activities involving the vagina. Abnormal vaginismus is an uncommon condition. However, vaginismus can be a "normal" condition (in other words, expected to occur) when painful genital lesions are present or if the female is anticipating forceful entry into the vaginal area.

HOW IS VAGINISMUS TREATED?