The anatomical region where sexual intercourse takes place in women is called the vagina. Vaginismus is the unconscious vaginal contractions beyond the control of the woman, which causes the muscles around the vagina to contract, a contraction in the whole body, a state of anxiety, fear and panic, causing the woman to close her legs tightly and push her partner with her hands. In the medical literature, it is also called sexual pain disorder in the classification of sexual dysfunctions. Painful sexual intercourse and vaginismus are two pathologies that can trigger each other.

The mouth, consisting of 2 cm smooth muscles at the entrance of the vagina, is tense and hard. Therefore, it does not allow sexual intercourse. The penis cannot enter the vagina.

Causes of Vaginismus

The most common causes of vaginismus are psychological concerns. The thoughts of “sexuality is bad”, “the hymen is a very valuable thing and should be protected”, which are taught to girls or encoded in the unconscious by our will, have an important place in the emergence of this problem. Sometimes the reason can be a lack of sexual knowledge, simple embarrassment and suppression of sexual feelings. Sometimes, the underlying cause is a traumatic experience, especially in childhood. In this case, more complex internal conflicts, wrong patterns or compulsions, such as the projections and effects of traumatic events in the past, which are pushed into the unconscious, may disrupt the body-mind integrity and cause vaginismus.

Types and Diagnosis of Vaginismus

The diagnosis of vaginismus is made by telling the couple what happened during the first sexual activity. Coitus, that is, repetitive and continuous involuntary contractions in the outer third of the vagina that prevent sexual intercourse, is experienced in the first time at moderate intensity, but it is often painful in a way that does not allow intercourse. This condition is called Primary Vaginismus. In primary vaginismus, the person has not had any successful sexual intercourse in his life. The most important reason underlying primary vaginismus is fear. Those who have never had vaginismus problems before, after birth, miscarriage, abortion, and after a hard gynecological examination, and those that are rarely seen due to tears and infections are called Secondary Vaginismus. While secondary vaginismus usually develops due to dyspareunia, that is, pain during intercourse, it may rarely occur as a recurrence of the problem in people who have been treated before.

Vaginismus and the Hymen

Hymen; Most of the questions in the minds of women with vaginismus are answered and “the thickness of the hymen” is shown as the reason for not having sexual intercourse. For this reason, most of the time, this membrane is cut with a surgical method called hymenectomy. But after the problem continues, the patient collapses. He does not want to seek help for a long time and loses the courage to be treated. Contrary to what is known, the incidence of an anatomical disorder of the hymen or vagina that will actually prevent sexual intercourse is below 1%.

False Beliefs Causing Vaginismus

False beliefs that cause vaginismus If we list the false beliefs that cause vaginismus, they are as follows:

It is believed that sexuality is something that men experience and that women have to do for men.

Thinking of sexual intercourse as a painful, bad thing.

Men should be thought of as dominant and not to be trusted.

The thought that experiencing sexual desire and pleasure will be perceived as a light woman, and the thought that the woman should not show herself.

There are false beliefs and myths such as “first sexual intercourse is very painful”. Women who grew up with the perception of something that should be missed and not experienced with this belief will be uncomfortable with the effect of these beliefs that have settled during relationships and will inevitably have contractions in the vaginal muscles.

There is no such thing as I can’t have intercourse because my vagina is small. Because the vagina is an organ that can expand ten times. After birth, a baby can easily pass through the vagina.

Vaginismus Treatment

Vaginismus is a disease that can be treated. No surgical intervention or other interventional interventions are required in the treatment of vaginismus. Vaginismus, which is a very serious problem in our country, is also known as the first night fear among the people. Vaginismus is a woman’s involuntary inability to have sexual intercourse during her sexual experience. Body and legs cramps, crying crises, frequent breathing and sometimes fainting can be encountered. Vaginismus, which is usually caused by lack of education and wrong information, is a 100% treatable disease.

The problem that vaginismus patients frequently encounter is the failure to diagnose the disease or its misdirection. First of all, the diagnosis of vaginismus should be determined definitively. Sometimes couples who cannot have intercourse due to male sexual dysfunction may mistakenly think that they have vaginismus. In fact, couples may sometimes be misdiagnosed as vaginismus because they do not know how to have sexual intercourse. Sometimes, they are sent to their homes by obstetricians who are not experienced in this field, saying that they are not vaginismus.

Roadmap for Vaginismus Treatment

In the roadmap to be followed for the treatment of vaginismus (although it differs according to the intensity of vaginismus on the woman), I will talk about the treatment of vaginismus in general terms. First of all, you should know that vaginismus is a treatable temporary discomfort. Vaginismus is not an incurable problem. Also, in the treatment of vaginismus, no surgical intervention or other interventional interventions are usually required. The woman is not asked to use any medication during the treatment process.

All that needs to be done is for the patient to find an experienced doctor, explain everything clearly, and most importantly, have the desire to heal. If the person succeeds in doing this, he will actually treat himself with the roadmap drawn by his doctor.

It is very important to have good mutual communication between the doctor and the patient at the beginning of the treatment. Evaluation of one’s insight into sexuality, helping couples communicate and increasing communication, marital therapy, revealing conflicts, and evaluating sexual attitudes and behaviors are very important.

“Why does vaginismus occur?” It starts with answering the question. What is the subconscious? What can it do? The first step of vaginismus treatment is to identify false thoughts and beliefs by informing about the subconscious and examining the subconscious processes.

Vaginismus Treatment Factors

There are 4 important factors for vaginismus and its treatment:

1- to trust

The bond established between the therapist and the patient is called the ‘Therapeutic Relationship’. It is important that this therapeutic relationship is well established for the success of all therapies. The main success criterion is that the patient who has a problem in vaginismus trusts himself, the therapist who administers the treatment, and the treatment applied.

Suggested studies should be carried out to the letter.

Vaginismus patients should also trust themselves. However, many patients who start treatment trust their physicians more than themselves. However, as the treatment process progresses, the sense of self-confidence increases.

2- Patience

It is normal to have ups and downs during treatment. Some objections, rejection, temporary unhappiness and reluctance may occur by the subconscious mind. Thus, treatments can proceed as ‘two steps forward, one step back’. This temporary situation is perfectly normal. It is extremely important for patients to be determined, ambitious and patient in this regard.

3- Homework

For many vaginismus patients, homework given by the physician can be boring and repulsive. Homework is actually boring for all of us, all our lives. Seeing homework as a ‘love assignment’, making it enjoyable, and doing it in a willing and motivated way will make it not boring.

4- Spousal support

Many vaginismus patients complain that their spouses cannot convince them for treatment. Most of the spouses of vaginismus patients do not accept such a disease, they think that only their spouse can overcome this problem and that no one can help their spouse. For this reason, many domestic unrest and arguments arise. Vaginismus is a sexual problem and requires professional support. In this regard, it is necessary for spouses to believe, be patient and motivating.

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