Vaginismus: Right and Wrong

Vaginismus is the inability to have sexual intercourse as a result of involuntary contractions in the muscles surrounding the outer part of the vagina (female sexual organ) despite the woman’s desire for sexual intercourse. In the meantime, symptoms such as intense anxiety, fear, spasms in the body, tremors, and involuntary closing of her legs can be seen in the woman. Vaginismus is a condition that can be easily treated with the right approaches, but the problem goes on due to some wrong practices, not participating in the treatment process or haste in the treatment, not participating in the treatment, wrong beliefs. If this problem that arises in marriages is not resolved, it can progress to processes such as divorce. Let’s examine some of the misunderstood issues and truths in vaginismus and its treatment, item by item:

  1. FALSE : Vaginismus occurs because the woman does not want sexual intercourse

TRUE: On the contrary, the woman cannot have sexual intercourse even if she wants to. occurring in the vagina The contraction occurs against the will of the woman, due to the intense anxiety she experiences. The important thing is to understand the cause of anxiety and to eliminate these contractions with the right approach to reduce anxiety. For this reason, the problem does not disappear when the woman wants, on the contrary, trying to solve the problem alone can make it even more complicated.

  1. FALSE: During sexual intercourse, there is a lot of bleeding and pain.

TRUE: One of the fears and often false information of women during the first sexual intercourse is related to bleeding. That the “hymen” will cause bleeding and it will be very painful. The structure that we call the hymen, called the hymen as it is commonly used among the people, is a structure as thin as an onion skin, with capillaries in places. During sexual intercourse, there is a slight peeling and if it coincides with the capillaries, a very slight blood can be seen in the form of leakage. The pain, on the other hand, is much less than the pain of a fine needle sticking into your hand and is often unnoticeable.

  1. FALSE: Vaginismus is caused by narrow vagina and anatomical problems.

TRUE: The vagina has a flexible structure like stretch fabric. It is as wide as a finger. When the penis is placed, it grasps the penis, when the child comes out, it expands as much as the child. When there is arousal, the structure and fluid of the vagina changes. In vaginismus, there is a problem in the muscle structure at the entrance. The penis cannot enter the vagina as it contracts due to tension.

  1. FALSE: Vaginismus improves with drugs and alcohol.

TRUE:In order to solve the problem, sometimes people who want to use drugs, unfortunately, sometimes health professionals can recommend drugs. However, vaginismus can be used as pain reliever, anxiolytic, local anesthetic, muscle relaxant, etc. does not improve with drugs. Sometimes people with vaginismus problems may have a psychological problem such as depression along with this problem. In such a case, medication can be used, for example, to correct depression. However, except for additional mental problems, drug use , It does nothing but waste time. Recently, we have heard from our patients that sexual intercourse is performed under anesthesia. However, this is not both an unethical practice and a vaginismus treatment with anesthesia. C Because the problem is the unrealistic thoughts and anxiety that cause the muscles to contract.As long as this anxiety is not resolved, the treatment will not be positive.

Some common misconceptions about vaginismus are as described above. However, the situation may be different for each individual and it is necessary to direct the treatment after everyone has gone through a separate evaluation process. In the treatment, after the couple is evaluated separately, the treatment is continued as a couple. Although it seems like the woman is having the problem, two people experience the problem together and the solution is together. The only proven treatment method for vaginismus is psychotherapy by a trained psychotherapist. Surgical procedures, sexual intercourse with anesthesia, alcohol intake, drugs, botox, physical therapy instead of treating vaginismus, they complicate it and it is a medical error. If such a problem is experienced, it should first be evaluated and diagnosed by a psychiatrist. If the evaluating psychiatrist is doing vaginismus therapy, he/she continues the treatment. If not, refer them to a psychiatrist or clinical psychologist trained in vaginismus therapy.

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