Description

Vaginismus

It is the involuntary contraction of the pelvic floor muscles in
the outer 1/3 part of the vagina, narrowing the vaginal entrance and preventing
sexual intercourse. In fact, vaginismus is a fear reaction; It can
even be called a panic attack against sexual intercourse. The approach of
the penis or another object such as an examination device, tampon, doctor’s
finger, partner’s finger or even his own finger to the vagina, or even the
partner’s positioning for sexual intercourse can trigger this fear reaction.

What are the Symptoms of Vaginismus?

Known as “five inclusions” of the vagina: “finger insertion,
tampon insertion, drug insertion with a vaginal applicator, getting a
gynecological examination, sexual intercourse” is not possible. It is
also common for a woman to be unable to look or even touch her own genital
area. A significant number of these women cannot complete any vaginal
penetration, including sexual intercourse. Sometimes the vagina may be
completely closed and impossible to enter; even during sexual intercourse
efforts, legs, back etc. Other muscle groups such as contractions may
occur, or they may feel as if their breathing will stop. They can close
their legs and push their partners. Because of the fear of pain and
failure, sex or anything related to sex can be avoided.

What are the Causes of Vaginismus?

There are different reasons for each patient, but the most common
fear of “it will hurt” is seen. These are the fears created by
exaggerated and unfounded stories about the opening of the hymen in the first
sexual intercourse. In societies where sexuality education is not given
enough, ignorance of sexuality, not knowing the location and structure of the
genitals alone can cause vaginismus. When the time comes, girls who grow
up in families where sexuality is seen as a shame and a sin cannot establish
the closeness required by marriage and experience extreme shyness. Girls,
who have been raised by saying “protect the hymen” since childhood,
unconsciously experience vaginismus on the first night of their marriage with
the instinct to protect this “treasure”, which they have protected
for years. Traditions such as “waiting for a bloody chador” or
“tying a red belt”, the fear of “what if there is no
bleeding?” Many reasons such as Turkish movies, newspaper reports,
false stories told between friends, accidentally witnessing the mother and
father having sex without knowing what happened in childhood can cause
vaginismus. Childhood sexual abuse, forced marriage, or problems with the
spouse, or fear of losing control in perfectionist personalities can also cause
vaginismus.

What Are The Situations That Can Be Confused With Vaginismus?

Dyspareunia can often be confused with vaginismus: pain, pain, burning,
stinging during sexual intercourse. Reason: There may be many conditions
such as vaginal and external genital infections, conditions that cause vaginal
dryness, some anomalies that prevent vaginal entry anatomically, structural
changes of the hymen and should be distinguished by examination.

What Does Vaginismus Patients Feel?

The most basic symptom of vaginismus is that the person
experiences a panic attack-like situation when the “moment” comes. He
is conscious but lost control. He pushes his wife, contracts, feels
fear. Depression can occur over time. She may think that this is her
fault and feel guilty that she is doing her husband an injustice. He can
propose a divorce to his spouse. He thinks that he is the only woman to
experience this. The woman often cannot open up to anyone and loses
self-confidence and hates herself. Fear of not having children adds to all
this.

What Are The Applications That Are Not Recommended In Vaginusmus?

We may encounter the words and practices of people who do not have sufficient
knowledge and experience about vaginismus that make treatment difficult and
direct them to unnecessary interventions. What are these? “ ‘Your
vagina is narrow’ ” Your hymen is thick or behind. ” ” Anesthetic creams are
the solution ” ” Take the hymen, the problem is solved ” Suggestions such as
” 24 hours treatment is possible ” are practices that abuse the patient and
actually aggravate the situation.

What are the principles of vaginismus treatment?

In our country, vaginismus is seen in one out of every 10 women
with active sexual life. Vaginismus is actually one of the sexual problems
that give the most satisfactory results.
Treatment varies from patient to patient, the underlying cause of each patient
is different, and in fact, vaginismus treatment is a personalized
treatment. The first thing to do is to apply to the doctor and be
examined.

Although vaginismus is a problem experienced in women,
this problem is a common problem of the couple. Supporting the spouse
facilitates the treatment and shortens the treatment time. After the
treatment of vaginismus, male sexual abstinence and erection problems can be
seen. For this reason, the presence of the spouse in the sessions during
the treatment prevents such situations that may occur.

Generally, no surgical intervention or interventional
procedure is required in the treatment of vaginismus.

Vaginismus Treatment

First, the woman’s external genital examination is performed: the
structure of the hymen and whether there is a condition that would prevent
vaginal entry is checked.

In addition, in the first meetings, it is checked whether
there is a conflict in the couple relationship and resolved if
necessary. Because the spouses’ perspective on sexuality and sexual
behavior characteristics can also cause problems and make treatment difficult.

Then, basic information about sexuality is provided, and
misinformation and beliefs of the couple are corrected. A woman with
vaginismus and her husband is first introduced to the anatomy of the genitals
and the physiology of sexual responses with the help of models and videos.

Women with vaginismus may have feelings of
“irritability, anger, guilt, sinfulness, anxiety, disappointment or
fear” that prevent them from having a pleasant and painless sexual
intercourse, and the verbalization of these feelings helps to solve the
problem.

Exercises under the name of “love games” are
suggested by changing the wrong behaviors. In fact, the couple is guided
to learn the “art of beautiful lovemaking”.

Among the treatments for vaginismus, behavioral therapies
are most commonly used: it includes many practical exercises for
learning. The purpose of vaginismus exercises is to enable the person to
recognize their own genital organs, to teach the mind to control the vaginal
muscles and to relax the vaginal muscles with correct movements. These are
“splits, relaxation with breathing techniques, Kegel exercises, finger
exercises and exercises with dilators”. The purpose of all these
exercises is to teach the patient that her vagina is extremely flexible and
that it is possible for a foreign body to enter the vagina.

Vaginismus problem is personal, and therefore its
treatment should be tailored to the source of the problem.

By carrying out all these stages together, it is ensured
that the couple has a healthy and happy sexuality as soon as possible.