Female sexuality is governed by biological, emotional, and psychological factors. Female sexuality, as in men in general, is influenced by bio-psycho-social factors. In particular, many factors such as hormones, the vascular and neurological structure of the genital area, emotional exchange with a partner, sexual beliefs, past sexual experiences, daily rush, and troubles affect sexuality in women. One of the topics our female clients consult us about most frequently is vaginismus. Studies also show that this problem is one of the five most commonly experienced sexual problems (along with low sexual desire, orgasm problems, lack of sexual arousal, and inability to enjoy sex). Sexual pleasure definitely has an emotional aspect. Fear of sex can also develop in those who have had any sexual trauma in the past or who view sexuality negatively due to the information and experiences they have received. Teachings and views on sexuality, the level of sexual information, and communication with a partner play an important role. If you think that intercourse is the only necessary element for sexual happiness, that all other sexual behaviors are unnecessary, that the first night will be very painful, or that women should not initiate sex, you have been exposed to urban myths. In this case, the accurate and scientific information we provide expands your perspective on sexuality.
What Is Vaginismus?
It is the first sexual problem we encounter in the work we have been conducting for years both as Prof. Dr. Halim Hattat and as the Aile Sağlığı Araştırma Derneği. Vaginismus is the unintentional contraction of the outer/anterior part of the vagina in a way that prevents sexual intercourse. The muscle surrounding the vaginal entrance controls the vaginal opening. Involuntary contraction of this muscle can completely block the penetration of the penis into the vagina during sexual intercourse. When asking “What Is Vaginismus?”, we must also note that in some cases, it can develop secondarily later on. This condition can develop following a problem creating vaginal pain, such as vaginal or urinary tract infections, or vaginal dryness due to hormonal reasons. Again, stress, anxiety, involuntary muscle contraction, arousal problems, vaginal dryness problems, low sexual desire, and sexual misinformation can be causes of vaginismus. In addition to monitoring physical conditions, psychotherapy helps. After a while, the psychology of the male partner whose spouse experiences vaginismus also deteriorates, and erectile dysfunction or a tendency to stay away from sex begins, leading to a process where the couple needs to be treated together.
What Does Vaginismus Mean?
A very large percentage of women in our country experience involuntary contraction complaints during sex. When speaking of the causes of vaginismus, the contraction problem can stem from an underlying fear of experiencing sexual pain. In this case, the contraction experienced especially during the first intercourse continues, creating contraction and pain in subsequent intercourses as well. Sometimes sexual pain (such as tears in the vagina caused by dryness, or infections) leads to contraction. The most important step in treating contraction problems is: strengthening vaginal muscles through training. If there are underlying factors creating sexual pain—with sexual information being chief among them—these also need to be resolved.
Causes of Vaginismus
Psychological and social reasons such as from whom and in what manner a woman learned her first information about sexuality, relationship problems with her partner, and traditional pressures hold an important place among the “Causes of Vaginismus.” For example, a woman growing up in an environment where all communication regarding sexuality is socially taboo can develop feelings such as terror, distress, and shame toward sexuality in this situation, feeling anxiety-induced low sexual desire. In this case, problems arise in the vascular, hormonal, and neurological factors required for the development of a quality sexual response, and an arousal or orgasm problem can develop. Sexual function problems in women are particularly heavily influenced by emotional factors, and most importantly, sexual problems trigger one another. For example, a vaginal lubrication problem can trigger pain problems or even withdrawing from sex. In some cases, vaginismus can appear later rather than on the first night. In this case, again, the primary important reason is vaginal pain. In such situations, causes of vaginal pain must certainly be addressed first in treatment. Again, arousal problems, problems regarding vaginal lubrication, and low sexual desire can be causes of vaginismus.
What Is Vaginismus Disease?
In vaginismus, during the first intercourse, the woman enters intercourse with the fear that it will hurt and that there will be bleeding. Due to this anxiety and fear, she starts involuntarily contracting herself, so much so that she does not allow intercourse. Remember, having unscientific and incorrect sexual information can lead to being unable to accurately evaluate your sexual health and your relationship with your partner, and failing to realize it when you encounter a sexual problem. Growing up with inadequate sexual education and sexual myths can lead to excessive performance excitement, especially during first sexual experiences, causing sexual problems. Remember, due to a lack of sexual information, there are many people who cannot have sexual intercourse for many years and do not consult their doctors about their sexual problems. A situation that frequently catches our attention: couples experiencing vaginismus risking living with this negativity and not consulting a doctor. Even if the first intercourse ends in failure, our couple thinks that the problem is temporary and will resolve on its own. As the inability to have intercourse continues in subsequent attempts, distress, tension, and the thought of being inadequate in her womanhood begin to emerge in the woman. On the other hand, the man thinks his partner does not want to be intimate with him, and feelings of rejection predominate. Therefore, our recommendation is to wait for about 1 week, and if you cannot solve the problem on your own, to consult your physician.
Vaginismus Symptoms?
When diagnosing by examining “Vaginismus Symptoms,” we benefit from the following roadmap that guides us. Your answers to these questions help us get to know you from psychological, socio-cultural, and organic aspects.
- Will it hurt very much during the first sexual intercourse?
- Will there be very heavy bleeding during the first sexual intercourse?
- Are you afraid of the first sexual intercourse?
- When you are with your partner, is there tension and distress before sexual intercourse?
- Is there pain before or during sexual intercourse?
- Is there involuntary contraction in your legs, hips, or vaginal entrance before or during intercourse?
- Do you contract yourself involuntarily to the extent that it completely blocks penile penetration into the vagina during intercourse?
- Do you pull back before or after sexual intercourse?
- Do you have pain when starting or continuing intercourse?
- Do you frequently feel disinterested in sex?
- Can you characterize the foreplay process as high-quality as a couple?
- Is there a vaginal dryness problem before sexual intercourse?
- Are there emotional communication issues between you and your partner?
- Is your relationship in distress due to the sexual problems you experience?
- Due to the sexual problems you experience, do you question your womanhood, feeling unhappy, insecure, or unappealing?
Vaginismus Treatment Methods
When asking “How Is Vaginismus Treated?”, the most important issue is the lack of sexual information. First, it is necessary to complete the information deficit, and then examine other factors. Some vaginismus patients, on the other hand, do not enjoy sexuality despite having sexual information. They can engage in intercourse, but with difficulty and pain. In this case, underlying hormonal and anatomical causes are investigated, examining whether there is a sensitivity in the woman’s erectile tissue and a local cause preventing intercourse. Regardless of which type of vaginismus problem it is, it should be treated with teamwork consisting of an andrologist, gynecologist, and psychologist. Once underlying hormonal, vascular, and neurological causes are eliminated, vaginismus can easily be treated through a successful counseling process. Another important point here is that the woman and the man are addressed together in treatment. The man’s perspective on sexuality and his anatomical knowledge need to be questioned. When organizing our treatment protocol, the point we particularly emphasize is: this should not be aimed at merely getting through a single first night, but at reconciling our female patient with her sexuality for the future. Otherwise, vaginismus can reappear perhaps as another type of sexual problem, and relationship issues grow progressively. For this reason, we first complete the sexual information deficit, informing our couple in detail about male and female sexual anatomy, the hymen, vaginal muscles, and the physiology of sexual intercourse. Afterwards, through sexual therapy homework (muscle exercises, individual homework, and partner exercises in later stages), the couple becomes ready for intimacy step by step. In vaginismus, as in all other sexual problems, evaluating the couple together is of particular importance. Applying the homework given by your Consultant willingly and carefully brings success. Resolving problems in the man during this process, such as erectile dysfunction arising particularly due to psychological factors or premature ejaculation, raises the quality of the couple’s sexual life.
How Long Does It Take to Treat Vaginismus?
Do not expect the sexual problems you experience on the first night to heal immediately. Although the vaginismus problem technically has a solution in a relatively short period, overcoming sexual problems as a couple on a psychological and emotional dimension can require some time. Here, with the help of your consultant, proper communication shown with mutual understanding brings success. The question “How Long Does It Take to Treat Vaginismus?” is one of the most curious questions. Vaginismus Treatment encompasses the stages of providing a positive approach to sexual intercourse, completing incorrect information and information deficits, and teaching arousal through behavioral therapy on the other hand. Patients who take pleasure in each new homework and prepare for intercourse, while not even wanting to touch their own body or look at themselves in the mirror when they first start treatment, begin to get to know their body, learn to enjoy stimuli, and thus find the opportunity to engage in intercourse. Experts on our team state that, although the duration of therapy varies from person to person, this problem can be treated in an average of 3 weeks to 1 month, over 4-6 sessions. We believe that treatment will achieve success with increased sexual education and especially the delivery of accurate and clear sexual information. Remember that every type of sexual problem has a treatment. What matters is consulting your doctor in time.
Of course, our goal is also to create a relationship in female sexuality where emotions are at the forefront. During this period in our treatment, the strengthening of your communication as a couple allows you to maintain a high-quality and enjoyable sexual life throughout the continuation of the relationship. During this process, we teach you the following:
- We teach you not to rush foreplay: Remember that there is a necessary period for sexual arousal and orgasm processes, especially for women.
- We discover with you what you like and help you express it: It is of great importance for you to review what you enjoy in sex, your expectations from your partner, movements that seem fun and enjoyable to you, fantasies, and environments.
- We discover with you the importance of emotionality and enable you to focus on it: A nice word, a kiss, a hug are great ways to show that you hold good feelings for your partner. Small touches do not always have to result in sexual intercourse. Many couples realize that vaginismus also negatively affects their emotional lives.
We support you in listening to your partner: Your sexual problems affect your partner as much as they affect you. You should know that when you are unsuccessful, stressed, angry, or anxious about relationship issues, he too can be hurt, upset, and irritated. Therefore, we help you bring out the negative feelings that need to be discussed together. Communication is the most important point in overcoming sexual problems.