It is a sexual pain disorder in which there are persistent, long-lasting, involuntary repetitive contractions in the muscles surrounding the vagina in the outer 1/3 of the vaginal entrance. These contractions are accompanied by contractions in the whole body, closing of the legs, fear, avoidance reaction, and the belief that entry is impossible. In our country, 50% of applications to psychologists are related to the problem of vaginismus.
When penetration is attempted, the expectation of pain turns into a conditioned fear response and causes the vaginal muscles to contract. Thus, the body does not allow sexual intercourse, or the intercourse occurs partially, or results in painful intercourse.
The aim of sexual therapy is not to relax the muscles; is to eliminate the fear and anxiety of pain.
Causes of Vaginismus
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Feeling pain at first attempts
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It devalues sexuality and a humiliating family
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Opressive/authoritarian father
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Weak/powerless mother
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Difficulties in the father-daughter relationship
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History of sexual violence, harassment, rape
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Forced marriage
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Not loving one's partner
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Homosexual identification
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Fear of failure
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Fear of losing the hymen
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Sexual taboos, misinformation
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Low pain threshold
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Problems with vaginal lubrication
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Not knowing the anatomy of the sexual organ
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In childhood- Warnings such as "cover your leg", "cover your skirt" during adolescence
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Unconscious conflicts
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Painful gynecological examination
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A blow or trauma to the genital area in the past
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Use of too many rectal suppositories in childhood
Common Characteristics of Those with Vaginismus Problems
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They may be resistant to becoming an adult woman
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They have difficulty expressing their anger
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They need approval
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They believe that the hymen will rupture
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They think that sexual organs are disgusting and shameful. they can think
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They do not recognize their sexual organs
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They see the hymen as sacred and must be protected
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There may be a history of sexual violence or harassment or rape. In the past
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They may have gone through strict religious education or religious rules may have dominated their development
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They attach extreme importance to the concept of virginity
Automatic Thoughts Accompanying Vaginismus
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“The vagina is too tight”
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“There is an obstacle like a wall at the entrance to the vagina”
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“There will be a lot of bleeding during penis entry”
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“ The inside of the vagina will tear during penis entry.”
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“If the penis goes in, it cannot come out; It remains united”
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“Sexuality is a sin, bad and immoral”
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“The hymen is valuable and must be protected”
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“The first intercourse is an exam in which the man will test the virginity of the woman”
Vaginismus Treatment
Vaginismus treatment After an evaluation process carried out with couples, therapy rules are stated and it begins with psychoeducation on sexual physiology and anatomy. During the evaluation process, the factors that cause the client to experience this problem are determined and therapeutic methods, colloquially called "talking", are applied. Additionally, there is homework to be given to our couples in each session. These assignments consist of home exercises that we will determine step by step, sometimes for filling out some forms and sometimes for practice, that will not burden the clients.
In this treatment, the frequency and times of meetings are determined according to the course of the study. The meetings are determined by communication when the homework given at the end of each session is completed by the client, rather than being held once or twice a week. In other words, each session reaches another step by completing the previous session and fulfilling the requirements of that step.
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