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Vaginismus is a condition characterized by involuntary contraction of the pelvic floor muscles.
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Women struggling with vaginismus cannot perform any sexual activity that involves vaginal penetration. (They may also experience the same intense symptoms when inserting a tampon or doing a pelvic exam.)
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It can cause major distress, relationship problems, and prevent women from starting a family.
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Healing of vaginismus is possible.
For the treatment of vaginismus, the pelvic floor physiotherapist uses pelvic floor muscle retraining techniques and self-management strategies to strengthen the pelvic floor muscles. It treats existing symptoms to normalize muscle tone and allow vaginal penetration without pain, anxiety, or fear.
How common is it?
Studies conducted around the world show the prevalence of vaginismus between 5% and 17%. states that it varies between . However, it is likely that actual figures are under-reported because women are embarrassed to seek help.
What is vaginismus?
Vaginismus is the involuntary contraction of the pelvic floor muscles. The condition in which a woman cannot have sexual intercourse at all due to involuntary contraction of the vaginal muscles is called primary vaginismus. Secondary vaginismus occurs when a woman was previously able to have sexual intercourse or insert a tampon but is no longer able to do so due to involuntary muscle spasms, fear and pain. Causes of vaginismus may sometimes be related to a painful or traumatic event such as infection, birth, gynecological surgery or abuse.
Vaginismus, genito-pelvic pain disorder or genito-pelvic penetration disorder (GPPD), pelvic floor overactivity/hypertonicity. It is also known as pelvic floor myalgia and is sometimes confused with vulvodynia.
Why does it happen?
Vaginismus is a real condition and It is important to understand that recovery is possible. Although there is a strong emotional component that is the primary cause of vaginismus in most cases, there is also a strong physical component in the development of this condition. Mind and body are interconnected.
Pelvic floor muscle To understand why the muscles contract involuntarily, we first need to understand the fight or flight response. Whenever the body and brain are exposed to a dangerous or traumatic situation, a series of automatic physical responses begin to occur to help cope. Let's think about what a very stressful event like being threatened, being physically or verbally attacked, or even constantly worrying about something can do to the body. In these cases, it can be easily felt that some changes are taking place in the body - the heart begins to beat faster, breathing becomes shallow or we can hold our breath for short periods of time, and we often tighten the muscles around the jaw and tense the muscles in the neck, shoulders, abdomen and hips. These reactions ultimately help us survive. It is part of a mechanism called the fight-or-flight response that triggers reactions in the body. In this way, we are ready to defend ourselves in case of danger or to escape from danger as quickly as possible.
From a survival perspective, it is a very well designed mechanism. If a lion starts chasing you, this autopilot response could save your life.
Unfortunately, this response can be exaggerated and less threatening conditions such as stress, fear, anxiety and It can be very difficult to control.
In vaginismus, this overreaction of the brain and pelvic floor muscles leads to constant muscle tension around the vaginal opening. Muscles become tense and tired. It develops painful areas that can lead to more pain when penetration is attempted. This is a vicious cycle, but with the right treatment method, these symptoms can be stopped and sexual life can continue as normal.
What treatments are available and how can a pelvic floor physiotherapist help?
Vaginismus treatment should include a multidisciplinary team consisting of a gynecologist, psychosexual therapist and women's health physiotherapist (pelvic therapist).
The goals are to ensure that there is no gynecological disease left untreated, to identify the root cause of the problem. to understand and create strategies to solve it, and finally to treat and retrain the pelvic floor muscles. Adopts a holistic approach that aims to treat the mind and body Pelvic floor rehabilitation for the treatment of vaginismus is an intervention consisting of pelvic floor relaxation and retraining techniques aimed at normalizing the muscle tone of the pelvic floor muscles and treating pain to allow vaginal penetration without pain, anxiety and fear. Vaginismus is highly treatable because the muscle is inherently sensitive. Accompanied by a specially trained physiotherapist (pelvic floor physiotherapy), he will guide you through the appropriate steps to overcome vaginismus. Your physical therapist will ask questions, educate you about your anatomy, and evaluate your pelvic floor muscles.
An essential part of recovering from vaginismus is being able to voluntarily understand where your pelvic floor muscles are and how to manage them. Manual therapy (trigger point release, dilator therapy, biofeedback) along with a home exercise program is very effective in overcoming vaginismus.
The next step after gaining pelvic floor muscle awareness is that the muscles react differently to sexual intercourse or the use of tampons. To train them to give. It is a learning process in which you develop the skills necessary to take conscious control of this muscle group and modify the conditioned reflex so that there is no involuntary tightening. The ultimate goal is to regain control of your mind and body's response to vaginal penetration, allowing you to enjoy comfortable sex.
Expectation of pain, emotional concerns, or unhealthy sexual messages can also increase vaginismus symptoms. Often, there are underlying negative feelings of anxiety associated with vaginal penetration. Please let your physical therapist know if you need help overcoming such emotional triggers.
If you are experiencing pain or difficulty with sexual intercourse or the use of tampons, do not suffer in silence! Please see your pelvic physical therapist for an evaluation so they can help you overcome your vaginismus.
Treatment involves a combination of strategies such as education, vaginal manual techniques, supervised exercises for the pelvic floor muscles, and a home exercise plan.
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Training and Recommendation – How to activate the brain's fight or flight response It is extremely important to understand what it does and how it affects the pelvic floor muscles. Your physiotherapist will support you in teaching techniques to relax the muscles and control this reaction.
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Manual for pelvic floor muscles techniques and exercises – treatment usually involves examination of the vaginal pelvic floor muscles and a series of exercises with the help of a physiotherapist. This is to help reduce muscle spasm and pain and retrain these muscles to regain flexibility and function to allow vaginal penetration without any pain. It is important to note that although there may sometimes be mild discomfort, this type of examination and treatment is not painful – the aim of the physiotherapist is to create a safe environment in which the patient feels comfortable, the pelvic floor muscles can relax and functionally regain their former health.
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Home exercise program and self-management – this usually involves a combination of exercises to relax the pelvic floor muscles, using dilators to help release tension in these muscles.
However, it is important to note that every case is different and treatment is always carefully designed for each woman following a comprehensive initial physiotherapy consultation.
Women struggling with vaginismus often feel guilty, embarrassed, and isolated, which is why it's important to share this information. Vaginismus is a real condition that can be treated. The sooner you begin your healing journey, the sooner you will begin to see improvements.
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