Vaginismus is the inability to have sexual intercourse, even though the woman wants to have sexual intercourse, as a result of involuntary contractions in the muscles surrounding the outer part of the vagina (female sexual organ). During this time, the woman may experience symptoms such as intense anxiety, fear, body stiffness, tremors, and involuntary closing of her legs. Vaginismus is a condition that can be easily treated with the right approaches, but the problem continues for reasons such as some wrong practices, non-participation in the treatment process or haste in the treatment, the man's failure to participate in the treatment, and wrong beliefs. If this problem that occurs in marriages is not solved, it can progress to processes such as divorce. Let's examine some misconceptions and facts about vaginismus and its treatment:
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. The contraction that occurs in the vagina occurs against the woman's will and due to the intense anxiety she experiences. The important thing is to understand the cause of anxiety and to eliminate these contractions as the anxiety decreases with the right approach. 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.
FALSE: There is a lot of bleeding and pain during sexual intercourse.
TRUE: One of the fears and often misinformation of women during the first sexual intercourse is related to bleeding. The "hymen" will cause bleeding and will be very painful. The structure we call hymen, commonly known as the hymen, is a structure as thin as an onion skin, with capillaries in some places. During sexual intercourse, there is a slight abrasion and if it comes across the capillaries, a very slight blood leakage may be seen. The pain is much less than the pain of a thin needle sinking into your hand and is often unnoticeable.
FALSE: The cause of vaginismus is the narrowness of the vagina and anatomical problems
CORRECT: The vagina has a flexible structure like stretch fabric. It is as wide as a single finger. When the penis is positioned, it grasps the penis, and when the child comes out, it expands as much as the child. When there is arousal, the vaginal structure and fluid change. In vaginismus, there is a problem with the muscle structure at the entrance. The penis cannot enter the vagina because it contracts due to tension.
FALSE: Vaginismus is corrected with medications and alcohol.
TRUE: In order to solve the problem, sometimes there are people who want to use medication, and unfortunately sometimes healthcare professionals can also recommend medication. However, vaginismus can be used as painkillers, anxiolytics, local anesthetics, muscle relaxants, etc. It cannot be improved with medications. Sometimes, people with vaginismus 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, apart from additional mental distress, drug use does not result in anything other than wasting time. Recently, we have been hearing from our patients that sexual intercourse is performed under anesthesia. However, this is both an unethical practice and not a treatment for vaginismus with anesthesia. Because the problem is unrealistic thoughts and anxiety that cause muscles to contract. Unless this concern is resolved, the treatment will not yield positive results.
Some common mistakes about vaginismus are as explained 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. Even though it seems like the woman is experiencing the problem, two people experience the problem together and the solution is together. The only proven treatment method for vaginismus is psychotherapy performed by a trained psychotherapist. Surgical procedures, sexual intercourse with anesthesia, alcohol consumption, medications, botox, and physical therapy complicate vaginismus instead of treating it and are a medical error. If such a problem is experienced, it should first be evaluated and diagnosed by a psychiatrist. If the evaluating psychiatrist is performing vaginismus therapy, he continues the treatment. If not, he/she refers you to a psychiatrist or clinical psychologist trained in vaginismus therapy.
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