About 1% of French women of childbearing age suffer from vaginismus, according to the CNGOF. The psycho-sexologist, Sophie Genin, reveals the causes of this sexual disorder and explains how to overcome it.
– Why doctor: On social networks, more and more women now dare to talk about their sexual health. In recent years, many have released the word around vaginismus. But what is it?
Sophie Genin: Vaginismus is an involuntary contraction of the pelvic floor. Clearly, this set of muscles surrounding the vagina contracts and prevents any penetration.
There are two forms of vaginismus. We speak of “primary vaginismus” when the patient has always been affected by this sexual disorder and has never managed to have a single sexual intercourse with penetration. The second form is called “secondary vaginismus”. In this case, the disorder occurs during a sex life that was going normally.
Vaginismus accounts for 6 to 15% of sexology consultations
What is the profile of affected patients?
During my consultations, I noticed that it is very often young women, aged around 20, who suffer from vaginismus. However, this sexual disorder also concerns people, aged 35 and over, who form a couple or marry later.
To date, the exact cause of vaginismus is unknown. But what are the different factors that can cause this sexual disorder?
Vaginismus can occur after a childbirth that went wrong or during which doctors used extraction instruments, such as suction cups or forceps. After this trauma, the patient may be apprehensive about any penetration. In some women, vaginismus presents after a traumatic experience, such as sexual assault or rape.
This sexual disorder can also be caused by the fear of losing one’s virginity because of certain family taboos or religious beliefs. In families, sexuality is never approached or it is evoked but with negative terms. Another possible case: strong pressure is exerted on the young woman to preserve her virginity. This strict education can install fear and make it grow a little more every day.
It is also possible that vaginismus appears due to the anxiety generated by the first sexual intercourse. Hearing our friends talk about their first time and who had pain, we can be apprehensive.
How do you know if you have it?
A woman may realize that she has vaginismus if her vagina stays closed and her partner’s penis fails to enter it during sex. She can also suspect it if she cannot introduce a tampon during her period, a finger or a sex toy.
Another sign: it is impossible to perform a vaginal examination or use a speculum during a consultation with a gynecologist. If the patient suspects that she has vaginismus, she should consult a midwife or gynecologist who should perform a medical examination to confirm the diagnosis.
As a reminder, vaginismus is not manifested by pain, because it is a hypertonicity in the pelvic floor. On the other hand, pain can occur if penetration is forced.
Which professionals to consult?
In case of vaginismus, it is important to consult a professional when one feels the need. You can go to a midwife, a physiotherapist or a sexologist.
The midwife will facilitate the rehabilitation of the perineum by helping the patient become aware of the contraction of the pelvic muscles so that they relax. During consultations, the practitioner can use vaginal dilators, from the smallest to the largest diameter, by massaging the entrance to the vagina. She can also use an anesthetic cream on the endovaginal parts, more precisely on the vestibule.
As for the physiotherapist, he will also help the person suffering from vaginismus to rehabilitate his pelvic floor thanks to Kegel exercises, namely movements of contraction and relaxation of the perineum. The sexologist will allow to have more information on vaginismus and to free the word around this sexual disorder. He can also give massage techniques for the female sex to be performed alone or with his partner.
Women affected by vaginismus can also turn to a specialist in aesthetic medicine. The latter can inject botulinum toxin, which acts directly on the contractions.
Vaginismus: “The elimination of guilt also makes it possible to fight against this sexual disorder”
What solutions can put an end to this problem?
It is possible to cure vaginismus thanks to multidisciplinary care and patience. To overcome this sexual disorder, it is advisable to rehabilitate the pelvic floor. We can also bet on relaxation exercises, mindfulness meditation with a mental visualization of the opening of the vagina which relaxes (for example: the image of a bud of a flower which opens). Removing guilt also helps to fight against this sexual disorder, because some people feel guilty for not being able to have sex.
Is it possible to prevent it?
We can prevent this sexual disorder thanks to a less strict parental education and the environment in which we grow up. Clearly, it is recommended that parents address this subject with their children, but they should not be exhibitionists either. You have to find a middle ground.