My Doctor Tells

Mumbai’s #1 Sex Health Clinic

Samadhan Health Studio

Dr. Ashok Koparday
Dr. Hetal Gosalia

Dr. Ashok Koparday | Dr. Hetal Gosalia

Vaginismus is silent suffering where sex is not happening. It is understood by a few, hardly expressed and approached for, but the fact lies it is curable to the core.

  • Are you a couple who is newlywed, who cannot have sex.

  • Are you a couple unable to consummate and opting to consult your gynecologist for a baby by the treatments for infertility?

  • Are you a man losing erection every time you attempt to insert in the vagina?

  • Or are you a woman afraid of sex, touching the vagina, masturbating, and tampons?

If you find yourself as one of these persons, then you have arrived at the right place because a sexologist is who you need to help you through this. Here we have provided an all-encompassing rundown of vaginismus including an explanation of why understanding vaginismus is important, how to deal with its effects, and win over it.

What is Vaginismus?

Vaginismus is the involuntary contraction of the vaginal muscles, known as the pubococcygeus muscles; at the time of insertion of the penis.

It is a psycho-physiological genital reaction of a woman, characterized by intense contraction of the perineal and paravaginal musculature, tightly closing the vaginal introitus.

It is a condition in which the muscles around the outer third of the vagina have involuntary spasms in response to attempts at vaginal penetration, not allowing for penetration.

The woman is unaware of muscles’ tightening, as it is a response of the brain to insertion of the penis.

She can’t see nor feel the vagina obstructing the entry of the penis.

Vaginismus is a latin word originated in 1861. Etomology of the word follows as vagina + spasmus, which means spasm in the vaginal muscles.

Fear of hymen tear

Women have the fear that, on insertion the hymen will tear which will lead to bloodshed. This fear involuntarily contracts the vaginal muscles and obstructs insertion.

Small Penis

Woman complaints or the man feels that his penis is so small that it cannot be inserted in the vagina. But the truth is, that the involuntary contraction of the vaginal muscles, does not allow the penis to be inserted.

Solution after Delivery

Women feel that after undergoing vaginal delivery, the muscles of the vagina will loosen up. But that’s not what happens. Even after a normal delivery, the vaginal muscles may involuntarily contract as a stimulus to insertion.

Erectile Dysfunction / Premature Ejaculation

The woman feels that her partner is losing erection when attempting to insert his penis in her vagina. And since this stands out visually, the man is blamed.

At Samadhan Health Studio, we get cases for psycho-sexual therapy 6 hours, 6 days even 6 years, and even more after marriage. As the couple is unable to consummate a tremendous frustration builds up among the two as they just cannot have sex. Couples longing for sex now start to avoid it. This, in the long run, leads to relationship issues and in some cases a divorce too. With our therapy, we have been able to help several couples, now able to consummate. The time to cure depends on multiple factors like willingness, commitment, and cooperation but the fastest success we could attain was in a month. Read on and you’ll also win over vaginismus and be able to consummate.

Primary

It is when the woman just cannot have intercourse for the first time. She might not be able to insert a tampon or her finger too. This may be associated with fear and anxiety as well.

Secondary

It is when the woman has enjoyed healthy intercourse earlier in life. She is now facing the pain and burning. It can be due to medical reasons or hormonal imbalance or some infections.

Dyspareunia

This is the pain felt during the attempt of insertion of penis ranging from mild discomfort to severe tearing pain with burning sensation.

Fear of gynecological examination

This is when the woman refuses the doctor for pervaginal examination. Even if she allows one finger insertion by the gynaecologist that doesn’t rule out vaginismus.

Fear of insertion

This is when the woman fears to insert tampons inside her vagina, fears to insert her own finger or any other object into the vagina.

Anxiety

This is when the woman feels anxious and/or depressed when his partner attempts to penetrate after an exciting foreplay.

Incorrect Diagnosis as ED

In India, vaginismus is presented as Erectile Dysfunction and/or Premature Ejaculation. This may appear paradoxical, but in India, especially when the man has self-doubt he concludes that the penis is not going inside vagina because of PE or is unable to consummate because of ED.

Here, the man wrongly believes that he is the one at fault for the failure in consummation.

It is just out of the blue to him or the couple, that there could be a problem in the entrance of the vagina. So if the man loses his erection, which is rock hard other times; during the attempt to insert, there are chances that the woman has vaginismus.

Self doubt and depression

Self-doubt is often present in innumerable men before marriage which could be due to the inexperience or bad sexual experience in the past or the feeling of inadequacy about the size of his penis or even myths related to masturbation, nightfall, loss of vital semen.

After an unsuccessful attempt of insertion of the penis in the vagina, the man gets down in a turmoil and starts doubting himself.

This may lead to depression. Here you need a sexologist to cure vaginismus and not pills for depression.

Avoidance of sex
After multiple failures, what happens is that the couple starts to avoid performing sex. Misunderstandings multiply in response leading to avoidance of sex. This builds up sexual frustration and puts on stake the love bond the couple had.

Don’t worry, you’re not the only one there are many silent sufferers.

Understand the problem and follow the treatment we’ve described, and you’ll cherish your life in the future

Relationship Issues

Couples generally get involved in blaming each other. The woman blaming the man for a small penis or for an insufficient arousal or ED. The man blaming the woman for not allowing the insertion of penis in the vagina. And the blame game begins between the duo. This ends up with relationship issues and may lead to a divorce too.

Delayed Pregnancy

Since the couple is unable to consummate, the pregnancy gets delayed and family pressure builds upon them. This even hampers their personal and/or love life.

The causes of vaginismus range from a mix of the physical or emotional causes or seem to have no origin at all. It may appear as a surprise and a woman simply will not be able to understand what is causing the discomfort

The woman is willingly wanting to love her partner sexually but sex is now a pain to her heart and no more pleasure.

Emotional Causes

Myth

Most women who experience vaginismus have fear about the insertion of the penis. The fear of pain and bleeding is ubiquitous. Often women have heard from their friends or relatives that,

“Initially sex is painful and little blood oozes due to hymen tear. After which, it becomes okay.”

When a woman is told sex is painful and when she anticipates pain, will there not be a reflex contraction of the muscles of the vagina as a means of protection?
In India, where there is orthodox socio-cultural upbringing even touching the ‘private’ part is shunned. Talking about ‘naughty’ things is taboo for good girls. Good girls are defined as those who do not talk about sex or do ‘those kinds of things’. Insertion of finger, tampon, or any object and per speculum or pervaginal examination by a doctor can be difficult, painful, or impossible due to vaginismus.

Most of the time the woman is not aware and neither is she at fault. It is an automatic reflex action of her body governed by the subconscious mind.

The vaginal muscles automatically tighten and close at a mere touch. The experience of pain, burning, and fear leads to a decrease in sexual desire.

Loss of Interest

The woman might be excited to have sex but physically inadequate foreplay and the lack of lubrication leads to pain due to which she now fears and loses interest in sex. This eventually reinforces the reflex of contraction and tightening of muscle which is neither seen nor felt by her, leading to vaginismus.

Performance Anxiety

When the couple prepares for sex, an anxiety builds up on what to do, how to do, what not to do, sometimes the woman isn’t desiring a baby and many other unaddressed questions. This leads to a vicious cycle and because of the anxiety the muscles of the vagina contract, irrespective of the fact that the woman may not want it to happen.

Relationship Issues

If the bond between the duo isn’t lovable, chances of a marriage against will then those hurts caused at the time of the marriage despite of a loving and caring husband and a better relationship now, may lead to vaginismus. Not just the stand alone reason, cause another being that in spite of a love marital relationship, there can be disputes which withdraw the woman from consummating with the man. This shall not be permanent and can be cured with a closure on the quarrel and a softer consentual attempt to sex

Physical Causes

Vaginal Delivery

In some cases, after the woman undergoes a vaginal delivery, there are chances of perineal tear, which may cause pain at the time of penile insertion.

Hormonal Changes

When a woman has underwent a child birth or any other illness or sometimes has or is entering her menopausal phase, then the vagina may not be ready to accept the penis.

Sexual Abuse

A harsh experience of the past flashes back every time there is an attempt of insertion. This leads to rejection of this decent attempt.

Side Effects of Psychiatric illness

Vaginismus in this case is abnormal vaginismus, which is uncommon. In rare cases the condition is a manifestation of serious mental illness and requires formal psychiatric evaluation and treatment. Gender identity conflict, a history of trauma from rape or incest, or an intense suppression of sexuality in childhood and adolescence are factors that often are associated with vaginismus.

Pelvic Injury

Any type of pelvic trauma or surgery.

Vaginal infections

Because infection in or on the vagina due to some other illness leads to pain and burning near the vagina which contributes as a reason for the occurrence of vaginismus.

In most of the cases there is no known cause of vaginismus.

There are no investigative tools or diagnostic laboratory tests for vaginismus. Hence, an attentive history taken by a sexologist is enough to give a conclusive diagnosis of vaginismus.

Cases to us at Samadhan Health Studio appear in two broad categories:

The man coming up as with a notion of erectile dysfunction or premature ejaculation  

The woman coming up saying, “I am unable to have sex”. Mostly the woman denies physical vaginal examination by the gynecologist.

There are definite methods by which vaginismus can be cured. The results are excellent with the guidance of a competent experienced sex therapist. If a urologist, gynecologist, or some doctor incompetently handles the treatment of vaginismus, the situation becomes complicated and frustrating. In spite of this, an experienced sex therapist can do wonders. Sexual adjustment often can be achieved through educative and supportive measures that lead to improved sexual self-awareness and response.
Cooperation and commitment of both partners make all the difference in treatments’ outcomes.

Vaginismus being an automatic response of the brain towards penile insertion the brain has to be trained here. So the treatment includes mind and body training.

  • Psycho-Sexual Therapeutic Counseling is of paramount importance in the treatment of vaginismus.
  • Cognitive Behavioral Therapy is used to address fear and anxiety.
  • Pelvic floor and vaginal muscle exercises are taught for relaxation.

Patients generally come up with questions like ‘Is vaginismus treatable?’ or ‘Does curing vaginismus require medicines’. The biggest fear women have for curing vaginismus are those giant-sized dilators. But the fact lies

Curing Vaginismus Doesn’t Require Dilators.

A surgical procedure called Fenton’s operation was previously advocated to broaden the vaginal introitus. This is unnecessary or rather useless.

We here at Samadhan Health Studio, advise Sex Joy Therapy. Sexual pleasure is the key to win over vaginismus. High erotic moods make the vaginal wall wet and the muscles open up there. This natural lubrication helps the finger and later the penis to slide into the deep valley of the vagina. To be noted that, the vagina is the same potential space from where the baby comes out in vaginal delivery.

The woman can practice inserting her own finger in the vagina in privacy either when alone or with a partner. Before attempting fingering, check the nails are trimmed and hands are clean. As a part of therapy, there has to be NO attempt at the insertion of the penis in the vagina. Did you notice that I use the word ‘insertion’ and not ‘penetration’? The reason being every single unsuccessful attempt at insertion brings the couple several steps back in the treatment procedure.

After clearing this stage, when the couple engages in wholesome, full-fledged, ecstatic sexual intimacy the focus shifts on the woman’s pleasure. Shamelessly, they indulge in every form of erotic sexual pleasure, except for the insertion of the penis in the vagina. Do consider reading our blog post on ‘How to sexually arouse and satisfy a woman’

The woman can use her masturbatory method and indulge in the sexual fantasy that arouses her. Follow our page on ‘Masturbation for Women’ for knowing more.

Once she is enabled to orgasm, at the peak of sexual arousal there is a flood of endorphins because of which body’s ‘pain’, ‘hate’, and ‘disgust’ threshold rises.

When one finger glides inside the vagina with ease and without any obstruction, the vaginal muscles start to adapt to insertion. Now two-finger insertions can be attempted. After a series of such sex play, the woman’s fear and anxiety diminish. She now becomes confident about the insertion of the penis.

In a correct sex position when the woman holds the erect penis and directs it at the entrance of the vagina and feels the tip of the penis touch the vaginal opening, the vagina gets familiar with the penis. Now with a gentle thrust insertion of penis in the vagina can be attempted. Several attempts may be required before the entire penis is able to glide in smoothly.

Following this procedure, vaginismus can be cured and the couple can consummate and have a baby naturally. This isn’t a condition that can be cured with a snap of a finger, it needs tender care and attention.

If this condition is left unattended, you wanting a baby will be led by a gynecologist for the treatments of infertility. Let’s agree upon one fact that, infertility treatments are for those who are not fertile, not for those who cannot consummate. If you are unable to consummate, following the above-mentioned treatment can help you cure vaginismus and conceive naturally.

A big gift from our side is a declaration that natural pregnancy is possible in spite of vaginismus. Yes, if you just want a baby and are fertile then you can conceive naturally. The process of fertilization of the ovum and sperm leads to the formation of the zygote, which then matures for 9 months to form a baby. And for this process, all that is needed is the semen in the vagina, not the penis. Do consider checking out our blog post on ‘Natural Pregnancy in spite of Vaginismus’ for more details.

By now we come to an end of the discussion of Vaginismus, the disease experienced by an overwhelming silent majority, understood by a few, hardly expressed and approached for. If you have been facing this and reading this text helped you do fill our voids with your testimonial. For any further questions, feel free to contact Dr. Ashok Koparday and Dr. Hetal Gosalia at Samadhan Health Studio. We will be more than happy to help.