Vaginismus is a spasm in the musculature of the outer third ofthe vagina which makes insertion difficult or impossible. For somewomen, this muscle spasm is painful; for others, it is not. Most womenexperience pain if they try to insert something in spite of this spasm. Is vaginismus always caused by abuse? No. Some research suggests a correlation between vaginismusand abuse, and other studies show no relationship. Many women withvaginismus have been abused, and many have not. Just because you'venever been abused doesn't mean you can't have vaginismus, any morethan being abused would guarantee vaginismus. What causes vaginismus? It is widely believed that in most cases of vaginismus, thespasm is triggered either by pain or the anticipation of pain(emotional or physical pain). Much like the way an eyelid closes whensomething comes to close to the eye or a muscle flinches in responseto an imminent punch, vaginismus is like a vaginal flinch. It is insome sense protecting the area, even though the woman doesn't want itto. Some women have fears or guilt regarding intercourse, others havephysical pain problems, and still others have no obvious cause fortheir condition. One perplexing aspect of vaginismus is thatoften the spasm remains long after the woman has dealt with anyanxieties or physical problems. So learning to control and eliminatethis spasm is how one cures vaginismus. If I have pain with intercourse, then do I necessarily have vaginismus? Not necessarily. Painful intercourse can be caused by anynumber of factors, and vaginismus isn't even the most common. Often,painful sex due to other conditions may lead to vaginismus, so even ifyou do have vaginismus, you may have another underlying primary causeof pain. The most common cause of chronic painful sex (or painful*attempts* at sex, depending on the severity) is vulvar vestibulitissyndrome (VVS). VVS can occur at any age, and often with no obviouscause and usually no visible symptoms. It is simply an enhancedsensitivity in, on, or near the vaginal opening. It should not hurt totouch any part of your vulva. If it does, you should look into thepossibility that you may have a vulvar pain condition. They areextremely common, and only seldom diagnosed. Most women suffer insilence. Most doctors do not routinely test for VVS, but the testsimply involves poking certain areas (corresponding to your vestibularglands) with a Q-tip and seeing if you have pain. There are otherproblems which can cause painful intercourse as well, including lichensclerosis (a skin condition), interstitial cystitis (involves thebladder), essential vulvodynia (which causes nearly constant pain),and others. These conditions are not widely understood or even recognizedby many doctors, so most women with these disorders (especially youngwomen) are likely to be misdiagnosed initially with vaginismus. If yoususpect you have one of these disorders, treatment by a specialist isrecommended. One excellent general resource which describes vulvarpain conditions is located athttp://www.vulvarpain.icomm.ca/paavonen_1.html A few other resourcesto help you find out more about these conditions are theVulvarDisorders list on yahoogroups:groups.yahoo.com/group/VulvarDisorders/ and www.vulvodynia.com whichhas a very useful FAQ, and www.vulvarpainfoundation.org as well aswww.wellweb.com/INDEX/QVULVODYNIA.HTM How can I cure this? Many women, though not all, find it necessary to treat theunderlying causes of their vaginismus. For some this will involvetherapy if emotional issues are involved, and for others they willhave to treat vulvar pain conditions, while still others may not needto focus on what initially caused their problem (some may not evenknow their cause), and just focus on controlling the muscle. Learning to control the muscle can be done in many differentways. The most common way is to gently insert progressively largerobjects (called "dilators") into the vagina so that the muscle spasmis unlearned. Two excellent sources on the web for instructions on howto use dilators are: http://www.med.umich.edu/obgyn/vulva/s&p.htm(you have to scroll down a bit to find the right section), andhttp://www.marriagebuilders.com/graphic/mbi5049a_qa.html (scroll heretoo). Other techniques our members have found helpful includerelaxation exercises, stretches, biofeedback-assisted musclerehabilitation, and focused exercises such as in Pilates. What are dilators and where can I get them? "Dilators," in this context, don't actually dilate, so it'skind of unfortunate terminology. The word refers to any objectsinserted vaginally to slowly condition the vaginal muscles to nottense up during penetration attempts. These can be candles, fingers,tampons, vegetables, dildoes, vibrators, or so-called "medicaldilators." The medical ones aren't significantly different fromdildoes, except that often a prescription is required, they are notavailable in festive colors, and in some cases, your insurance maycover them. Women on our list have tried all of the different kinds listedhere. Depending on your financial situation, whether you are beingtreated by a doctor or self-treating, and your personal preference,any of these may help you. Some women prefer vibrators because theyfind the vibration tends to relax the muscles, while others prefernon-vibrating dilators. Medical dilators are typically provided by physicians ortherapists, and dildoes and vibrators may be purchased at sexshops. Some shops recommended on our list that have online orderingand discreet shipping are www.a-womans-touch.com and www.goodvibes.comas well as many others. More shops are listed in the links section ofour website. Should I use lubricant? If so, what kind? Yes! Especially if you are just practicing with dilators, youmay not be aroused enough to provide adequate lubricant. Manydrugstores carry personal lubricants. The most common ones availableare KY (liquid is more highly recommended than the jelly) andAstroglide (also recommended). Many women prefer lubricants that areavailable at sex shops, for various reasons. Visit any online sexstore and you will see many possibilities to choose from, and oftenthe stores have good descriptions to help you choose. One popularlubricant on our list is called Liquid Silk, and is only availablefrom sex shops. Are there any good resources on the web? In print? Yes. Links that our members have found useful are listed on:http://groups.yahoo.com/group/vaginismus/links/ Also, there are other vaginismus groups that may be ofinterest. One is just for partners of women with vaginismus, and is atgroups.yahoo.com/group/vaginismuspartners Another is for women withvaginismus, their partners, and medical professionals. It is atgroups.yahoo.com/group/1vaginismus We know of a few internet lists about vaginismus which are forspeakers of languages other than English.
Whether your vaginismus is due to emotional issues or not,many develop sexual issues as a result of having vaginismus. For many,support groups such as ours help a lot, and for some, professionaltherapy is useful. One option is to write our list and see if otherwomen in your area have found good therapists who are knowledgeable inthis area. A resource for Americans is the American Association of SexEducators, Counselors, and Therapists, which has a website atwww.aasect.org where you can search for a sex therapist in your area.