Vaginismus is the inability of a woman to maintain penetrative intercourse, and affects 8% of women. Vaginismus may be preceded by dyspareunia, which is discomfort or pain that makes sexual intercourse difficult or even impossible. Sometimes it also makes medical exploration via the vagina impossible.
Causes of vaginismus
According to specialists in Aesthetic Medicine, we differentiate three types of vaginismus. When it is caused by a disease or underlying organic cause, we speak of organic vaginismus; when vaginismus is caused by a vaginal muscular contraction, we speak of functional vaginismus; when it is caused by a sum of organic and functional causes, it is known as mixed vaginismus.
Organic Vaginismus
There are different causes that provoke organic vaginismus, but the most frequent are:
- Decreased vaginal discharge, especially in the vulvar region. We differentiate between primary dyspareunia, when it occurs early, and secondary dyspareunia, when it occurs late. Furthermore, it can be external, in the vestibule, or internal, in the deep portion of the vagina or inside the pelvis. In some cases the discomfort may be in both areas.
- Occlusive or rigid hymen.
- Vaginal contracture, septate vagina, severe cervicitis, retro position of the uterus, prolapsed uterus, neoplastic disease of the uterus, tubal and ovarian infection or pelvic endometriosis.
- Abnormalities of the vulva, vagina, urethra or anus, caused by trauma or regional inflammatory processes.
Depending on the intensity, three types of vaginismus are distinguished; grade I, in which the vagina can be explored gynecologically, grade II, in which the vagina cannot be explored but can be penetrated by dilators or other objects such as tampons, and grade III, which cannot be explored or penetrated.
Functional vaginismus
The main factors that cause functional vaginismus are fear or anticipation of painful intercourse, fear of tearing, fear of pregnancy, or fear of relapsing into a pelvic problem; anxiety or stress prior to intercourse; partner problems, such as abuse or mistrust; traumatic experiences, such as violence or sexual abuse; and childhood experience, with rigid parenting or inadequate sex education.
Sometimes, however, there is no identifiable physical or nonphysical cause.