Sexual Healing: Do I have Vaginismus?

[Heather34]

Hi all. I came across a great article from Dr. Laura and Jennifer Berman. In it, a young woman describes the symptoms of vaginismus and a dismissive experience with her gynecologist.

The doctors replied:

“Don’t believe it is all in your head. You are not alone because there are many women who suffer from vaginismus as well as pain related to it. There are many psychological components to vaginismus — fear, anxiety, lack of trust, feelings of vulnerability, past history of trauma or abuse — all which must be dealt with in therapy. However, vaginismus is sort of like a panic attack.

Often people who suffer from panic attacks first have one randomly. Then after that every time they have an attack its because they are panicking about having a panic attack! The same is true in this situation. The spasms become a knee jerk reaction that you can’t control even if you want to.

We recommend a gynecological physical therapist or someone who can work with you with biofeedback and dilation of the vagina in a safe and supportive setting. It is a real physical problem that deserves real physical attention in addition to psychological support.”

I love that they recognize that vaginismus has a real physical aspect to it that needs to be addressed and I also loved the comparison to a panic attack. For partners or others who may not understand vaginismus, sharing this article might help them to understand it more.

http://abcnews.go.com/GMA/story?id=127063&page=1

[Aimee Goldman, RWHNP]

Great article Heather. I too like the comparison of vaginismus to that of a panic attack. In vaginismus muscles which are involuntarily tight become even more so when intercourse is attempted. The mind is anticipating pain, so when intercourse is attempted this anticipation plus the involuntary muscle tightness makes intercourse quite difficult.
Like panic attacks, there is usually some degree of underlying anxiety , fear, mistrust or depression associated with vaginismus.
Here at Maze we do not just treat the physical component of vaginismus. Every patient seen here gets a very thorough psychological evaluation prior to meeting with the medical staff. We find this approach to be very helpful in helping patients overcome vaginismus.

[Aimee Goldman, RWHNP]

Great article Heather. I too like the comparison of vaginismus to that of a panic attack. In vaginismus muscles which are involuntarily tight become even more so when intercourse is attempted. The mind is anticipating pain, so when intercourse is attempted this anticipation plus the involuntary muscle tightness makes intercourse quite difficult.
Like panic attacks, there is usually some degree of underlying anxiety , fear, mistrust or depression associated with vaginismus.
Here at Maze we do not just treat the physical component of vaginismus. Every patient seen here gets a very thorough psychological evaluation prior to meeting with the medical staff. We find this approach to be very helpful in helping patients overcome vaginismus.

[Heather34]

This is so great Aimee and receiving the emotional support both pre and post-procedure is such an important element of the treatment and what makes the entire program work so well at Maze. There are so many stories and posts from patients who received Botox in other countries, etc. but received zero support. In Julisa’s story, she had 2 courses of Botox in her home country and both failed. No post-procedure support was given. She had the Botox treatment program with Dr. P and received the emotional support as well as the help with dilation and keeping dilation logs/tracking progress and she achieved pain-free intercourse just 7 weeks after treatment after struggling with vaginismus for 7 years. She has written “I’m having intercourse 3 times a week and it does not hurt at all. Im just a little tense in my legs but thats nothing. I’m glad it doesn’t hurt at all. And tell you the truth, I enjoyed it the last time we did it. It was different then the other times.” Similarly, a second testimonial from a woman who received the Botox treatment at Maze also reflects the importance of receiving the support you describe. The patient writes “The support and aftercare I received from the center was very beneficial, and although being diagnosed with vaginismus was a challenging experience for me, overcoming it has really helped me gain even more confidence”.

[IDontKnowWhatImDoing]

I’m not sure what to think.
I can insert tampons (its a struggle but it works), fingers when I am warmed up, and my boyfriend after a about a half hour of slow insertion and pausing. My problem is the pain. It hurts to be touched down there at all. Its this explosive burning sensation that I can feel in the nerves of my pelvis all the way down my legs. I can bear it for a time but I have to push my boyfriend away frequently and take breaks before wanting to try again. If I can’t get him inside of me, I get so frustrated, sometimes I push myself past pain points to make it work but then the pain takes over and I have to stop. I’ve been reduced to tears in front of him and I hate it because I know it kills him to hurt me. But days after I feel my stomach cramp, I feel incredibly sore, and it hurts to stand up straight, I just curl into a ball afterwards.
I can’t get this off my mind. I know this is affecting my relationships. I don’t want to be scared of this anymore and I want to understand what pain-free sex is.
I also don’t know what I’m expecting from this blog. It’s cool to see I’m not alone but I’m not sure what to do.

[Aimee Goldman, RWHNP]

It sounds to me that you may be experiencing Vulvodynia or Vulvar Vestibulitis. This condition is diagnosed by physical exam using a q tip and by your history. There is a lot of different theories about the exact etiology of this condition.
When we diagnose Vulvodynia we use a variety of different topical medications along with some oral medications which we find to be somewhat helpful.
At Maze, we now have a low level laser that we use in patients with Primary Neuroproliferative Vulvodynia. The laser is virtually pain free and requires a minimum of biweekly visits for 6 weeks. We have found that the laser has been very beneficial to patients who are suffering from this condition.
So, the first step would be to get a diagnosis. If we feel that you are a candidate for the laser we would offer it to you.

I also recommend the following support groups
Vulvodynia.com
Vulvodynia-support.com
Vulvodyniasupport.com

I am certain we can help you!!

[IDontKnowWhatImDoing]

I’m not sure… It’s not the opening skin that’s the problem so much as penetration. It is okay to be touched everywhere (except directly on my clitoris–in that sense i can see vulvodynia…if it can be this specific then I agree with your suggestion, but then, what of the rest?). The first time I tried to have sex, my boyfriend couldn’t enter me. It was as if there was not a hole anymore. It was a slow build up to penetration and sometimes I am just too tense to fit him. I know the muscles can contract pretty hard on his finger when we are warming up.
Yesterday we had tried again and were successful in penetration, but the burning happened deeper inside me. When we finished, I felt so sick to my stomach I couldn’t eat. Now, nearly 24 hours later I feel soreness all over the canal, worsening at the deeper end, rather than the opening. Usually it feels like I had pulled a muscle or intense period cramps. The burning, although there, is not usually as prevalent as the pain of him entering.

[recessivegenequeen]

Hi IDontKnowWhatImDoing! I’m not a medical expert so I won’t pretend I know how to diagnose your symptoms, but it’s super clear to me that your sexual life causes you anxiety, discomfort, and pain, and that it’s not the way sex is supposed to feel. For those reasons alone it’s worth seeing a doctor for, most of all because it can give you the peace of mind of knowing what’s happening with your body. A hugely pivotal moment of my sexual life was discovering through online research that my problem had a name and a treatment, and another big moment was later on when I went to the Maze clinic and had a doctor confirm what I had long known: that I had vaginismus. Knowing what you’re dealing with is a huge step toward solving it.

If you live anywhere near New York City, the Maze clinic is an incredible place because you are amongst people who believe and understand you, but if not, I would recommend trying to find a women-friendly doctor or gynecologist in your town to speak to about your issues. If possible, call them ahead of time and see if they’ve treated patients with vaginismus (or for that matter even heard of it) so that you can discern if they’ll be understanding. This is not something you should have to live with – there are incredible treatments out there and wonderful people who can help you!

[Aimee Goldman, RWHNP]

Often times Vaginismus and Vulvodynia go hand in hand. Many women who we treat at Maze do in fact have both conditions.
Sometimes the muscles in the vagina are so tight that the pain is experienced in the vestibule and during intercourse or when attempting to insert a tampon.
Think it is best for you to get a proper diagnosis so that you can begin treatment. Sex should not be painful and anxiety producing.

[Rachel Hercman, LCSW]

“It is a real physical problem that deserves real physical attention in addition to psychological support.”

So important. I wish all medical providers knew this!

[Heather34]

Hi IDontKnowWhatImDoing! I’m so, so sorry for what you have experienced with the pain. I had pain with any attempts at insertion and visited a gynecologist who was dismissive when I brought up vaginismus; automatically diagnosed me with vulvodynia; and said I had to see a sex therapist before she would try to examine me again. I left in tears. What I find so awesome about the Maze team is they treat not only vaginismus but so many other pain disorders (i.e. vulvodynia, vulvar vestibulitis) and they can treat them in combination. It’s also so seriously nice that they understand the conditions and you will never be made to feel like “it’s all in your head” like so many other doctors treat the conditions like. Regardless of the term for what you are experiencing, I am so sorry that you have this pain. If you can work with Maze in any way, please do. If not, maybe they can direct you to a gynecologist in your area who is sensitive to vaginismus, vulvodynia, vulvar vestibulitis, etc. Sending you my total support today.