| Brett Farrow
Vaginismus is generally summarized as the persistent or recurring difficulty a women experiences in allowing penetration of any kind, whether that is a finger, penis, tampon or gynecological examination tool. This difficulty occurs regardless of a woman’s desire to allow penetration, which may seem totally out of sync with her ability to do so. On paper, it may not sound too difficult to diagnose vaginismus, but it actually can be. It is still necessary to look into the issue in detail in case there are underlying or concurrent conditions that may also need to be overcome.
Women with vaginismus are often immersed in a cycle of fear and avoidance around penetration, since their resistance to penetration usually leads to some degree of physical pain. The pain occurs because of involuntary contractions of the vaginal muscles, which vaginismus sufferers will have little to no control over. At best, they will experience fear and resistance, and at worst, pain too.
Why is it hard to diagnose vaginismus?
The reason it is sometimes difficult to diagnose vaginismus is that some have what is called partial vaginismus. Total vaginismus is more obvious because women with this can’t tolerate any kind of penetration, at any time. With partial vaginismus, the fear and involuntary muscle spasms can be related to specific situations, people, or other variants, and these variants can be changeable. Women with partial vaginismus can sometimes tolerate penetration to some extent, albeit with difficulty.
For some women the condition is lifelong (known as primary), and for others it can happen later in life (known as secondary). There may also be other elements involved, such as a hypertonic pelvic floor. Likewise, other conditions may overlap; for example, vestibulodynia or dyspareunia. For all of these reasons vaginismus is considered to be a clinical syndrome rather than a definitive diagnosis.
How will your practitioner diagnose vaginismus?
To diagnose vaginismus, your healthcare practitioner is likely to go over your entire psychosexual history. Your practitioner is also likely to ask personal questions about your medical history, your symptoms, your typical reactions to penetration, your anxiety levels and fears, and your current sexual relationship/partnership.
It is likely that you will need a physical examination to properly diagnose vaginismus. Your practitioner will assess your levels of distress, anxiety, and mental or emotional resistance to penetration, which is actually considered to be more important in the diagnosis than physical spasms, muscle tone or the presence of pain.
The physical examination of your genitals and pelvic area is necessary also for exclusion of other issues, dysfunctions, injuries or infections that could be presenting similar symptoms to vaginismus - or actually causing it.
What to do when you have a vaginismus diagnosis
Your practitioner will determine whether the cause is psychological, in which case you may be referred for psychological treatment for vaginismus. If the cause is determined to be physical, you may be referred to a pelvic floor physical therapist, a sex therapist or a gynecologist. It could be that the cause is multifaceted, so you may need to see more than one type of specialist.
Finally, vaginal dilators are one of the most common methods of treating vaginismus, whether inside the treatment room or at home in your own time. We have heard more success stories with dilators than we could possibly recount, but we highly recommend them as a treatment if your Doctor does diagnose vaginismus. We hope you found this article informative, and don’t forget to check out our blog for more vaginismus articles.