What Is Vaginismus?
Vaginismus can be defined as involuntary vaginal muscle spasm causing vaginal discomfort, burning and pain. This can cause persistent or recurrent difficulties for a female to have sexual intercourse, pelvic exams (i.e. Pap tests), or to even insert a tampon. There is often avoidance and anticipation or fear of pain, linking the manifestation of physical symptoms with influencing psychosocial factors. Not only can physical conditions (such as muscle tension) contribute to pain, but situations such as past sexual abuse/trauma, fear of painful intercourse and negative emotions towards sex can widely contribute to vaginal pain.
How can vaginismus affect birth?
Some studies suggest pregnant women with vaginismus have higher rates of caesarean section due to request by the birthing parent. In addition, higher rates of birth complications can be attributed to the psychological trauma and fears of vaginal pain associated with the condition. That being said, some women develop vaginismus after giving birth due to physical or psychological trauma experienced during delivery.
While there is no rush for women post birth to resume regular intercourse, it is important to remember that experiencing pain, burning, or intense vaginal tightness with intercourse is quite common, but not normal, after birth. If you are experiencing these symptoms, you should consult your healthcare provider as well as a pelvic health physiotherapist.
The good news:
Vaginismus is very treatable at any stage of your reproductive life, and there are many skilled health care practitioners who specialize in treating sexual dysfunction with good success. Vaginismus can be treated with a combination of psychiatric counselling to address any psychosocial factors, and pelvic floor physiotherapy which focuses on the mental and physical release of the pelvic floor tissues through a variety of treatment techniques. Physicians may be involved in rarer cases where medications are required in the treatment plan.
Exercises
Pelvic floor relaxation in low supported squat
- Stack 1-3 yoga blocks or use a small stool
- Slowly lower down onto the blocks (lead with tailbone)
- Feet should be wider than shoulder width, and make sure upper back is upright (vs slouched over)
- Focus on bringing your breath in through your nose (imagine filling a balloon full of air in your pelvis) and exhaling through pursed lips
- Repeat for 3-5 mins
Perineal release
- Place a ball (tune-up or tennis) on your perineum (area between your vagina and anus)
- Sit on a firm surface (padded chair works best)
- Ensure ball is between sitting bones (too far forward will create vaginal pressure, and too far back will create rectal pressure)
- Allow your body to relax over ball (if too much pain, add a pillow/towel/blanket on top of chair)
- 1 minute working up to 5 minutes
Vaginal Dilators
- Dilators are a useful tool that can be used at home in order to help gently stretch and release tissues of the pelvic floor.
- They can be used outside of the vulva at the beginning so the body can adjust, and then internally to help release tension.
- There are different types of dilator sets to choose from as there are a variety of sizes and material (silicone, plastic, glass).
- Talk to your healthcare provider about the best set for you, and to learn how to use the dilators!
Sets of dilators available from:
Resources:
Written by Sarah Trottier, Physiotherapist.
Sarah has a clinical focus in Women’s & Pelvic Health, as well as Orthopaedics. She currently lives and works in Ottawa, Ontario, Canada.
Disclaimer – Everything shared is for informative purposes only. It is not intended for assessment, diagnosis or treatment purposes. If you feel there needs to be further investigation, please seek out a qualified health care professional for a proper assessment.