Advice for women with vaginismus — Ask Dr Jean

Question

A friend realised she had a problem in her teens when she simply could not insert tampons because of the terrible pain experienced. She had no idea what was wrong with her until she came across an article in a magazine about vaginismus. She finally had a name for her problem.

Most GPs have heard of the condition, but have not been able to give her really helpful advice. A gynaecologist treated her with contempt when approached about her suffering and caused considerable pain during the examination. This put her off seeking further advice for a long time. She has since married an understanding man and had two children, but the problem persists. With an exercise regime she can sometimes feel improvement, but it doesn't last. She is now in her late 30s. Any help would be appreciated.

Answer

Vaginismus is when the pelvic floor muscles are tightened – that is, overactive – so that inserting tampons or having sex with penetration is very painful or impossible. The tightening is involuntary and often women are unaware their pelvic floor muscles are tight and tender.

Women need to have a team of health professionals helping them to overcome the tightening:

• A sympathetic GP
• A pelvic floor physiotherapist to help teach pelvic floor relaxation using trigger point therapy and also vaginal trainers
• A sexual therapist and a psychologist to help your friend to learn to understand why there is an unconscious fear on having penetration.

It may take some time to overcome and treat, so making small advances are very positive in your friend's management.