Understanding vaginismus to overcome it

Vaginismus is an involuntary contraction of the muscles of the perineum which makes penetration impossible. This disorder affects approximately 1 to 3% of women. Marion Pollono, physiotherapist specializing in the perineum and sexologist, tells us more.

Vaginismus is a common disorder and yet sometimes still unknown. Solutions exist but you still have to dare to talk about it, be directed towards the right professionals and understand what is happening in your body.

Vaginismus should be dissociated from dyspareunia , which is pain linked to penetration.

Vaginismus: what is it?

“ We speak of vaginismus when there is an impossibility of penetration linked to perineal hypercontraction ,” begins Marion Pollono. The perineal physiotherapist specifies that it is necessary to distinguish between primary and secondary vaginismus. In the first case, there was never any penetration.

In the case of secondary vaginismus, penetration was possible in the past but is no longer possible.

Vaginismus can only concern the sexual act (it is then situational) or more broadly, the introduction of a tampon or a finger is also impossible, as is a gynecological examination (we then speak of global vaginismus).

The causes of vaginismus

The causes of vaginismus can be multiple and vary depending on the type of vaginismus.

“ In primary “phobic” vaginismus, the fear of pain is at the forefront among these women who very often suffer from a lack of information about their own sex and its representation, the idea of ​​a vagina that is far too small to accommodate the man's penis is almost constant ,” explains the National College of French Gynecologists and Obstetricians (CNGOF).

“ These are rather young women, in the discovery of sexuality, who have never had penetration, very often the cause is psychological, there are several avenues:

• a mother-daughter fusion, which prevents the woman from identifying as a sexual woman;
• conflicts of loyalty, the partner does not correspond to the criteria of the family, to the education received (religious difference for example)
• Fear of the masculine, of penetration, of illness, of pregnancy…

This leads to non-identification in the body diagram of the vaginal cavity. The woman is not aware that she can be penetrated. It's as if someone asked her to put a pen in her ear, she gets the idea that it's closed, too small. And she has even less idea of ​​making this vaginal hollow something linked to sex and pleasure. It’s not integrated into the sexual pattern,” explains Marion Pollono.

As for secondary vaginismus, it is “ often linked to pain or psychological trauma , or even problems with the partner, etc. », specifies the physiotherapist and sexologist. To talk about vaginismus, however, the problem must have been present for a while; a temporary impossibility of penetration over a short period of time will not be considered as such (but that does not prevent you from speaking to a professional about it. health to understand).

The impact of vaginismus on a woman's love life

Each woman who suffers from vaginismus will not have the same love life and therefore the repercussions, particularly psychological, will not be the same. “ Among vaginal women there can be different typologies: some remain single because of this symptom because they are apprehensive, other women are in a relationship with their partner and have an adapted sexuality outside of penetration which goes very well. These couples consult when they have a child plan. Last case, there are couples without sexuality or with marital conflict and there may be partners who ask questions, or have symptoms mirroring this disorder: erectile dysfunction, premature ejaculation, etc., ” describes Marion Pollono. Before reassuring: “ many men are caring, listen and adapt. I see them every day! »

What are the treatments ?

Vaginismus is not inevitable. If you think you might be affected, start talking to your gynecologist or midwife. Your doctor can then direct you to the appropriate professionals. This may involve therapy to explore events that could explain this disorder. Consulting a sexologist can also be useful, whether alone or in pairs.

“ This psychological approach is interesting and can sometimes be sufficient but in the majority this will not be the case, there is a problem in identifying the body diagram, it is necessary to identify the symptom, explain the anatomy well, and carry out therapeutic education on anatomical boards ,” explains Marion Pollono, who advises the patient to work with a specialized physiotherapist or midwife, using different exercises. “ We can use a probe or manual work to relax the perineum , there are different techniques. Working with dilators is particularly interesting, it will help to gradually stretch and soften the area. And we will automate the release gesture before penetration, while often the area is completely locked. They will become aware of the possibility of penetration of the vaginal cavity. To do this, they must introduce the dilator themselves. This will help to overcome their fear, gain self-confidence, and be reassured ,” continues the specialist.

We published an intimate testimony from one of our subscribers who told us (not without humor) how she managed to overcome her vaginismus in several stages. Not to be missed, under any circumstances!

How to re-tame your sexuality?

Once is not customary, communication is the key to taming your sexuality again. Opening a dialogue with your partner is essential. Informing yourself as a couple about what vaginismus is will allow everyone to understand that it is not a challenge for the couple and that it is possible to overcome this problem together. “ This requires communicating with your partner, being able to surround penetration with a sexual context, which is never the case in the office. This makes it possible to reintegrate three essential elements: excitation, lubrication and vascularization into the process . Then, it will be a matter of gradually introducing penetration, the partner has a role to play, he can start by introducing a finger, surround this gesture with excitement, give caresses outside of penetration... Hypnosis or sophrology can be interesting to surround this moment with positive thoughts. » All this is always done with the consent of both, of course and if you feel that it is too much, physically or emotionally, you stop everything! Just because you don't succeed the first time doesn't mean you should lose hope. Take the time you need, take care of yourself.

Nina Ristori

Sources:

• Interview with Marion Pollono, physiotherapist specializing in the perineum and sexologist
• “ What is vaginismus? », National College of French Gynecologists and Obstetricians (CNGOF)