What is the difference between primary vaginismus and secondary vaginismus?

Vaginismus has two major classifications.

Vaginismus can be experienced by women at any age or time in life. It has two major classifications; primary vaginismus and secondary vaginismus. The medical community typically uses these terms to indicate the time of onset. The labels assist the medical community and researchers in diagnosis and classification. For the individual woman, the distinction between the two types tends to be of less importance. Whether primary or secondary, both are highly treatable.

Primary Vaginismus

Primary vaginismus usually refers to the experience of vaginismus with ‘first-time’ intercourse attempts. Typically, primary vaginismus will be discovered when a woman attempts to have sex for the very first time. The spouse/partner is unable to achieve penetration and it is like he ‘bumps into a wall’ where there should be the opening to the vagina and entry is impossible or extremely difficult. Primary vaginismus is the common cause of sexless, unconsummated marriages. Some women with primary vaginismus will also experience problems with tampon insertion or gynecological exams.

Secondary Vaginismus

Secondary vaginismus usually refers to the experience of vaginismus a little later in life, after a period of pain-free intercourse, and typically following temporary pelvic problems. A woman may have had a number of years of being able to have normal, pain-free intercourse and then experience a temporary pain-causing problem such as a yeast infection (or any of a wide range of physical problems – see Causes for more examples). The initial pain problem may have been addressed medically, healed, or been managed, and yet the woman continues to experience ongoing troubles with sexual pain. In some cases, the severity of secondary vaginismus could escalate to the level that penetration becomes difficult, painful, or impossible. It can also impede a woman’s ability to experience orgasms, as a sudden pain spasm may abruptly terminate the arousal buildup toward orgasm. Some women with secondary vaginismus will also experience difficulty with gynecological exams or tampon insertion due to involuntary tightness.

Variations in the classifications

Note that these definitions can be a bit restrictive in some cases. For example, some women are able to tolerate years of uncomfortable intercourse with gradually increasing pain and discomfort that eventually interrupts sex. Women may also experience years of intermittent difficulty with entry or movement and have to constantly be on their guard to try to control and relax their pelvic area when it suddenly ‘acts up’. Vaginismus has a wide range of manifestations, from impossible penetration, to intercourse with discomfort, pain or burning, all resulting from involuntary pelvic tightness (see Symptoms). Depending upon the classification, there may also be some minor differences in the way in which vaginismus is treated.

Other Classifications

Beyond the above basic classifications, physicians and specialists may use other medical terms referring to vaginismus such as:

Apareunia

Apareunia is a general term that refers to a condition where one is unable to have sexual intercourse. Vaginismus is one type of apareunia (if it is completely preventing penetrative intercourse).

Dyspareunia

Dyspareunia is a general term that refers to a condition where there is pain during sexual intercourse. Vaginismus is considered to be one type of dyspareunia, but is closely associated with all types of sexual pain.

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"I can recommend use of this resource by all patients with vaginismus" - APTA Journal of Women's Health Physical Therapy
- Beth Shelly, PT, BCIA-PMDB

 

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