The Internal Alarm
Vaginismus may result from a combination of physical or non-physical causes, or seem to have none at all.
For many women, vaginismus comes as a surprise; unexplained tightness, discomfort, pain, and entry problems are unexpectedly experienced during intercourse attempts. The pain results from the tightening of the muscles around the vagina. Since this occurs without the conscious intent or control of the woman, it can be very perplexing.
Usually at the root of vaginismus is a combination of physical or non-physical triggers that alert the body to brace and protect.
Additional sexual attempts that result in discomfort further reinforces the reflex response. When the body experiences increased pain, it reacts by bracing more on an ongoing basis, further entrenching this response and creating a vaginismus cycle of pain.
Since vaginismus causes can be triggered by physical events as simple as having inadequate foreplay or lubrication, or non-physical emotions as simple as general anxiety, it is important that it be understood that vaginismus is not the woman’s fault. Once triggered, the involuntary muscle tightness occurs without conscious direction; the woman has not intentionally “caused” or directed her body to tighten and cannot simply make it stop.
Women with vaginismus may initially be sexually responsive and deeply desire to make love but over time this desire may diminish due to pain and feelings of failure and discouragement. It is extremely frustrating to be unable to physically engage in pleasurable sexual intercourse.
The anticipation of pain, emotional anxieties, or unhealthy sexual messages can contribute to and reinforce the symptoms of vaginismus. Frequently, but not always, there are deep-seated underlying negative feelings of anxiety associated with vaginal penetration.
Emotional triggers that result in vaginismus symptoms are not always readily apparent and require some exploration.
It is important that effective treatment processes include addressing any emotional triggers so a full pain-free and pleasurable sexual relationship can be enjoyed upon resolution.
Examples of Physical Causes
Temporary pain or discomfort resulting from insufficient foreplay, inadequate vaginal lubrication, etc.
Any type of pelvic surgery, difficult pelvic examinations, or other pelvic trauma
Physical attack, rape, sexual/physical abuse or assault
Side-effects may cause
Pain from normal or difficult vaginal deliveries and complications, C-sections, miscarriages, etc.
Menopause and hormonal changes, vaginal dryness / inadequate lubrication, vaginal atrophy
Examples of Non-Physical Causes
Fear or anticipation of intercourse pain, fear of not being completely physically healed following pelvic trauma, fear of tissue damage (i.e. "being torn"), fear of pregnancy, a concern that a pelvic medical problem may reoccur, etc.
Past emotional/sexual abuse, witness of violence or abuse, repressed memories
Overly rigid parenting, unbalanced religious teaching (i.e. "Sex is BAD"), exposure to shocking sexual imagery, inadequate sex education
Sometimes there is no identifiable cause (physical or non-physical)
Anxiety or Stress
General anxiety, performance pressures, previous unpleasant sexual experiences, negativity toward sex, guilt, emotional traumas, or other unhealthy sexual emotions
Abuse, emotional detachment, fear of commitment, distrust, anxiety about being vulnerable, losing control, etc.
Retraining the vaginal muscles to respond differently to the anticipation of intercourse is key to the successful training of vaginismus. The process of learning muscle control, combined with a series of limbic reduction exercises, changes the conditioned response so the mind and body no longer overreact to penetration. Practical program steps will comprehensively address both body and mind components to resolve all triggers so that when intercourse is attempted involuntary spasms no longer occur and pain is eliminated.