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. These 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 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, making entry 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 usually refers to the experience of developing vaginismus a little later in life, after a period of pain-free intercourse. Medical conditions such as yeast infections, cancer, or thinning of the vaginal walls due to menopause (see Causes for many more examples) can trigger the vaginismus condition. Vaginismus should be considered when a woman continues to experience ongoing sexual pain after her medical problem has been treated and healed. A woman’s ability to experience orgasms can also be affected as a sudden pain spasm may abruptly terminate the arousal buildup toward orgasm. Some women with secondary vaginismus may 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 but bearable intercourse with gradually increasing pain and discomfort that eventually becomes so pronounced that sex is no longer possible. 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).
Beyond the above basic classifications, physicians and specialists may use other medical terms referring to vaginismus such as:
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 is a general term that refers to a condition where there is pain during sexual intercourse. Vaginismus has been considered to be one type of dyspareunia, but is closely associated with all types of sexual pain. As of 2013, genito-pelvic pain/penetration disorder replaces vaginismus and dyspareunia in the DSM 5.