Endometriosis and Vaginismus
Vaginismus is the involuntary contractions of muscles around the vagina, which happen during the penetration of the penis or any object into the vagina. The symptoms of vaginismus can range from mild to severe. To many who experience vaginismus, it can be very painful. Vaginismus symptoms may not be consistent- the symptoms may present even if the previous penetration was painless. Endometriosis and vaginismus can sometimes be linked.
What causes vaginismus?
It is not clear why vaginismus happens. However, some of the known causes include:
- anxiety, which may or may not be related to the act of intercourse itself
- current or healed vaginal injuries
- prior vaginal medical interventions
- fear of sex due to negative feelings or past trauma
What are the symptoms of vaginismus?
Symptoms of vaginismus include pain or discomfort during vaginal penetration, not being able to have sex, and painful sex (dyspareunia).
Are endometriosis and vaginismus linked?
Physical discomfort and sexual dysfunction are some of the main symptoms of endometriosis. Dyspareunia, vaginismus, chronic pelvic pain, unexplained pain in the vulva (vulvodynia), and lack of vestibular lubrication are some of the sexual dysfunctions happening in women with endometriosis.
Women describe the feeling of vaginismus as burning or throbbing pain. Women may feel these sensations due to physiological disturbances caused by endometriosis.
According to Dr. Seckin, spasms due to vaginismus must be distinguished from pain experienced during intimacy and orgasm.
How can doctors diagnose vaginismus?
Doctors can diagnose vaginismus by ruling out other reasons for vaginal pain and muscle spasms. They usually do this with a pelvic exam often without an internal exam of the vagina. They may also ask you about your medical and sexual history to better understand your situation.
How can vaginismus be managed?
Treatments for vaginismus focus on relaxing the muscles around the vagina and reducing anxiety and fear that can contribute to vaginal spasms. Your doctor may recommend certain treatments such as:
- lidocaine or creams to ease pain
- physical therapy to relax the pelvic floor muscles
- vaginal dilation to stretch the vagina and make penetration easier
- cognitive behavioral therapy to understand reasons for anxiety
- exercises to improve your libido
How can sexual intimacy be enhanced?
Reduced libido due to endometriosis is often the result of a combination of physical pain and anticipated pain. The anticipated pain can further increase vaginismus. If endometriosis is the reason for vaginismus, laparoscopic deep excision surgery is the gold standard for lasting symptom relief.
Techniques such as a sexual position that is comfortable for both partners, spending more time in foreplay, using lubricants to reduce discomfort, and proper communication with your partner go a long way in making sexual intimacy more pleasurable.
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