Patient's question:
How to handle vaginismus?Doctor's answer:
Most cases of sexual intercourse vaginismus occur in newly married women, sometimes also in women who have been married for many years. The factors that cause sexual intercourse vaginismus can generally be categorized into the following types:(1) Psychological factors, which are the most common.
① Some women lack a correct understanding of sexual life, become overly tense, or have intense fears of tearing the hymen, of sexual intercourse, of external objects impacting the vagina, or of pregnancy.
② Long-term marital discord, where the wife has a strong aversion to sexual life.
③ The patient views sexual intercourse as a dirty, sinful, or shameful act, or has a history of severe traumatic sexual experiences in childhood.
④ Past severe psychological trauma due to forced or violent rape makes it easier for vaginismus to occur during sexual activity.
(2) Improper positions or methods. For example, if the position is incorrect, excessive pressure on the anterior wall of the vagina, especially the urethra, can cause pain, leading to vaginismus. If such situations occur repeatedly, it may cause abnormal psychological development in women, resulting in vaginal muscle spasms during intercourse.
(3) Lack of preparation before sexual activity. If the female's vaginal opening is dry, and the male's actions are impatient or rough, it can cause pain. If the male does not sufficiently stimulate the female's erogenous zones before intercourse, or if intercourse is forced without the female's consent, overly rough or violent actions during intercourse can lead to vaginismus due to aversion or fear.
(4) Organic lesions of the vagina. Infections of the reproductive organs, such as cervicitis, vaginitis, local inflammation, deformities, or tumors, may sometimes trigger vaginismus, though this is relatively rare.
(5) Other factors.
① Abnormal hymen: such as a tight hymen with insufficient tension, or a very small opening.
② Trauma, infection, or tears in the hymen.
③ A relatively tough hymen, where the tearing during first-time intercourse is excessively painful, leading to reflexive or defensive vaginal spasms.
④ Prior vaginal stenosis or surgical scars. After perineal reconstruction or episiotomy, scars may remain, causing the vaginal opening to become tight and smaller.
Women with vaginismus should receive timely symptomatic treatment, as otherwise, it may affect marital life.