Vaginismus: A Short Story

Abigail, 20 year old second year student in a West-African University sits in her room.  She hears a knock, peeps through the window only to find her boyfriend, not again she mutters under her breath.\

She has been avoiding her boyfriend since the last time he tried to have sex with her, it was the weirdest moment in her life as she writhed in pain when her boyfriend tried to penetrate her.

Moments later after trying severally her boyfriend got dressed, but before he turned to leave, he looked over her helplessly and said “Abbie, you should get help as soon as possible”.

Arriving the school clinic a few days ago, she walked briskly through the door to the records office to pick up her file and headed straight to the doctor’s waiting room. “Abigail Goda” a nurse called out, she suddenly jerked back up from her state of deep thought.

On entering the doctor’s office she lowered herself to a chair. In a couple of minutes with tear-filled eyes she explained her ordeal, “I fear my boyfriend may break up with me” she concluded

The doctor stood up and patted her by the shoulder, he consoled her by telling her she’s going to be fine that she just has a medical condition known as Vaginismus.

Vaginismus is a medical condition in which there is involuntary narrowing of the pelvic floor muscles. Hence it becomes very painful, difficult, or impossible to have sex, insert tampons, or undergo a vaginal examination.

In simpler terms it appears as if the vagina tightens up when something is about to be inserted into it. This may lead to sudden uncoordinated muscle movements (spasm)  and temporary cessation of breathing.

Types of Vaginismus

1. Primary Vaginismus: This is a lifelong condition in which the pain has always been present, it is often discovered during the first attempt of intercourse.

The male partner gets a “hitting a wall sensation” at the vaginal opening. The attempt to penetrate is accompanied by pain, general spasms and temporal breath cessation but the symptoms stops once the attempt of penetration stops.

2. Secondary Vaginismus: This develops after the woman has already experienced normal sexual function, hence the pain hasn’t always been present. It usually stems from specific events such as an infection, a medical condition, menopause, trauma, surgery, or childbirth.

3. Situational Vaginismus: This occurs only in certain situations. It may not occur during sex, but in other situations such as gynecological examinations or tampon insertion.

Causes of Vaginismus

• Emotional Triggers such as: Fear of pain or pregnancy, anxiety, relationship problems such as having an abusive partner, trauma such as rape.
• Physical Triggers such as: Infections, cancer, menopause, surgery, inadequate foreplay, medication side effects

Diagnosis/Treatment

To diagnose vaginismus the gynecologist would ask a few questions about the patients medical history and do a pelvic examination.

Possible causes are then identified and managed. Possible treatment strategies aim to reduce the tightening and the fear of pain or pain associated.

Treatment Strategies

Educating and counselling about sexual cycle responses and anatomy to help the patient understand the reason for the pain.

Pelvic floor exercises to improve control of the pelvic floor muscles.

Emotional support to help the individual identify and resolve emotional factors that might be involved.

Encouraging the woman to gradually touch the area, slowly going deeper so as to reduce the sensitivity over a period of time.

Use of a physical dilator, gradually increasing the size until a  comfortable build up to attempting sexual intercourse is possible.

In conclusion, this condition can be handled with the help of a specialist and a supportive partner where applicable.

Opi Ibinabo Miracle

Pharmacist-in-training University of Port – Harcourt