The last blog entry was a guest post by Angelique Montano-Bresolin, a pelvic health physiotherapist at Proactive Pelvic Health. Angelique described a multi-disciplinary approach to treating vaginismus. Today, I’d like to talk more about the role of sex therapy in treating this painful condition.
As Angelique described, vaginismus refers to the involuntary contraction of vaginal muscles during attempted penetration, such as during intercourse, gynecological exams and sometimes tampon insertion. This muscle contraction results in pain. Women may describe feeling as if their vagina is too small to accommodate their partner. Pelvic floor physiotherapy helps the woman gain the ability to both control and relax the muscles. Yet physiotherapy alone is often not enough to treat vaginisums. This is because vaginismus has an impact on the woman emotionally and psychologically, which can in turn impact her behavior. This is where sex therapy comes in.
When I meet with a woman who is experiencing vaginismus, she often describes multiple emotions around sex. Fear of the pain caused by vaginismus, guilt for not being able to have intercourse with her partner, regret and disappointment over not having the sex life she would like, and sometimes irritation and resentment at her partner for expressing their dissatisfaction with the situation. Sometimes the woman has begun to avoid all forms of sexual contact, and even non-sexual contact for fear that her partner will expect intercourse and she will disappoint him again.
When I meet with her male partner, he may report feeling guilty for still wanting to have sex, or for causing her pain. He may avoid physical contact for fear of rejection, or because he does not want her to think she must have sex with him despite the pain.
As illustrated above, the problem of vaginismus is not merely the pain. It is also the way the pain impacts the behavior of both the woman and her partner. It is not uncommon for couples to report greater irritation and frustration with each other in other areas of their life, as a result of the stress from the impact of vaginismus, leading to an overall decrease in relationship satisfaction.
As a sex therapist, I work with couples that are impacted by vaginismus. I help them learn to support each other in meeting this challenge. We work on any communication problems that may have developed as a result of the vaginismus, and take steps to increase the couple’s feelings of connection and closeness. As sessions progress, couples are able to stop the negative cycle of avoidance of physical or sexual touch, and rediscover pleasure.
Vaginismus is a painful condition, both physically and emotionally. It affects the woman and her partner. Yet it is a highly treatable condition. With a combination of pelvic physiotherapy and sex therapy, women and their partners can bring pleasure and fun back to the bedroom.