Primary Versus Secondary Vaginismus

Primary Versus Secondary Vaginismus

Pain with sex is never acceptable, and unfortunately, far too many women just “grin and bear it” unnecessarily. The problem with this is that a vicious cycle is created – the more painful sex you have, the more anxiety and fear is created about having sex. Anxiety and fear then lead to anticipatory spasms of the pelvic muscles, creating even more pain. Can you see why this is a problem?

If you are someone is having pain with sex, the first thing your provider should help you to figure out is where the pain is coming from, and why. Vaginismus is defined as the involuntary spasm or contraction of the muscles that surround the vagina. For women with this chronic condition, any kind of vaginal penetration can be painful – especially intercourse. However, there are several subtypes of vaginismus and it’s important to know the difference.

Primary vaginismus often happens to younger women and is typically accompanied by fear and anxiety of the penetration itself. In many cases, young girls first try to insert a tampon and are unsuccessful due to tight muscles or obstruction from a thick or high hymen. After several attempts, the pain intensifies, and they become avoidant of penetration. Often these women are unable to have a speculum exam at the GYN, and of course, intercourse seems impossible. No one knows what causes primary vaginismus, but it is not an uncommon medical condition and the earlier it is identified, the easier it is to treat!

Secondary vaginismus is a bit different. This condition is seen in women who have previously had successful, pain-free penetration in the past. Then due to some other etiology (chronic vaginal infection, menopause, vulvodynia), the pelvic floor begins to tighten and can go into spasm in response to repeated attempts at painful sex. Anxiety and fear tend to play less of a role here, as these women typically did not have issues in the past and are left wondering why suddenly, sex hurts. Secondary vaginismus is also easily reversed by identifying the root cause of the pain and addressing that first.

Fortunately, there is treatment available for all types of vaginismus. Vaginal dilation, topical medications, anxiety management and lots of lubrication can be a huge help. We specialize in treating vaginismus here at Maze women’s sexual health. If you experience vaginal pain during sex of any kind, contact us for a free phone consultation. We are here to help!

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