One of the main difficulties experienced during sexual intercourse is vaginismus, which contrary to what it may seem, is quite common, but little recognized, vaginismus is a very common sexual dysfunction that can lead to problems in the couple related to loss of self-esteem. , anxiety, communication or frustration on both sides.
About one in three couples have a problem of sexual dysfunction, many women feel uncomfortable or ashamed when talking about problems related to sex, pain and the inability to maintain a penetrating relationship, however, we must try not to underestimate these situations, because a problem that has a solution becomes a physical and psychological nightmare for those who suffer from them.
- Vaginismus is a condition that causes an involuntary contraction of the pelvic wall muscles surrounding the vagina.
- Causing the partial or total closure of the vagina.
- Causing pain and impossibility when attempting penetration.
- The contraction of these muscles can be mild or intense.
- Depending on one or more.
- The other.
- There will be situations of discomfort and even inability to have penetration sex.
It is part of the group of sexual disorders for pain. In the last publication of the DSM-V manual, “Do pain-related disorders (dyspareunia and vaginismus) merge under the name genitourinary-pelvic penetration disorder/pain?(Moyano and Sierra, 2015, p. 277-286).
Despite the new category, it is most common to refer to the problem classically as vaginismus, the diagnosis of the problem is complicated, since it is almost always based on the information of the woman who suffers from it. This is usually complicated due to the above contraction.
Following the most recent studies, we can talk about two types of vaginismus, according to Engman (2007):
On the other hand, it is necessary to distinguish whether it is a primary or secondary vaginismus, the first has to do with psychological or combined factors, secondary vaginismus occurs after an injury after surgery, a fall, thrush or recurrent cystitis.
90% of sexual dysfunction problems have a psychological origin, the main causes identified are past trauma or sexual abuse, mental health factors or poor response for continuous physical pain, despite the rejection that can lead to penetration, this is not related to loss The woman can perfectly feel desire and arousal, and can reach orgasm by stimulating the clitoris.
According to Barlow’s model (1986) – Sexual dysfunction is due to a multidimensional process that combines the interaction between cognitive interference and anxiety (?). So it responds negatively to more or less explicit sexual situations, which in turn leads the attention to focus on irrelevant stimuli or circumstances or negative expectations?As a natural process, will this increase the negative emotional response which, in turn, will strengthen the negative process and thus interfere with the sexual response?(Carrasco, 2001).
According to the DSM-IV, this can be a permanent or acquired problem, i. e. it is possible to be present at the first penetration attempt; If purchased, either from continuous discomfort during penetration or sexual abuse, it can lead to injuries that favor the persistence of dysfunction, so it is always advisable to see your doctor to rule out organic factors, such as atrofic vaginitis or even diabetes (which can cause dryness and irritation), infections or endometriosis.
According to Master and Johnson (1970, 1987), there would be personal and impersonal factors. Staff have to do with information issues, cultural myths, fears, fear of rejection or pain, among others.
Although his studies are almost forty years old, the truth is that problems related to myths and misinformation persist. The generations are different, but what was the misinformation a few years ago that we can now translate more by distorted information (movies, erotic films, etc. ) modes,” social media, etc. ).
“Eroticism is one of the foundations of self-knownness, as indispensable as poetry. ” – Anas Nin-
Impersonal problems have to do with the communication of the couple, roles of power between the two, aggression, loss of physical attraction, mistrust or different attitudes towards sex, this decompensation can lead to problems of dyspareunia (physical pain during sex).
Multidisciplinary strategies are currently recommended. Address the problem from different medical areas. Ideally, you should have a gynecologist, a physical therapist and a psychologist. In all three areas you can work from medical control, muscle work of the area and sexual thoughts, attitudes and skills to improve individually and on the part of the partner.
At the muscle level, physical therapists work with the idea of hormonal changes, muscle fibers, calcium release and inflammatory substances that affect the area, generally using techniques such as sensory discrimination, manual pressure, dilators, pelvic wall formation, postural rehabilitation and work in the abdominal region for long-term recovery and prevention.
The psychological part, which is part of sex therapies, is essential to complete an adequate recovery, remember that 90% of cases have a mental origin, a percentage that increases when we talk about the conditions and circumstances that cause the problem to continue or intensify Treatment will be oriented towards a series of key points in three dimensions: that of thought , that of emotions and driving.
At the thought level, sex-related myths and beliefs, as well as fears and beliefs about sex, are reviewed. Working with obsessions and negative thoughts is necessary to advance, sex and its difficulties are present in daily life and generate associated psychological problems.
Concern for the couple and mistrust are two enemies to fight during therapy, expectations about pain are finally reviewed, and when it comes to emotion, issues related to anxiety, fear and self-esteem are worked on.
“In every erotic encounter there is an invisible and always active character: imagination. ” – Octavian Paz-
Both individually and as a couple live exposure or psychoeducation techniques are used, sometimes women are the first to ignore the anatomy and possibilities of the vagina.
Self-exploration and self-stimulation training is used to improve self-awareness about the body’s own reactions and responses to stimulus (?) And sensory concentration to reduce anxiety in the face of sexual contact, learn to give and receive pleasure and increase communication?(Olivares Crespo and Fernandez? Velasco, 2003, p. 67-99). All combined with techniques such as muscle relaxation (tension?Bloating in sexual interaction).
Whenever there is communication, understanding, patience and love, we can find therapeutic support in the person next to us. Regarding the presence or absence of the partner in therapy, the authors Olivares and Fernandez?Velasco (2003) remind us that:
Hartman and Daly (1983) have shown that couples therapy can improve the effects of sex therapy. In addition, ceceres (1993) stated that the combination of sexual therapy and partner therapy is necessary to solve sexual problems, just as intervention in sexual problems would. Be desirable, although this is not enough to improve the partner (pages. 67-99).
The truth is that solving sexual problems usually greatly improves the relationship, eye, this does not mean that a bad dynamic in a couple with multiple problems is solved by sex, the treatment of such problems has a high probability of success. more shame or fear that prevents many women from ending the taboo of penetration difficulties (whether vaginal medical examination, sex or intimate hygiene).