Sexual disorder vaginismus: "Most women are completely unexpected"

Pain during sex can have many causes.

Sexual disorder vaginismus: "Most women are completely unexpected"

Pain during sex can have many causes. Many women suffer from vaginismus, a spasm of the pelvic floor muscles. According to psychologist Dr. Hanne Horvath, co-founder of the therapy platform Hellobetter and co-developer of the online therapy program Vaginismus Plus, assumes that the psyche "plays a major role". In the interview, the expert explains about the sexual dysfunction.

What is vaginismus?

dr Hanne Horvath: Vaginismus describes pain, sometimes also the feeling of cramping of the pelvic floor muscles during insertion or attempted insertion into the vagina. For example during sex, when inserting a tampon or similar.

What are the symptoms of vaginismus?

People experience pain during insertion (dyspareunia) or an involuntary spasm of the pelvic floor muscles that surround the vagina. This makes insertion of a penis or a tampon, for example, or a gynecological examination painful or impossible. The pain is described as burning, throbbing, stabbing, or cutting. Vaginismus is therefore often accompanied by fear of vaginal insertion and pain. Not only can this affect sexuality, but gynecological examinations can also become a burden. It is not uncommon for fear to lead to sexual situations being avoided. This can then not only put a strain on your own sexuality, but also on your sex life with your partner.

Are the symptoms mainly physical or psychological?

We can assume that the psyche plays a major role in this. Sexual reactions are not only purely physical, but also psychological processes. Although vaginismus strikes most women completely unexpectedly and it almost seems like a random event. But everything has a cause, even if the person affected is often not immediately aware of it. Often it is a web of different experiences that contribute to the development of vaginismus - not a single event. The most common causes include negative childhood experiences, pressure to perform and excessive expectations, fear of pregnancy and STDs, negative body image and low self-esteem or fear of giving up control, and stress.

Which and how many women often suffer from vaginismus?

According to studies, more than 20 percent of premenopausal women are affected by penetration pain. This corresponds to around four million women in Germany. However, experts assume that the number of unreported cases is high, since those affected are often ashamed to talk about complaints in the genital area. The severity and development of vaginismus can differ from woman to woman. For some women, sexual intercourse has never been possible or only with pain and impairment. For others, the symptoms only developed over time. However, these differences may not affect the course of treatment. The other effects of vaginismus also vary.

How to treat vaginismus?

Targeted relaxation of the pelvic floor muscles, but also general relaxation of the body, can help treat and alleviate vaginismus. Breathing relaxation is an effective way to relax. About five minutes a day are enough for this, in which you make sure that the exhalation is a little longer than the inhalation.

So-called exposure is also a good way to treat vaginismus. Here you expose yourself in very small steps to what causes pain or frightens you. In the case of vaginismus, this involves vaginal training with so-called dilators, which are penis-shaped objects of different sizes. For use, consultation should be held with the gynecologist. Generally, the smallest dilator is inserted first and gradually increased in size. It is also about the muscles learning not to cramp. Through the experience of careful insertion, the body "learns" and those affected reduce fears.

How should your partner deal with it?

Vaginismus often leads to fear and avoidance of sexual situations. This can then not only put a strain on your own sexuality, but also on your sex life with your partner. It is important to talk about it, to address the fears and to find out what both can do to take away the fear. Of course, the partner should not exert any pressure, but try to show understanding for the fears. Dealing with the symptoms together and researching ways to alleviate them can be very helpful.

Do you think the disease is currently sufficiently discussed?

I think that a lot of educational work still has to be done here and, above all, can be done. According to studies, more than every fifth woman is affected - many of them probably without even knowing it. If we talk openly about vaginismus, we may also reach people who have problems during sex or, for example, when inserting a tampon, but have no idea that they can do anything about it! Research into effective therapeutic measures to deal with sexual difficulties in women is still a marginal area that is not given sufficient attention worldwide. But I think we're on the right track.

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