Vaginismus, Is It Defined By Fear?

The internet definitions of vaginismus I don't like.

In this case multiple definitions I read define vaginismus as "involuntary and persistent contraction of the pelvic floor muscles that may prevent vaginal penetration." That part I agree with.

The second part of the definition is the part I have a problem with. Many medical websites also have as part of their definition that it is caused by fear. Is fear causing the tight muscles or are the tight muscles and pain causing fear? I would like to think fear is secondary to the pain the person has experienced.

Fear can cause tightening of the muscles which can cause pain which can cause fear and more tightening of the muscles and the cycle continues. Until we break the cycle. And that is what we are trying to do in physical therapy. Break the pain cycle which can decrease the fear cycle to allow for vaginal penetration.

Vaginal penetration doesn't only mean penis in vagina. It can mean wearing a tampon or menstrual cup. Penetration can be with a toy or finger. A finger can be one's own or a partner's. Don't think vaginismus can only happen to sexually active heterosexual people. It can happen in anyone with a vagina.

This diagnosis can take time to break the cycle and heal. There is also often a lot of shame and guilt, especially if one is in a relationship and sexual activity is limited due to pain. I highly recommend that my clients receive mental health therapy along with physical therapy for vaginismus. Sometimes a sexual educator or couples counselor is necessary, but not always. If the client is in a relationship it is important that the partner is involved on some level, at least in knowing the disease is real and physical.

Also, trauma is often involved in this person's past. This may mean sexual trauma. It could be medical trauma. It often involved non-consensual touching of the vagina at some point in my client's past. This is not ok and never the fault of the client, which is why mental health therapy is so important to accompany physical therapy whenever trauma is involved.

So maybe fear is a cause of vaginsimus, but fear due to trauma, not just fear without a cause.

If you identify with these, please first seek mental health therapy. It is so important. When you are ready, reach out and I would love to help with the physical aspect of vaginismus. If you need recommendations for trauma therapists I know plenty in the area and would be happy to give you the names of people who can help you.

My deepest desire is that Recharge Therapy would be a safe space and a place of healing for vaginismus or any other condition. Nothing is done without full consent. Clients may come in for vaginismus treatment but don't feel comfortable getting a pelvic floor exam, that is ok. We work together throughout the entire process, both the client and the physical therapist. There is no pressure to have any body part examined at anytime until the client feels ready. There is plenty we can do during a physical therapy session that doesn't involve pelvic floor examinations.

If you need help with vaginismus or any other condition please start by emailing or scheduling a free phone call to see if we are a good fit. I know this is a highly sensitive topic that often involves trauma in the past and I want all clients to feel comfortable coming to Recharge Therapy.

Sometimes the treatment for vaginismus is only a few sessions and sometimes it takes a few years. Everyone is different and everyone progresses at a different pace. That is why there is no "one size fits all" therapy for vaginismus or any other condition or diagnosis. We always work at your pace.