Vaginismus (The Tight Vagina): Causes, What to do!

Vaginismus commonly known as the tight Vagina is a medical condition whereby there is strong contraction of the muscles of the vagina that is so strong that forces the vagina to closes itself.

Let me tell you a little story:
IT’S BEEN A LONG time since I had a babe who had symptoms just like hers.

Back then in 2011, it was like torture, everything, every effort between the sheets, was futile. At some point I could get frustrated and throw in the towel in obvious frustration, but moments, later I’d be crawling around again, with my cobra ready to strike, hoping that things would be different the next time. Ije agwo men na aga na abali eeh!

Each time I was wrong. Konji issa bastard, eziokwu m.

So when this particular Igbo babe recently walked up to me just outside the hospital to complain about something similar, I already knew where she was going.

But I had to be sure I heard her right, if not anything else, I wanted her to say it again.

“Doctor Caséy, abeg this is a big problem for me,” she said.

“What exactly is it?”

She paused a bit. “I find it difficult to have sexual intercourse with my boyfriend.”

“Why is that so? What happens when you try to?” I asked.

She took a deep breath. “Each time he tries to penetrate me, I feel so much pain that I could scream and push him away! It’s like my vagina is so tight nothing can penetrate it without causing me pain.”

A medical condition known as Dyspareunia (painful sexual intercourse), I thought to myself. But then I had to be sure. “When did you notice it?”

“Ever since I was a teenager and started having boyfriends, it was always a problem each time we made out and he tried to penetrate. The second guy I dated managed to penetrate and that was how I lost my virginity, but the sex could not continue because the pain was unbearable. The thing na afu m ufu too much!”

“Go on,” I said, keeping a straight face.

“It has caused a breakup in the three relationships I’d been in before now, Doctor. I want to have sex and enjoy it, biko, but the pain is unbearable, and I even noticed that when I get so horny and try to insert anything there, as per, you know, masturbation,” – she simpered – “the pain comes back and I just can’t do it! Amu na agu m, but I can’t even taste it because of the pain.”

“You mean nothing can enter there without pain? Penis or dildo or anything else?”

“Mbakwa o! I’m serious, Doctor,” she said. “Not even my own fingers!”

There and then I knew what symptom she had, but the exact diagnosis, I wasn’t sure of.

“Have you gone to see any doctor about it?” I asked.

She shook her head no. “I don’t know how to go about it.”

“Your symptom is what’s called vaginismus,” I said.

Vaginismus, kwa?”

I nodded.

I often remember my terrible experience with my babe that had it that year. Konji wan finish my life. Nna mehn, your something will just stand up like izaga, but no place to charge your phone, especially in the middle of the night or when Harmattan cold is dealing with both of you! You’ll wake up and see it nodding its head like Agama lizard.

Any attempt to plug your phone and the pain will make her throw away your charger! And even if you have pin-mouth charger like some of my guys here, my brother, nothing for you.

So I began to explain to this babe.

What is Vaginismus?

Vaginismus is a condition in which the vaginal muscles go into involuntary rapid contractions (spasms) and causing intense pain on any attempt at penetration, and thus making sexual intercourse impossible. It’s often noticed during first attempt at having intercourse and results in painful sexual intercourse, a condition known as Dyspareunia. Read more about painful sexual intercourse here.

Symptoms of Vaginismus

An individual with this condition would show the following symptoms

  • Difficult and Painful sexual Intercourse
  • Absence of Sexual Satisfaction
  • The pain experienced may or may not go away after intercourse.
vaginismus
Image credit: DRELIST

Risk Factors For Vaginismus

Risk factors for vaginismus include:

  • A history of sexual abuse,
  • Endometriosis (a situation whereby normal tissues of the womb – uterus – are found elsewhere in the body),
  • Vaginitis: Infections of the Vagina or
  • Even a past episiotomy (cut into the vaginal muscle during labour to help deliver a baby).

Types of Vaginismus

Vaginismus makes every sort of vaginal penetration impossible due to the intense pain from the muscle spasms. It can be primary or secondary.

Primary vaginismus arises in girls who have never had any form of vaginal penetration without pain.

Causes of Primary Vaginismus
Some of the possible causes are:

  • vulva vestibulitis,
  • vaginal candidiasis,
  • urinary tract infections,
  • a history of sexual abuse,
  • domestic violence,
  • rape,
  • general anxiety disorders,
  • religious reasons (seeing sexual intercourse as a sin) or
  • even a fear of the partner’s penis being too big.

Secondary vaginismus arises in women who had previously been able to have vaginal penetration without pain.

Causes of Secondary Vaginismus
It can occur due to;

  • years infections, or
  • even trauma during childbirth,
  • psychological factors, or
  • a combination of other causes such as not trusting one’s partner enough, poor body image, and so on.

Treatment of Vaginismus

The trouble with vaginismus is that treating it requires identification of the actual cause and most times, they are unknown.

  • Psychotherapy: more or less a Psychosexual problem.
  • Use of copious amounts of lubricants,
  • Use of Hegar’s dilator or
  • Use of drugs like anxiolytics
    have all been used with varying degrees of success.

All ladies who have this condition are to see a doctor (a gynaecologist), and he/she would guide you on the best approach to managing this condition.

Complications of Vaginismus

Individuals with this condition may have:

  • Marital or relationship difficulties
  • Poor self-esteem,
  • Depression and
  • Anxiety.
  • Infertility may be an issue.
  • Penis Captivus may be a possible complication.

The thing adiro easy to manage at all. Back then eeh, the Konji showed me pepper! And if na that year, mehn, na to go find Lux soap or Premier Soap. If that one no dey available, na to use ncha nkota!

I don’t want to remember my sorrow when my babe of 2011 had vaginismus! The thing mere m 30!

Konji issa bastard, I swear!

Authors

  • Dr Amaefule Caséy Kingsley, holds an MBBS degree from the University of Benin, UNIBEN and a BSc degree from the University of Nigeria. Dr Caséy is a medical doctor who has special interest in sexual, reproductive, mental and child health. He is a confounder of XDIFY, a sexual, reproductive and mental health forum. He is also an author of many books in the same areas. You can follow Dr. Amaefule Kingsley Chibueze on Twitter on: @caseyamaefule

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