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Primary Versus Secondary Vaginismus

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

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

Primary vaginismus most often occurs in younger women and is usually accompanied by fear and anxiety of penetration. In many cases, young girls try to insert a tampon first and fail because of tight muscles or blockage from a thick or high hymen. After several attempts, the pain intensifies, and they refrain from entering. Often these women can’t get a speculum exam at the GYN, and of course, intercourse feels impossible. No one knows what causes primary vaginismus, but it is not an uncommon medical condition and the sooner it is identified, the easier it is to treat!

Secondary vaginismus is a little different. This condition is observed in women who have previously had successful, painless penetration. Then due to some other etiology (chronic vaginal infections, menopause, vulvodynia), the pelvic floor begins to tighten and may go into spasm in response to repeated attempts at painful sex. Anxiety and fear play a lesser role here, as these women usually have no problems in the past and wonder why all of a sudden, sex hurts. Secondary vaginismus is also easily reversed by identifying the root cause of the pain and addressing it first.

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