There is no need to live with sexual pain in the 21st century. In our first installment we explained what Vaginismus is, a condition associated with sexual anxiety and pain. Now we are taking a look at the cure.
We live in such a technological advanced world that will soon have door-to-door drone pizza delivery. So why is there so little written and spoken about women’s sexual pain in South Africa?
“30 percent of women reported some difficulty with pain the last time they had sex”, according to an article in Psychology Today.
Our focus in this article is to cover what can be done about it and the different treatment modalities available. Because guess what? There is a lot you can do!
BEAUTY WARRIORS DEEP DIVE
We are excited to say that Beauty Warriors research uncovered a multitude of options that can assist with Vaginismus. Clinical hypnotherapy to Botox and all the in between. On a more serious note, our investigation revealed that a visit to a specialist physiotherapist or a session with a sexual psychologist does wonders. Sounds a little extreme?
In actual fact, Vaginismus is a condition that more often than not needs a multi-disciplinary approach. The key point being that you need to figure out what works for you. The psychological role of the fear response is real and does need to be addressed when looking at a treatment program.
South Africa has finally caught up with the world and women now have varied options to consider. A proper diagnosis is the first step – this condition is often not properly diagnosed.
The best option is a gynaecologist that has sexual dysfunction training, a woman’s health physiotherapist or book an appointment at My Sexual Health. There are so many conditions associated with painful intercourse that correct diagnosis is important.
VAGINISMUS VS DYSPAREUNIA
Often confused with Vaginisumus, the most common condition associated with painful intercourse is Dyspareunia.
Dyspareunia can be superficial or deep. Superficial dyspareunia occurs in or around the vaginal entrance. Common symptoms include superficial vulval pain, itching, burning and stinging. Pain may be constant but can also be triggered by nonsexual activities such as exercise.
Common causes may be inadequate lubrication, vaginal infection, topical irritants, urethral problems, radiotherapy or sexual trauma. Deep dyspareunia, pain resulting from pelvic thrusting during intercourse, is common. It may be caused by pelvic inflammatory disease, local surgery, endometriosis, genital or pelvic tumors, irritable bowel syndrome, urinary tract infections or ovarian cysts.
BREAK THE PAIN CYCLE
Once you have your diagnosis that it is Vaginismus, we would strongly advise seeing someone like Hester Van Aswegen, a woman’s health physiotherapist. She deals with pelvic floor dysfunction as well as ante- and post-natal physio. The main area of focus is to break the cycle of pain.
“Vaginismus is curable, 100% curable.” says Van Aswegen, “It takes time and guidance and it takes an approach that addresses the issues that contribute to this. You cannot begin to treat vaginismus unless you address the physical, psychological and the social problems associated with it.”
WHAT ARE PELVIC FLOOR MUSCLES?
They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women). These muscles must be able to contract to maintain continence, and to relax allowing for urination and bowel movements, and in women, sexual intercourse. With Vaginismus, these muscles go into an involuntary spasm from fear of pain.
“The goal is to achieve good relaxation of the pelvic floor to allow for pain-free sex and also normal function of the pelvic floor so that there are no other problems with the bladder or bowels either”, Van Aswegen explains. “We want to teach a woman to have control over her body and give her the tools to manage the condition. For some it is once off and for others they might need to manage it for the rest of their lives.”
VAGINISMUS PHYSIOTHERAPY PROGRAM
– Pelvic floor physical therapy can include manual therapy techniques e.g. myofascial and trigger point release. Scar tissue mobilisation as well as neural mobilisation to reduce tension and muscle spasm.
– Breathing techniques to increase relaxation of the muscles in this area. Van Aswegen empathises, “It is essential to teach correct breathing and mindfulness/awareness of tension patterns in the body and what is happening in pelvic floor muscles during everyday life.”
– Rehabilitation and exercises to normalise the muscles are part of the treatment. Often includes stretching and relaxation type exercises as well as postural and core exercises as needed.
– Women can use vaginal dilators to stretch the muscles physically, which help desensitise the area. They also help you become less fearful of touch and more comfortable to insert something into the vagina.
– Machines used can include biofeedback – to down train or strengthen the muscles if necessary and also other methods like dry needling / tens / electrotherapy.
Aswegen concludes by saying that, “Home exercises include lots of breathing techniques, relaxation, stretches and dilator use. Then eventually following a sensate focus programme and reintroducing sexual intercourse once it is pain-free to insert a dilator into the vagina.”
Look out for Part 2, coming in out in a few days where we look at other cures such as psychotherapy, hypnotherapy and botox!