Vaginismus: What is it and what does it have to do with menopause?

At any time of life, but especially during the menopause, you could experience involuntary contractions & tightening of the close muscles within your vagina. This is known as vaginismus (NHS, 2021). You may be wondering: Why does this occur, and why does it happen during the menopause? Although the answer is complex, it can be summarised (Wiginton, 2020):
  • During menopause, certain changes in the female body take place, including reduced oestrogen production.
  • The lack of oestrogen can lead to vaginal dryness while weakening the skin that recovers it.
  • The above changes can result in vaginal spasms.
Furthermore, emotional changes, anxiety, and stress experienced during the menopause can also contribute to spasms especially during sexual intercourse (McEvoy, 2021). It’s important to consider vaginismus during the menopause as it is a condition that can be treated. Below we explain all about what it is, including the signs, symptoms, and main treatments.

Vaginismus: signs and symptoms

Vaginismus can be accompanied by a variety of symptoms (Goodman, 2020; Conn, 2022):
  • Painful or uncomfortable sexual relationships are an early symptom.
  • That uncomfortableness can be described as burning or a hit.
  • The discomfort can also appear in gynaecological exams and even using tampons or menstrual cups.
  • This can also contribute to a fear of having sexual relationships or loss of sexual desire.
It should be noted that these symptoms appear involuntarily. On the other hand, they might be accompanied by symptoms of different illnesses, like vaginitis or other infections that also can cause this discomfort (Alizadeh, 2019). What is vaginitis and why is it related to menopause?

How can it be treated?

Like many other menopausal symptoms, this discomfort can be treated pharmacologically and non-pharmacologically. These are described below.

Non-pharmacological treatment

There are some important actions that women with this discomfort can practice, for example (NHS, 2021; Daňková, 2019):
  • Emotional advice and psychosexual therapy.
  • Relaxation techniques such as Mindfulness.
  • Relaxation-focused sensorial techniques to increase sexual desire in intimate relationships.
  • Pelvic-floor exercises such as Kegel exercises.
  • Vaginal training using vaginal dilatators.

Pharmacological treatment

The use of medication must be prescribed by a physician. Treatment may also target the causes of this complication (hormonal alterations, infections, among others) (Conn, 2022). Please speak to a Doctor for more information.

How to prevent vaginismus?

Currently, there are no effective measures to prevent this discomfort, especially during menopause (Winchester Hospital, 2022). However, women can do pelvic-floor strengthening exercises (also known as Kegel exercises) to help to prevent pelvic pain (Sharif, 2017). Now you know what vaginismus is, as well as its signs, symptoms and options for treatment. Please consult your Doctor for more information. References Alizadeh, A., Farnam, F., Raisi, F., & Parsaeian, M. (2019). Prevalence of and Risk Factors for Genito-Pelvic Pain/Penetration Disorder: A Population-Based Study of Iranian Women. The Journal of Sexual Medicine. doi:10.1016/j.jsxm.2019.04.019 Conn, A., & Hodges, K. R. (2022). Genitopelvic pain/penetration disorder - Gynecology and Obstetrics. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/gynecology-and-obstetrics/sexual-dysfunction-in-women/genitopelvic-pain-penetration-disorder Daňková, K., Machač, Š., Vrzáčková, P., Klapilová, K., Kovář, P., Zábranská, L., Damborská, Z., Wiecek, P., & Vrána, T. (2019). Vaginismus – koho zajímá? https://www.prolekare.cz/casopisy/ceska-gynekologie/2019-3-7/vaginismus-koho-zajima-113053 Goodman, B. (2020). Vaginismus: Types, causes, symptoms, and treatment. WebMD. https://www.webmd.com/women/guide/vaginismus-causes-symptoms-treatments McEvoy, M., McElvaney, R., & Glover, R. (2021). Understanding vaginismus: A Biopsychosocial Perspective. Sexual and Relationship Therapy, 1–22. https://doi.org/10.1080/14681994.2021.2007233 NHS. (2021). Vaginismus. NHS choices. https://www.nhs.uk/conditions/vaginismus/ Sharif, H., Puppo, V. & El Fekih, M. (2017). Importance of Kegel Exercises for Male and Female Sexuality and Prevention of Vaginismus. The Journal of Sexual Medicine, 14(5). e340. doi:10.1016/j.jsxm.2017.04.604 Wiginton, K. (2020). Painful sex during menopause: What to know. WebMD. https://www.webmd.com/menopause/painful-sex-menopause Winchester Hospital. (2022). Vaginismus. Winchester Hospital. https://www.winchesterhospital.org/health-library/article?id=96850

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