Vaginismus can be simply described as the inability to take a foreign body into the vagina. The diagnosis is made when sexual intercourse is absent or partially painful.

Vaginismus is the most common reason for consulting a doctor among sexual problems. Couples cannot accept this disease, which they have often never even heard of, at first. They usually think of it as ‘first night fright’ and give it time. However, with persistent, unchanging contractions despite the time that has passed, they enter into research on ‘What is vaginismus? At this stage, they meet ‘Vaginismus’ and start to search for ‘Vaginismus treatment’.

What is Vaginismus?
Vaginismus can be simply described as the inability to take a foreign body into the vagina. The diagnosis is made when sexual intercourse is absent or partially painful. In addition, not being able to have a vaginal examination, not being able to have a smear, not being able to use vaginal tampons or suppositories are also indicators of vaginismus.

The medical definition of vaginismus is the reflex, involuntary and repetitive contraction of the outer 1/3 muscle group of the vaginal canal during sexual intercourse. As a result, sexual intercourse cannot take place and in some patients it may even turn into a panic attack-like state.

Why Does Vaginusmus Happen?
Vaginismus is a condition faced by one in 10 women in our country. The causes of vaginismus are psychological and anatomical factors. While 90% of vaginismus is psychological, 10% has anatomical problems.

Often the psychological cause is that the subconscious mind is filled with ‘sexual myths’. Let’s examine in more detail the psychological reasons for this ‘superstition’, which is popularly known as ‘fear of the first night’.

Psychological Factors
The psychological causes of vaginismus include faulty upbringing, past harassment or sexual abuse, sexual traumas, and incomplete or exaggerated information about sexuality.

“Sexual myths” play an important role in psychological factors. Sexual myths are unrealistic, but accepted by the public with a firm belief in their truth.

The most common sexual myths;
Heavy first night bleeding
The opening of the hymen (hymen) will be in the form of rupture and explosion,
Sexual intercourse is very painful,
Death after intercourse on the first night
Locking at first sexual intercourse (penis captivus myth),
Vagina is too narrow or closed
Penile penetration into the wrong hole (anus, urethra).

ANATOMICAL FACTORS

• Among the anatomical causes of vaginismus, the most common problem is hymen problems. Hymen that is not physically normal in appearance;
• Imperforate hymen, meaning a completely closed hymen,
• High-edged hymen,
• A veiled hymen,
• A hymen with a hole like a sieve,
• In addition, congenital vaginal development disorders (short vagina, blind vagina), giant condylomas (warts), vaginal canal cysts and tumors constitute anatomical obstacles that prevent sexual intercourse.
• With the treatment of these conditions, which can be diagnosed with a correct gynecological examination, the vaginismus problem also disappears.

What are the Symptoms of Vaginismus?
Vaginismus is a problem of introversion. Therefore, the diagnosis can be made with findings other than the inability to have sexual intercourse.

The most common findings;

• Absence of sexual intercourse
• Partial but painful sexual intercourse,
• Not being able to insert a tampon or a bulb into the vagina,
• Not being able to put a finger in the vagina,
• Not being able to touch the genital area, or not being able to let your spouse/partner touch it,
• Not being able to do personal hygiene or waxing, epilation
• Not being able to have a gynecological examination
• Not being able to wear an ultrasound probe or speculum during the examination
• Not being able to stand naked in the presence of their spouse/partner, not allowing their body to be touched in general.

Even the presence of just one of these symptoms can raise suspicion of vaginismus… often not diagnosed until the first sexual experience. However, some patients arrive already aware of these symptoms.

What are the Types of Vaginismus?
There are different types of vaginismus.

Types of Vaginismus
Primary Vaginismus (Primary Vaginismus)
Primary vaginismus is an ongoing and unresolved problem since the first sexual experience. It is also called ‘lifelong vaginismus’. Most patients are diagnosed with primary vaginismus.

Secondary Vaginismus (Secondary vaginismus)
Vaginismus is an acquired condition. It is also called ‘acquired vaginismus’. This usually occurs after a triggering event when there was a normal sexual relationship in the past. Secondary vaginismus can often develop after a difficult, traumatic, painful and painful birth. It can also occur after an abortion, a difficult gynecological examination, a painful sexual intercourse. It is much rarer than primary vaginismus.

General Vaginismus
It means that the problem of vaginismus exists in any situation independent of the partner, place and relationship. It is also called ‘generalized vaginismus’. As a result, women will experience vaginismus problem at any age, no matter who they marry.

Situational Vaginismus
Unlike general vaginismus, it is a vaginismus condition that occurs due to a specific partner, place or relationship. Although it is more rare, when these situations change, the vaginismus problem will be solved.

Partial Vaginismus
In such patients, part of the penis can enter the vagina, albeit painfully and painfully. It is also called ‘partial vaginismus’. As a result of partial intercourse, miracle babies can be conceived and born.

How is Vaginismus Diagnosed?
Vaginismus is a disease that couples investigate and learn about as a result of the absence of union on the first night. A definitive diagnosis can be made after a gynecologist’s examination. When making the diagnosis, a detailed patient history is taken and a very brief, visual gynecological examination is performed.