Vaginismus, a painful gynecological condition, is often associated with sexual abuse and relationship conflict, but a recent Journal of Sexual Medicine study suggests that these pathways may not be as prominent as originally thought.
Affecting an estimated 5% to 17% of women, vaginismus is marked by involuntary muscle spasms in the vagina at the start of penetration. For women who are anxious or fearful about sex, the spasms act as a form of protection and make intercourse extremely difficult, if not impossible. The situation can occur even when a woman is in a healthy, loving relationship.
As a result, vaginismus can be a source of great distress for women and their partners, who many not understand why the woman’s body is responding this way. Some couples avoid intimacy because of it.
In the past, vaginismus has been linked to psychological issues, such as anxiety, negative views of sex, passive aggressiveness, and past childhood sexual abuse. Little is known about possible physical factors that could contribute to vaginismus. This study explored both angles.
Using structured interviews, gynecological exams, mental health evaluations, blood tests, and other assessments, the researchers considered the roles conditions like neurological disease, diabetes, metabolic syndrome, and menopause might play in women with vaginismus.
The study sample consisted of 255 women who were seeking help for sexual problems at a clinic in Italy.
In addition to medical exams, the women completed a series of questionnaires related to sexual function, mental disorders, sexual distress, and body uneasiness.
Twenty of the women were diagnosed with vaginismus; the remaining 235 were not, although other sexual dysfunctions, such as hypoactive sexual desire disorder (HSDD), sexual pain, and arousal and orgasmic disorders were diagnosed in the latter group. Women with vaginismus tended to be an average of ten years younger than the rest of the sample.
In many ways, the two groups were similar, with no significant differences reported for urinary and gynecological health, body uneasiness, prevalence of psychiatric disease, medication use, and relationship parameters.
However, in a mental health assessment, women with vaginismus were more likely to have histrionic traits (e.g., they were more emotional, excitable, and dramatic).
They also had more sexual pain compared to women without vaginismus, according to a sexual function assessment. Other assessment domains, such as arousal, lubrication, and satisfaction, were similar for the two groups.
“Our data also suggest that, as would be expected, women with [vaginismus] present a very specific dysfunction that does not undermine the integrity of the subject’s sexuality,” the authors wrote.
Distress was associated more with the duration of vaginismus than the severity.
Overall, the authors concluded that “[n]either traditionally reported conditions (in particular, sexual abuse, relational factors, gynecologic diseases) nor newly investigated parameters (clinical, hormonal, and metabolic alterations) appeared to play a role in the development of [vaginismus.]” But they called for further research to confirm their findings.
The Journal of Sexual Medicine
Maseroli, Elisa MD, et al.
“Psychobiological Correlates of Vaginismus: An Exploratory Analysis”
(Full-text. November 2017)