Vaginismus

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Vaginismus
Vaginismus

Video: Vaginismus

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Video: How did I overcome my vaginismus problem? (Vaginismus Animation Film) 2023, January
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Vaginismus

Vaginismus means the involuntary spasms of the pelvic floor muscles that surround the vagina (ICD 10). The penis cannot penetrate through the vaginal opening, or this is only possible with pain. The pelvic floor muscles and the outer third of the vagina cramp reflexively and involuntarily. A tampon or your own finger may also not be able to be inserted. Certain gynecological exams may also not be fully feasible. Vaginismus can exist forever, but it can also occur after sexual intercourse was possible in the past.

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  • What are the causes of vaginismus?
  • How is the diagnosis made?
  • How is the treatment carried out?
  • Whom can I ask?
  • How are the costs going to be covered?

What are the causes of vaginismus?

If organic causes for the symptoms can be ruled out (e.g. infection / inflammation, cramp-like pain can also occur in endometriosis, for example), other aspects must be considered.

Apart from organic causes, reasons for vaginismus can include misconceptions about the size and elasticity of the vagina, but also the size of the penis (e.g. the assumption that the vagina is too narrow for the partner's penis). Fears of pain or injuries during sexual intercourse or traumatic experiences (e.g. abuse) also play a role. In addition, vaginismus can be related to rejection of sexuality in general or of the partner in particular, as well as problems in the relationship. Sexuality is not always rejected outright. Therefore, affected women - with the exception of penile penetration - can certainly have sexual experiences.

How is the diagnosis made?

Questions about sexual life and relationships are included in the anamnesis discussion between the doctor and the patient. In addition to physical aspects, the doctor also gets an idea of ​​the possible psychological causes that may be the basis of vaginismus. Talking about issues and problems related to sexuality is not always easy. On the contrary: the inhibition threshold is often very high. This requires trust and empathy on both sides as well as the willingness to change something in the existing situation. That is not always easy. Ideally, however, an open and honest conversation can be held.

In addition, the doctor will carry out a physical examination, taking into account what the underlying problem allows (e.g. tactile findings, ultrasound, smear, secretion findings, etc.).

How is the treatment carried out?

If the problems are based on organic causes, these are treated.

It often takes time for patients with vaginismus to confide in a doctor and seek help. The underlying problems are not always consciously perceived.

Therapy also often requires a lot of patience on the part of everyone - including the partner, for example. One possible therapy is slowly “approaching” and “getting used to” new experiences, so that the patient “learns” that sexual intercourse is possible without fear and pain. Exercising the pelvic floor muscles or doing a vaginal self-exam can help. The doctor also informs you about "wrong ideas".

For example, small plastic pens of increasing strength can be used in therapy. These are inserted into the vagina by the woman herself (without putting it under pressure) - so that gradually a “feeling” for her own vagina arises and the experience is made that insertion is possible without pain. Later, the insertion of one's own finger and finally the erect penis can be experienced painlessly.

Accompanying psychotherapy or sex therapy may also be necessary, which deals with the relationship to one's own body and with sexuality (couple, individual, sex therapy). Ideally, the partner is included in the therapy. So-called sensuality exercises can be used, but also relaxation methods, etc. Further information on psychotherapy.

Whom can I ask?

The general practitioner can be the first point of contact. However, a visit to a gynecologist is necessary for diagnosis or treatment.

Doctors who specialize in sexual medicine, clinical psychologists and psychotherapists can also be involved in the diagnosis and / or therapy.

How are the costs going to be covered?

Sexual dysfunction is not considered a disease in the sense of social security law. Treatments for sexual dysfunction are not covered by health insurance.

The costs are only taken over by the social security agencies in individual cases.

In the case of certain services (e.g. psychotherapy), the patient will share the costs. Further information can be found under Psychotherapist and Psychotherapy: Offers & Addresses.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

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