Menopausal (secondary) vaginismus is characterized by the gradual onset of penetration difficulty after having enjoyed many years of normal, pain-free vaginal function.
Lisa, a 60 years old professional lady in a happy marriage for the past 30 years, arrived for her appointment quite distraught: “It started 8 years ago with a burning sensation after vaginal intercourse, and got worse and worse over time. After 2 years it became so bad that penile penetration became impossible; now I can’t even insert an applicator with lubrication, and gynecologic examinations are horrible! What is going on?”
The woman with menopausal vaginismus will not need training for what vaginal penetration is all about, but rather a solution to the interruption. She will be cognizant of the need to restore vaginal penetration for prompt medical care in addition to sexual activities.
The course of treatment for secondary vaginismus will depend on the severity of the vaginal restriction, the duration (how long) of penetration difficulties, and her suitability for vaginal Estrogen replacement. Intervention is short-duration – about 4-9 sessions – and the prognosis is typically excellent.
Suffering in pain or giving up on sexual intercourse should never be a ‘given’ in menopause. The sense of relief, and the feeling of ‘being normal again,’ are empowering.