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Vaginismus: is something (not) wrong with my vagina?

Despite widespread online visibility in recent years, vaginismus continues to be an elusive condition.  Professionals are still not sure how to diagnose it, treatment is not standardized, misconceptions abound, and the women who suffer often find themselves left alone searching for solutions.

Why is vaginismus so confusing at our times, with advances in medicine and readily available information?

Answer #1: because vaginismus is NOT a disease/pathology/physical anomaly but rather a stress response of the sympathetic nervous system, our guardian at times of fear, worry, or danger.  It is a psychosomatic condition, a fusion between medical and mental health that is not yet in the professional mainstream.

Answer #2: because of the woman’s inability to “take a look at the vagina and see if anything is wrong” because of its location inside the pelvis, unlike the male’s penis that is external and may be looked at anytime.  The only time she can see her vagina is when a speculum is used, which is typically done only during a gynecologic examination.  No wonder this invisibility makes the vagina quite mysterious and misunderstood to the point of believing that pain upon penetration – or complete inability to penetrate – must signal a physical problem with the potential for further harm.

Answer #3: because the woman with vaginismus will have difficulty believing that nothing is wrong with her vagina. She will often insist that there must be something physically wrong, especially because the connection between our stress response system and the genitals is still not widely recognized nor accepted.

By the time our vaginismus treatment process gets to demonstrating a gynecologic exam, we make sure to have each patient looks at her own vagina through the open speculum – some will even take a photo of it on their mobile phone – as proof that it is merely a simple canal that connects the outside world to the uterus… Yet a canal that is subjective to reactive clenching, which vaginismus is all about.

About The Author

vaginismus specialist Dr. Ditza Katz team member Women's Therapy Center

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