Vaginismus is classified as a pain disorder. The pelvic floor muscles and the outer third of the vaginal muscles cramp involuntarily and reflexively in a painful way. The cramping can go so far that tampons cannot be inserted and gynecological examinations become impossible. The vagina does not allow the penis to penetrate, seemingly without the protagonist's cooperation. This is because a vaginist woman does not make a conscious decision not to allow penetration. On the contrary, she is usually completely at a loss and feels helplessly at the mercy of her body. What is behind this and how can it be helped?

Lifelong or sudden onset?

First of all, vaginismus as a sexual dysfunction is not as widespread as listlessness or premature ejaculation. Scientific sources speak of 0.4 to 1% of all women. I have also found much higher figures in the double-digit percentage range. However, we should not confuse vaginismus with dyspareunia (pain during sexual intercourse). As a rule, younger women tend to be affected.

In sexual medicine, a distinction is made between the primary and the secondary type.

• The first type restricts sexuality from the outset and is therefore lifelong.
• The second type occurs after certain events and is therefore acquired. Until then, there were no such symptoms. This can be caused by fears during pregnancy, sexual or emotional boundary violations or experiences of violence.

Body-oriented sex therapy according to Sexocorporel also differentiates on another level.

• Here there is phobic vaginismus with the fear of what could penetrate the body. According to sex therapist Susanna-Sitari Rescio, who works according to the Sexocorporel concept, these women often have a high level of body tension and self-control.
• On the other hand, there is vaginismus due to an identity problem. This is dominated by a fear of what might come out. These women often have a girlish appearance and a close bond with their mother. They are not sure of their role as a woman, and may even reject it altogether.

In both types of vaginismus, the women have very high muscle tension. The pelvis is very tight and we often find a hollow back. They also have other complaints related to tension, such as teeth grinding or back problems. Vaginistic women are perfectly capable of reaching a climax. According to Rescio, however, they tend to reach orgasm by tensing their bodies and simply exerting pressure without touching themselves. This is also rather problematic in partnered sexuality.

An extreme protective attitude

One thing remains, no matter how we define it:

And that is the muscular armor that is built up as protection.

If a woman unconsciously tenses up so much that penetration is not possible, the question of why arises. It is important to find out. If vaginismus occurred at a certain point in time, you should look at what happened beforehand. If, on the other hand, it has existed for a lifetime, it is important to work through deep-seated fears.

• What could be behind a woman blocking the way to her innermost self?
• What is happening on the outside?
• In the relationship?
• What is the relationship to one's own gender like?
• What is the self-perception as a woman?

In addition, bodywork exercises can be used to perceive and change body tension, especially in the pelvic floor. Pure relaxation exercises are less useful, as the body armor is a protective mechanism and cannot simply be magically removed through relaxation. It is much more about regaining control through bodywork.

It is often recommended to practise penetrating the vagina with vaginal sticks, which are available in different strengths. However, before you can start, it makes sense to explore your own sex first. What does the vulva look like, how does it feel, which touches are pleasant? It's also about testing the pain threshold. How far can I go today, tomorrow or the day after tomorrow? Healing a woman with vaginismus doesn't happen overnight. But it is very possible. But it requires outside help!

Anja Drews - qualified sex educator for ORION