Istanbul Vaginismus is a sexual dysfunction that is frequently encountered in the world and especially in our country. Vaginismus, which is refrained from being pronounced especially in closed and traditional societies, can be seen in almost one out of every ten women. Despite being so common, this dysfunctional dysfunction can be permanently treated with modern and scientific methods.
Vaginismus is the inability to take any foreign body (penis, finger, tampon, suppository, etc.) into the vagina even if desired. With another definition, vaginismus is the inability to have sexual intercourse or painful intercourse as a result of involuntary contractions of the vagina muscles.
Vaginismus patients have no problems in foreplay or emotional bonds with their partners. During foreplay and reunion, subconscious and learned false information come into play and contraction begins. Vaginismus patients have some typical reactions. After these reactions, the acceleration of the heartbeat, panting, fear and excitement in a panic attack-like situation, the woman squeezes and tenses herself as much as possible, and in this way, it is not possible for the penis to enter. With this condition, sometimes there may be pain, and sometimes there is only fear. Afterwards, the woman who does not want the continuation of the relationship closes her legs tightly and rejects her husband by pushing, ending the relationship. Almost all of the thoughts about sexuality and vagina in women with vaginismus are negative. These negative sexual messages in women are very diverse and these messages trigger an involuntary (reflex) reaction of the muscles in the vagina (especially the PC muscle) to contract.
What Are the Symptoms of Vaginismus?
Although the symptoms of Istanbul Vaginismus are thought to appear in the first sexual experience, they can be observed before. From the stories of patients who come to us with complaints of vaginismus, we observe that women with vaginismus are more insensitive to sexuality than other women, starting from the age when their sexual identity begins to develop.
Avoiding conversations about sexuality, being uncomfortable, beliefs that sexuality is a bad and dirty activity, ignoring the vagina, not being able to look or touch, attaching a sacred meaning to the vagina and virginity can be counted among the first symptoms of vaginismus.
The symptoms of vaginismus begin to show themselves more clearly in the first sexual experiences and then in the active sexual process. It is known that during foreplay and masturbation, clitoral orgasm is experienced, fluid is secreted in the vagina, and pleasure intake is normal. A woman with vaginismus symptoms cannot combine with her reactions during intercourse and involuntary contractions in the vagina.
What are the Causes of Vaginismus?
What are the causes of vaginismus? It is not possible to collect the answer to the question in a single item.
Every woman experiencing vaginismus determines her own reasons. People's family structure, upbringing style, personality structure, social structure, beliefs and perceptions are different from each other in their experiences. Therefore, each vaginismus experiences its symptoms for unique reasons.
Vaginismus is a finding of psychological origin to a large extent. Although there is a common belief that childhood sexual traumas are the triggering cause for vaginismus, the situation is not as expected.
Many messages that negatively affect the sexual identity development of girls who grow up in traditional families lay the foundation of the disease. These messages are loaded with a heavy meaning of sexuality with the phenomenon of "honor", giving the image of impurity to sexuality, being a life-and-death issue of virginity, and many similar distortions.
In addition to upbringing and social gender, another factor that causes vaginismus is the first night stories told exaggeratedly. The exaggerated stories told about the first night of people who have not had sexual experience increase the expectation of "pain" against sexuality and form the basis for vaginismus.
Personality structures are also an important factor in the causes of vaginismus. Women with controlling and perfectionist personality structures unconsciously reject the relationship because of losing control during the relationship or their distrust of an unknown experience. However, the expectation of high pain-pain in people with low pain threshold creates a negative and excessive fear and does not allow the relationship to take place.
Negative gynecological experiences can also negatively affect the vagina and activities related to the vagina and form the infrastructure of vaginismus. During the examination, the approach of the physician, the content of the examination and the attitudes may negatively affect the person in this direction.
Causes of Istanbul Vaginismus can occur for this and many similar reasons. It should be noted that whatever the cause, vaginismus can be treated permanently with scientific methods.
Istanbul Vaginismus Treatment
Istanbul Vaginismus is a discomfort that can be treated in a short time and permanently. For the treatment of vaginismus, there are some stages that couples go through before the decision stage. The fact that the relationship, which is encountered on the first night, cannot be realized, is met with astonishment in couples. It is believed that the tiredness of the first day and the stressful process of marriage preparations will heal on their own over time. Every attempt made after this is still inconclusive and the shock experienced by the couples begins to leave its place to the questions. In our society where sexuality is not talked about and problems cannot be expressed, vaginismus creates a perception of a problem that people only experience. Therefore, it is delayed in seeking a solution.
Taking action in a short time for the treatment of vaginismus is very important for the marriage to not wear out. The inability to reunite leads couples to an asexual life over time. The decrease in sexual sharing causes tension and weariness between couples. There are also dissolutions in relationships where sharing decreases. In order not to experience all these negativities, it is necessary to take a step for treatment from the moment the symptoms of vaginismus appear.
Vaginismus treatment is carried out by many centers. In order to diagnose vaginismus correctly and to apply the right treatment methods, the first thing to do is to be evaluated by a specialist gynecologist and a sexual therapist. Thanks to this evaluation, vaginismus is diagnosed and the treatment method to be applied can be determined and the contractions can be graded.
Vaginismus is unfortunately a subject that can be abused. Due to the wrong and incomplete treatment methods applied by many people who claim to be able to cure vaginismus, many couples experience financial and moral destruction and lose hope that their ailments will get better.
Cognitive sexual therapy and behavioral sexual therapy methods are the shortest and permanent treatment methods applied in the treatment of vaginismus in the scientific world.
Thanks to cognitive sexual therapies, women with vaginismus and their spouses renew their perceptions of sexuality and reconstruct the wrong information with the correct ones. In this way, the wrong information learned in the past is replaced by scientific and correct information. Although cognitive sexual therapy is an important part of vaginismus treatment, it cannot be a treatment method alone. Because vaginismus cannot be completely overcome by having the right information. In addition, behavioral therapies that include vaginal exercise exercises and ensure conscious control of the vagina should be applied so that the problem of vaginismus can be truly treated.
As a result of these therapies, the person is able to control the contractions in the vagina and there is a permanent improvement as he realizes this by learning.
Vaginismus Treatment Methods
Istanbul Vaginismus treatment methods differ in terms of the methods used by practitioner specialists.
Regardless of the treatment method to be applied for vaginismus, the obligatory step is gynecological evaluation. Gynecological evaluation provides important findings in determining the treatment method to be applied.
A) The Importance of Gynecological Evaluation in the Treatment of Vaginismus
Vaginismus causes can be seen psychologically and physically. In some cases, a mixed structure is also observed. For this reason, the element that will determine the diagnosis and treatment method of vaginismus is the gynecological examination. If the gynecological evaluation is missed, incomplete treatment will be applied since the factors in the anatomical structure will be ignored.
The gynecological examination performed in the treatment of vaginismus is different from other examinations. Considering the patient's vaginal sensitivities, it is painless in a short time and no medical device is used.
B) Treatment Methods Applied in the Treatment of Vaginismus
Among the scientific methods in the treatment of vaginismus, the treatment methods that provide the shortest and permanent solution are cognitive sexual and behavioral sexual therapies. Other treatment methods applied together with these;
Finger Exercises: Finger exercise, which is one of the first methods that comes to mind when it comes to the treatment of vaginismus today, involves a long and laborious process for both the patient and the practitioner. It starts with the stages of touching the vagina, correct breathing control, massaging the vagina, and examining the vagina with the help of a mirror, which are given to reduce the patient's anxiety level and change their perceptions about the vagina. Patients who can realize this process begin the next stage, namely finger exercises. At the end of these exercises, which start with the exercise of pushing the first knuckle of the little finger into the vagina and progress gradually, paired finger exercises and then intercourse are recommended. With this treatment method, which consists of a very long process, there are people who overcome vaginismus. The fact that the patient finds the treatment method disgusting due to the negative judgments that the person feels about the vagina and the high resistance makes finger exercise treatment difficult.
Kegel Exercises: The scientist who found this method, Dr. It is an exercise that takes from Kegel. The purpose of Kegel exercise is to make the pelvic muscles controllable and stronger. Kegel exercise, which is known to be very useful in sexual therapies, also has the feature of increasing sexual desire as it intensifies the blood flow into the vagina.
The pelvic muscles used for the realization or delay of urination, stool and gas needs are also located in three quarters of the vaginal entrance. For this reason, it is aimed to control and strengthen these muscles, which are involuntary contractions in the vagina and are controlled in urination, defecation or gas production.
Kegel exercise is primarily recommended while urinating in order to feel the muscles better. Instead of emptying the urine all at once, it is requested to complete the urine in the form of hold and release. The pelvic muscles, whose control is learned in this way, are completed by performing frequent-release exercises even when there is no urine.
Although Kegel exercise is important in the treatment of vaginismus, it is not a treatment method alone.
Cognitive Therapy: One of the vaginismus treatment methods is cognitive therapy. One of the causes of vaginismus is the lack of knowledge and fears of false information. Cognitive therapy is a process that provides correct information to couples and restructuring the perception of sexuality created with false information. In this way, the person's anxiety about the unknown decreases and he becomes aware of the wrong information he has. Cognitive therapy, which is very useful in these aspects, cannot be sufficient alone in the treatment of vaginismus. According to the results of both the trainings and the professional groups of many of our patients who come to us with the complaint of vaginismus, the cause of the disease is not lack of knowledge, but rather different concerns.
Behavioral Therapy: Behavioral therapy is one of the scientific methods applied in the treatment of vaginismus. It consists of exercises that control involuntary contractions in the vagina. Behavioral therapy takes place painlessly and under therapist control. Thanks to this method, involuntary contractions are taken under control, while realizing this as a learned behavior causes the treatment to be permanent. Behavioral therapy is one of the treatment methods that produces the shortest and permanent solution in the treatment of vaginismus in modern science. When supported with cognitive therapy, it gives 100% permanent results.
Hypnosis: Hypnosis is an application consisting of suggestions given to the subconscious after the person is half asleep and fully relaxed. With this application, it is possible to reduce the level of anxiety and to have a healthy infrastructure for treatment. Although it is not possible to completely eliminate vaginismus with the suggestions given, it is a good support method for treatment.
Surgical Methods: Surgical methods applied in the treatment of vaginismus are not sufficient alone for the treatment of vaginismus. In vaginismus, which is seen due to anatomical conditions, some surgical methods applied to the hymen create a healthy infrastructure for treatment, however, they do not eliminate vaginismus symptoms. As a vaginismus treatment, surgical interventions made only on the hymen are incomplete applications. For this reason, it is a distinctive feature that the specialist who decides on the surgical procedure is a specialist gynecologist and a sexual therapist.
Surgical procedures applied in vaginismus symptoms associated with anatomical causes;
a) Hymenotomy: It is the enlargement of the membrane in case the hymen (hymen) is high-sided. Depending on the degree and severity of vaginismus, the patient can continue his daily life immediately after this procedure, which is performed with local or general anesthesia. This process, which takes about fifteen minutes, is performed to create the infrastructure of behavioral therapy.
b) Hymenectomy: Hymenectomy is the operation to completely remove the hymen (hymen) due to its structure. It is preferred in fibrotic, high-edged and hard-consistent hymen structures. The complete removal of the hymen takes an average of half an hour and is optionally performed under general anesthesia. After an average of one month after the procedure, the treatment is completed with behavioral therapies. Hymenectomy, like other applications, is not a stand-alone treatment method.
