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does fear create vaginismus

Does Fear Create Vaginismus? Or Vice Versa?

I came across an article that came out last month and it brought up an old question I often muse over--Does Vaginismus create the fear and anxiety in women, or does an underlying fear or anxiety create Vaginismus? As we often say in physical therapy "It depends".

With some of my patients, there is a specific injury or infection that is at the root of their pain. The story is similar whether they were diagnosed with Vaginismus, Vulvodynia, Vestibulitis, Dyspareunia, or a host of many other diagnoses that lead to painful intercourse. For example, a young girl that always wore bathing suits and developed recurrent yeast infections, only to find out that over a decade later she had developed vaginismus. She had no fear or anxiety going in to first sexual encounter, yet she had severe pain. Now, she presents with what I perceive as fear and anxiety. Should she be treated for fear and anxiety? Or just the pain? Or both?

Then, I have a subset of my patient population that admit going into their first attempt at intercourse, they expected that it would hurt. Why did they think this? Usually it is their friends or sister that makes reference to this, so there is already some level of fear or anxiety going into their first experience. Alternatively, some of my patients are brought up in a household where sex is never talked about, or if it, it is always in a negative light. "Sex is bad". Again, this puts a preconceived negative emotion to what would hopefully be a very positive experience.

In the case of the vast majority of the women I've treated over the years, there is an overwhelming physical component to their pain which is clearly made worse by the emotional/psychological component. Just to draw a parallel to other types of muscle-based pains, the same emotional/psychological components are observed in patients with low back pain, neck pain, knee pain and basically any type of pain. If it hurts your back to bend over, you will eventually stop doing that functional activity in order to avoid the back pain. If it hurts your knee to run, you will eventually stop running to avoid the pain. If it hurts to have sex, that too, will cease in order to avoid the pain. People with chronic back pain get anxiety and/or fear around doing certain activities, as do women with sexual pain. Health providers need to end the stigma associated with female sexual pain and point their patients and clients in the right direction.

The best way to treat these women is through a multidisciplinary approach that address all facets: physical and emotional. An important third factor is any potential medical problem, that clearly must be ruled out so the true healing can begin.

Click here for more blog posts on vaginismus and overall sexual health.

Reference:

Curr Opin Psychiatry. 2014 Nov;27(6):4-6-12 (https://www.ncbi.nlm.nih.gov/m/pubmed/25211497/)

Photo Credit: freedigitalphotos.net by Andy Newsom

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Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

Read more: Testimonial by R.M., Age 40

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by Y.L. (mom of 2)

After having my second baby via C-section I searched for months to try to find help for my lower back pain and separated abdominal muscles. I finally came across Heather Jeffcoat via a mommy blog. I reached out to her via email and set my first appointment. My first appointment went amazing … she listened to what my symptoms, check my separation and explained to me in detail what the next steps would be. Not only did my abdominal separation go from 3 to about 1 -1/2 but my back has pain has significantly reduced. I’m personally recommending all my mommy friends to Heather!

Y.L. (mom of 2)

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

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