Vaginismus is a common but often misunderstood condition that affects women across the world. In this blog, we will give a detailed explanation on vaginismus and the different available treatment options. If your patients are struggling with vaginismus, they are not online: help is available.
But what actually is vaginismus? It’s an involuntary contraction of the pelvic floor muscles that impedes penetration, be it during coitus or while inserting a tampon, sex toys, a finger, a speculum or during vaginal exploration.
What is vaginismus?
Vaginismus is a sexual dysfunction that ‘s more common than one may think as it’s not often openly discussed. Estimates are that it affects 4-7% of all women. The number of patients that see a doctor because of sexual dysfunctions ranges from 5 to 20%, but it is most likely an underreported matter because of its sensitive nature and the shame associated with it.
This muscular hyperactivity is caused by trigger points located on the muscles and the contraction is generated in spite of the existence of desire or excitement. Even though the woman apparently feels relaxed, penetration tends to cause a stinging feeling or even pain.
There are two different types of vaginismus:
- Primary vaginismus: in these cases the woman never was able to receive vaginal penetration.
- Secondary vaginismus: in these cases the woman used to be able to receive penetration normally and the symptoms started appearing later on.
But what causes the appearance of vaginismus?
There are different triggers for vaginismus, classified as either emotional or physical. There is usually not one sole cause for the appearance of vaginismus: it rather tends to be a mixture of several factors.
¿Pero qué provoca esta dolencia?
Emotional triggers can be for instance: fear of pain or pregnancy, anxiety, feelings of guilt, pressure (affective, familiar or social), relationship problems (abusive partner or feelings of vulnerability), sexually traumatic experiences (rape or abuse), childhood experiences ( exposure to sexual intercourse or sexual images), among others.
On the other hand, physical triggers can be recurring infections, medical conditions (cancer or lichen sclerosus), childbirth, menopause, pelvic surgery, insufficient vaginal lubrication equivalent to vaginal dryness, increasing pain during penetration, secondary effects from medication, etc.
How to treat vaginismus
Until now, vaginismus is considered to be a psychological pathology and its treatment is therefore mostly based on psychotherapy.
And although the emotional background is of vital importance, we should not forget that it’s essentially about myofascial trigger points in the muscles and that the issue, as with any other contraction of other muscles in the body, should be treated taking this into account.
In many cases, even doctors or specialized gynecologists are unaware of effective treatment methods, apart from the injection of certain medicines that help relax the vaginal muscles. They refer their patients to other professionals such as physiotherapists for physical therapies, contraction exercise or muscle relaxation or psychologists for sex education and counseling.
Furthermore, medical professionals often ignore the existence of other means and / or technologies that can substitute injectable drugs or they promote masturbation as a means of learning how to locate tension of the vaginal muscles in combination with vaginal dilators in order to enable normal coitus and solve the problem of vaginismus. Nevertheless, this can increase the emotional burden thusly rendering the treatment ineffective.
Therefore, apart from psychological treatment (except for those cases where the origin is exclusively physical), it will be necessary to get the help of a physiotherapist specialized in pelvic floor, who can carry out an adequate anamnesis and evaluation and offer a personalized treatment.
Physiotherapists have a wide range of options to relax the pelvic floor muscles, such as:
- Techniques for body awareness
- Progressive perineal massage
- Liberation through manual pressure
- Liberation through dry needling
- Negative biofeedback, among others
Even so, many physiotherapists are not very successful in their treatments as the results are very slow to appear and don’t persist in time. They can also be uncomfortable for the patient and generate the opposite effect of what they were looking for.
It is therefore important, when taking a physical approach, to have access to a tool that allows the inhibition of the sympathetic system. This part of the autonomic nervous system is activated in stressful situations, when the body enters in fight or flight mode, generating cortisol, the stress hormone. This is translated into an increase of the heart frequency, inhibition of digestion and an increase of the body’s muscle tone, including the pelvic floor muscles, generating a spasm that narrows and tightens the vaginal cavity.
Treatment of vaginismus with Capenergy
The application of CAPENENERGY’s radiofrequency systematically inhibits the activity of the sympathetic nervous system, thusly activating the parasympathetic system, in charge of relaxation and digestion. The body responds by decreasing the heart rate, stimulating digestion and relaxing the muscles of the entire body.
The treatment with Capenergy’s radiofrequency is very simple: it makes use of automatic active plates, equipped with a temperature sensor, that are located strategically to generate this relaxation.
The treatment furthermore reduces pain and inflammation, improves the blood flow, transporting oxygen and nutrients to the vaginal mucosa and improving its natural lubrication.It is also a perfect initial treatment that allows stretching the muscles later on, in an early stage, without any discomfort.
One of the aspects that makes CAPENERGY different from other tecar devices with pelvic floor applications, is its intracavitary MJS probe with temperature sensor which enables a pleasant internal treatment of the vaginal wall. Thanks to its anatomic shape, it is possible to carry out a series of safe and comfortable movements.
The anatomic shape of the MJS probe or Capenergy’s other treatment probe with specific dimensions for the treatment of vaginismus, allows for a pleasant and safe organic genital approach, thanks to the use of single patient and single use probe cover and the temperature sensor that assures a treatment with the risk of burns or electrical discharges.
Other TECAR devices generally use resistive intracavitary probes, which always implies the risk of burns and allows only for a static, motionless treatment. This is not at all effective in the treatment of vaginismus as it’s not possible to perform a localized massage of the vaginal anatomy including the vaginal walls as well as the minor and major labia, introitus, clitoris and perineum.
How to treat vaginismus with Capenergy
According to the type of patient and the resistance offered to digital vaginal examination of the area or the introduction of any type of dilator, CAPENERGY allows external application of its technology during the first sessions (1 to 3), positioning the so-called automatic plates on the mons pubis while externally applying the manual capacitive electrode, bordering the vaginal entrance.
Furthermore, the vascularization effect of the area and the emission of radiofrequency is effective as it already stimulates muscular relaxation and improves irrigation and lubrication. The stimulation of body awareness and the pedagogical support of the physiotherapist furthermore help the patient overcome the next treatment steps.
For a more global treatment, it is also possible to position the plates on the suprarenal glands, in charge of cortisol regulation. One can also work with cross fires (capacitive and resistive electrodes at the same time), massaging the paravertebral muscles where the sympathetic lymph node chain is located.
In the same way, we can also perform cross fires to relax the diaphragm, a muscle very much linked to the pelvic floor.
Through this indirect approach, we can later on move to a direct treatment of the pelvic floor. From the 4th or 5th session on, it will in all likelihood be possible to perform a combined action with the intracavitary MJS probe consisting of a gentle massage of the vaginal cavity in order to relax the muscles and performing a ‘pain-free’ intracavitary treatment.
On average, the treatment of vaginismus will require a minimum of 8 to 10 sessions (according to pathology / patient). This treatment has a biological effect that gives the patient a sense of recovery of its pelvic floor anatomy and functionality, as the mucosa becomes more hydrated and the muscles completely relax. From this point on, the patient can continue doing exercise and external stimulation to further improve this relaxation and vaginal dilation.
It is important to always accompany the treatment with a correct evaluation of the progress, so both the physiotherapist and the patient have an objective idea of how the muscle tone is evolving. The electromyography is the ideal instrument for the registration of these changes of the basal muscle tone. This tone will start with a high value and during the course of the treatment we will see how it gradually goes down until reaching values close to 0.
Finally, it is also important to complement radiofrequency treatment with other techniques the patient can use autonomously, as for instance the application of gentle and sustained vibration in the perineal area, the use of dilators of gradually larger sizes, breathing techniques or mindful relaxation. The rejection effect to physical contact or pain will no longer exist, as the goal of muscle relaxation has already been met.
CAPENERGY C500’s technology is an innovative advance for pelvic floor professionals and specialized physiotherapy focused on vaginismus, thanks to the efficiency of the treatment and the short-term results, enabling a natural and biological recovery of the vaginal anatomy through the extracavitary and intracavitary vascularization of the tissues.
It is a painless and non invasive treatment even when penetration is involved, considering its a gradual and progressive process enabled through external automatic treatments that increase the patient’s confidence and trust. It has nothing to do with the injection of drugs which is perceived as a very painful procedure by the patient, with questionable results in time as it does not generate a biological response nor long lasting internal muscular or cellular regeneration.
The treatment with CAPENERGY C500 also increase the possibility of pregnanct after the treatment of vaginismus or vulvodynia. Not only because of the recovery of vaginal stimulation but also because of the improvement of blood flow and cellular stimulation received by the area which facilitates the implantation of the fertilised ovum. There are therefore more benefits for the patient in comparison to other stimulating techniques that only have localized or external effects.
Capenergy’s patented intracavitary MJS probe has been designed specifically for this type of treatments as well as other pelvic floor pathologies such as chronic pelvic pain caused by endometriosis, episiotomies, fibrosis or pelvic pain in general.
CAPENERGY’s innovative technology is therefore a great therapeutic alternative for physiotherapists, specialized professionals and gynecologists.
Would you like to know more about Capenergy’s tecar therapy and how it can help you in the treatment of vaginismus? Request a free demo.