Treatment of vaginismus ### What is vaginismus? Vaginismus is a condition in which the muscles around the vagina contract unconsciously when trying to penetrate. This problem not only prevents sex, but it can also make it difficult for women to have examinations or use tampons. ### Why does vaginismus occur? Several reasons can contribute to this disorder: - **Fear of pain or bleeding** in the first sex - **Anxiety and mental stress** - **past negative experiences** (such as abuse or sexual violence) - **False beliefs about sex** - **Physical factors** such as frequent infections or vaginal dryness ### Complete methods of treating vaginismus; Reaching a relationship without pain #### Step 1: Education and Awareness - Getting to know the anatomy of the female body and sexual cycle. - Correcting misconceptions and reducing the fear of penetration. - Using books, educational videos and expert advice. #### Step 2: Relax and reduce anxiety - **Diaphragm breathing exercise:** Inhale for 4 seconds, exhale for 6 seconds. - **Progressive relaxation:** contracting and then relaxing the muscles from head to toe. Mindfulness meditation: focusing on the present moment and reducing negative thoughts. #### Step 3: Reverse Kegel exercises (relaxing the pelvic floor muscles) - While sitting or lying down, imagine releasing the flow of urine or stomach gas. - This exercise should be done 2 to 3 times a day and 10 repetitions each time. - Goal: the patient learns to control the muscles. #### Step 4: Treatment of tactile vaginismus and gradual exposure - First, touching the external area of the vagina by the person himself. - Then touching with a finger (first superficial, then a little deeper). - In the next stages, use of lubricating gel and gradual entry. - This stage should be calm, unhurried and accompanied by a sense of security. #### Step 5: Using a vaginal dilator - Starting with the smallest dilator size and holding it for 5 to 10 minutes. - Going to a bigger size after getting used to it. - The combination of this exercise with deep breathing and reverse kegel is very effective. #### Step 6: Joint exercises with spouse - **Sensate Focus:** Non-sexual touch like massage or hug, to increase intimacy. - Inserting the dilator or finger by the wife in the next steps, with coordination and calmness. - attempt to penetrate only after the complete success of the previous steps. #### Step 7: Pelvic floor physiotherapy - **Biofeedback:** The patient sees on the monitor when the muscles contract or relax. - **Massage or mild electrical stimulation:** To reduce muscle spasms. - In resistant cases, it is necessary to see a physiotherapist specializing in gynecology. ### Vaginismus treatment steps table (practical guide) ### Frequently Asked Questions **1. Is vaginismus always curable?** Yes, in most cases it is treated with non-drug methods and regular exercises. **2. Is the treatment painful?** No, the goal of treatment is to reduce pain and create a pleasurable relationship. The exercises are done gradually and without forcing. **3. What should be done if the treatment does not work?** In resistant cases, pelvic floor physiotherapy or a combination of advanced psychological treatments are recommended. **4. Should the spouse participate in the treatment process?** Yes, spousal support is very important, and without it, the chances of treatment failure increase. ### Summary Vaginismus is a common but completely treatable disorder. With training, relaxation exercises, reverse kegel, dilator and support of the spouse, you can reach a **painless and enjoyable relationship**. ✍️ This article has been prepared with the scientific guidance of **Dr. Zahidaran**, consultant and therapist of sexual disorders Dr. Ansieh Khodgaran Khamse **Obstetrics and Gynecology Specialist and Female Cosmetic Surgeon** **Master Course in Female Cosmetic Surgery from Europe** **Consultation and examination of pregnancy, women's diseases and infertility** More than 12 years of experience in the field of female cosmetic surgeries and performing more than 2000 successful female cosmetic surgeries, including labiaplasty, perinoplasty, vaginoplasty, and gel and fat injection to the bikini area. Call 09028477793 for advice