Firstly, talking about vaginismus, a depressed woman comes to mind. It is not only the cyclical changes in physiological and psychological terms that women have to endure and become resilient. Women also need to change to external circumstances. Hence, they are probably designed to be flexible enough for change. However, depression can get the better of even the so-called toughest woman. The good news is that it is something that Psychiatrists can treat to the fullest degree. Among the various symptoms of depression that are easily modified with medications, sexual symptoms are rarely discussed. However, one symptom rarely discussed is sexual problems or disinterest due especially to physical causes resulting in depression.
A specific sexual disturbance, especially during the initiation of first sexual contact or encounter, is dyspareunia. The female version of which is vaginismus, which could be more common in depressed women. Various successful vaginismus treatments do not require interventions. These include medications, surgical operations, psychotherapeutic measures, nor any other complex interventional procedures.
Vaginismus is treatable and the success rates are quite high.
Among the most effective treatment approaches in depressed women with vaginismus is pelvic floor control exercises, commonly known as kegel exercises. This, along with insertion or dilation training using objects specific to the sexual treatment procedures, is helpful. Resulting in pain elimination techniques using psychotherapeutic measures like exposure and response prevention is helpful. Likewise, transition steps with incremental tolerance to pain and enjoyment of the act are taught. Also, exercises designed to help women identify, express, and resolve any contributing emotional components are helpful. They either are from past experiences or from ill-informed sexual learning experiences, which are mostly hearsay.
Women can do their treatments in the comfort of their homes. Thus, allowing a woman to work at her own pace in privacy or cooperation with her health care provider. The sexual pain, tightness, and penetration difficulties due to vaginismus in depressed women are completely treatable. In addition, they fully overcome any remaining pain or discomfort with time.
Women experiencing pain or tightness during sexual activities can expect great benefits. However, if the pain is associated with penile penetration problems, including unconsummated relationships, they can expect a high degree of resolution of vaginismus. This is true even in depressed women. This would allow for full pain-free and adequate intercourse to the satisfaction of both partners.
Vaginismus treatment in depressed women and exercises follow a manageable, step-by-step process ~
Step 1 –
Understanding Vaginismus. Step 1 provides an overview of vaginismus and how symptoms can arise from it. Symptoms include sexual pain, tightness, burning sensations, or penetration difficulties that may result from it. Women start their sexual endeavors with this approach. The women become proactive about their sexual health. This is because understanding vaginismus is fundamental to the process of overcoming it. Topics also include obtaining a solid diagnosis, treatment methods, relationship issues, pelvic/relaxation techniques, conditioned responses, and muscle memories.
Step 2 –
Sexual History Review & Treatment Strategies. A balanced approach helps women review and analyze their history. Exercises help identify and evaluate any events, emotions, or triggers contributing to vaginismus sexual pain or penetration problems. Checklists and detailed exercises map out a woman’s sexual history and pelvic pain events, working toward appropriate treatment strategies. Emotional reviews help detail any negative events, feelings, or memories that may collectively contribute to involuntary pelvic responses. Topics also include blocked or hidden memories. In addition, how to move forward when there have been traumatic events in a woman’s past.
Step 3 –
Sexual Pain Anatomy. Women often lack complete information about their body’s sexual anatomy, function, and the causes of pelvic pain and penetration problems. Confusion regarding problems with inner vaginal areas and vaginal muscles frequently leads to misdiagnosis and frustration. Step 3 educates about these sexual body parts, emphasizing their role in sexual pain and penetration issues. Topics include how to distinguish what kind of pain or discomfort is normal with first-time or ongoing sex. Also, what physical changes occur during arousal to orgasm cycles in the context of sexual pain or penetration problems. In this step, explanations about the Anatomy areas such as the hymen and inner vulva. These areas are demystified (for example, there are six diagrams of hymen varieties to help distinguish hymen problems).
Step 4 –
Vaginal Tightness & The Role Of Pelvic Floor Muscles. Female sexual pain and penetration difficulties typically involve some degree of involuntary tightening of the pelvic floor. This step focuses on the role of pelvic floor muscles, especially the pubococcygeus (PC) muscle group. This explains in great detail how triggering the PC once continues their involuntary tightness. This continues with increasing attempts at intercourse. Effective vaginismus treatment focuses on retraining the pelvic floor to eliminate involuntary muscle reactions that produce tightness or pain. Learning how to identify, selectively control, exercise and retrain the pelvic muscles is a trick. This is to reduce pain and alleviate penetration tightness and difficulties is an important step in vaginismus treatment.
Step 5 –
Insertion Techniques. Allowing initial entry without pain for women with painful penetration is the purpose of this technique. In this step, women practice pubococcygeus (PC) muscle control techniques. Women allow the entry of a small object (cotton swab, tampon, or finger) into their vagina. Thus, gradually working completely under their control and pace. The step helps in any previous closure of the entrance to the vagina and prevention of penetration by involuntary muscle contractions. Women begin to take full control over their pelvic floor. They subsequently learn how to flex and relax the pelvic floor at will, eliminating unwanted tightness and allowing entry.
Step 6 –
Graduated Vaginal Insertions: However, when used properly, vaginal dilators are effective tools to help further eliminate pelvic tightness due to vaginismus. Also, dilators provide a substitute means to trigger pelvic muscle reactions. Thus, the effective dilator exercises in Step 6 teach women certain techniques. However, these include overriding involuntary contractions and relaxing the pelvic floor to respond correctly to sexual penetration. Subsequently, graduated vaginal insertion exercises allow women to transition comfortably. Hence, this is to set the stage where they are ready for intercourse without pain or discomfort.
Step 7 –
Sensate Focus & Techniques For Couples To Reduce Pelvic Floor Tension. Helping with the transition to pain-free intercourse, this step explains sensate focus techniques. This is for couples to use to reduce pelvic floor tension and increase intimacy. Couples begin to work together during this step as exercises teach how to practice sensate focus (controlled sensual touch) successfully. In addition, they prepare for pain-free intercourse using techniques from earlier steps. The exercises build trust and understanding. In addition, they assist in the process of adjusting to controlled intercourse without pain.
Step 8 –
Pre-Intercourse Readiness Exercises Finalizing preparations for couples to transition to fully pain-free intercourse, this step completes pre-intercourse readiness—couples review and practice techniques that eliminate pelvic floor tension and prepare to transition to full intercourse. Preparing ahead of time is the key to this step. This is to manage, control, and eliminate pain or penetration difficulties. Hence, the exercises assist with the final transition to pain-free intercourse.
Step 9 –
Making The Transition To Intercourse. Step 9 explains the techniques used to eliminate pain and penetration difficulties while transitioning to normal intercourse. This section includes many troubleshooting topics of great use. Examples include, such as positions to use to maximize control and minimize pain, tips to ensure more comfortable intercourse, etc.
Step 10 –
Full Pain-Free Intercourse & Pleasure Restoration. The final step toward overcoming vaginismus includes penis entry with movement and freedom from any pain or tightness. To educate, build sexual trust and intimacy are the goals of Step 10. They help complete the transition to full sexual intercourse free of pain. Couples can begin to enjoy pleasure with intercourse, initiate family planning, and move forward to live a life free from vaginismus.