Vaginismus

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Vaginismus is a sexual disorder that is characterized by the outer third of the vaginal muscles tightening, often painfully. A woman with vaginismus does not willfully or intentionally contract her vaginal muscles. However, when the vagina is going to be penetrated, the muscles tighten spontaneously due to psychological or other reasons.

Vaginismus can occur under different circumstances. It can begin the first time vaginal penetration is attempted. This is known as “lifelong vaginismus.” Alternately, vaginismus can begin after a period of normal sexual functioning. This is known as “acquired-type vaginismus”. For some women, vaginal tightening occurs in all situations where vaginal penetration is attempted (generalised type). For other women, it occurs in only one or a few situations, such as during a gynecological examination at the doctor’s office, or with a specific sex partner.

Causes

There are many possible causes of vaginismus. One example is an upbringing in which sex was considered wrong or sinful—as in the case of some strict religious backgrounds. This is common among women with this disorder. Concern that penetration is going to be painful, such as during a first sexual experience, is another possible cause. It is also thought that women who feel threatened or powerless in their relationship may subconsciously use this tightening of the vaginal muscles as a defense or silent objection to the relationship. A traumatic childhood experience, such as sexual molestation, is thought to be a possible cause of vaginismus and acquired-type vaginismus is often the result of sexual assault or rape.

Symptoms

Vaginismus can occur when any kind of penetration of the vagina is attempted. This includes attempted penetration by a penis, speculum, tampon, or other objects. The outer third of the vaginal muscles contract severely. This either prevents penetration completely, or makes it difficult and painful. The woman may truly believe that she wants to have sexual intercourse or allow the penetration, but that her subconscious desires or decisions do not allow her to relax the vaginal muscles.

Treatment – Psychotherapy

There are three settings in which psychological treatment can occur. These are in individual, couple, or group settings. During individual therapy, the treatment focuses on identifying and resolving any underlying psychological problems that could be causing the disorder. Problems stemming from issues such as childhood trauma or rape are often resolved this way. Revealing insecurities or fears about sex resulting from such things as parents’ attitudes about it, or a religious upbringing, can often be discussed successfully if the affected woman can trust her therapist.

Couples therapy is often used as treatment for sexual disorders, the idea behind couples therapy is that any sexual problem should be treated as a problem for the couple as a whole, and not just addressed as a problem for one person. Because this view is taken, the therapist interacts with the patients both separately and as a couple. The therapist addresses both the couple’s sexual history and any other problems that may be occurring in the relationship. Confronting these problems may help to resolve the cause of the vaginismus. Working with a therapist on relationship problems can be very effective— perhaps especially so if the vaginismus is caused by a subconscious use of vaginal muscle spasms as a nonverbal form of protest about one or more aspects of the relationship. The couple is educated about vaginismus disorder and given advice on the kind of activities that can be engaged in at home that may be helpful in overcoming the disorder.

Group therapy, which can be very effective, is another form of therapy for vaginismus. In this form of therapy, couples or individuals who have the same or similar sexual disorders are brought together. For people who are embarrassed or ashamed of their disorder, this setting can provide comfort and strength. It is often very beneficial to witness another person discussing sex and sexual problems in an open and honest forum. It can also help to inspire patients to become more open and honest themselves

Male rape and sexual abuse

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What is male sexual assault?
Male sexual assault is when you have been forced to take part in any sexual act with another man or woman which you did not willingly consent to. Even if you did not resist or fight back at the time of the attack, it is still assault.

Who can it happen to?
Quite simply, anyone. It could have happened to you whilst you were a child or a teenager, or as an adult. It is not a ‘gay crime’ – it happens to more straight men than gay men.

Who are the perpetrators?
Again, it could be anyone – male or female. But the facts show that more men were abused from within the family than outside, and more men were raped by people they knew rather than strangers.

How common is it?
It’s much more common than most people think. Research statistics tell us that almost 3% of men reported a non-consensual sexual experience as adults and over 5% of men reported sexual abuse as a child.

Is it a crime?
In England there were changes to the 1956 Sexual Offences act in 1994 which made the rape of a man an equal crime to rape of a woman. Further updates to the Sexual Offences act in 2004 mean that the different types of sexual assault that men can experiences have been defined.

What kind of effects can male survivors experience?
It varies from individual to individual, but common effects include; feelings of isolation, depression, anger, anxiety, issues about sexuality and gender, substance abuse, self-harm, eating disorders, negative body image, fears about abusing, hyperconsciousness of body and appearance,  PTSD/C-PTSD and DID.

Who else is affected?
The psychological and mental health issues which survivors often experience, can also lead to real problems with relationships. So anyone who shares his life, be it partner, friend or family, can be affected.

Why is male rape and sexual abuse such a taboo subject?
Firstly, few people even realise that male rape exists. So a man who is trying to come to terms with sexual assault can feel like there is nowhere to turn. But secondly, society itself places certain expectations on men – they are supposed to be “strong” and “able to take care of themselves”. This only heightens the sense of confusion and self-doubt felt by survivors of male rape and sexual abuse; many of them end up blaming themselves.

Why do so many men suffer in silence?
Because of our society’s taboo about male rape and sexual assault it is rare that a victim will go to the police or seek immediate help – on the contrary, he will often be as desperate to keep it a secret as his attacker is. As well as the trauma and feelings of shame, many of our clients face the difficulties of people’s attitudes to male rape and abuse.

For more information on male rape see here