Overcoming Vaginismus During Menopause

Vaginismus is a common condition during menopause that can cause painful sex. Treating it may require medication, therapy, or lifestyle changes.

Vaginismus: A Most Challenging Problem

Women who have vaginismus have to deal with intense and involuntary muscle spasms of the vagina. This makes intercourse painful and even potentially impossible, and it can affect a woman’s self-esteem, sex life and health. Vaginismus can be caused by a variety of issues, including injury, trauma, infection or hormonal changes.

Since hormonal shifts can be a trigger for vaginismus, it is a common problem among menopausal women. If you wish to seek treatment for vaginismus, there are many potential options open to you.

Late-Onset Vaginismus May Be More Common Than You Think

There is often a stereotype around vaginismus that makes people think you notice it the first time you have sex. However, not every case of vaginismus involves a woman trying to lose her virginity and being shocked by sudden, intense pain. Many women with vaginismus have actually been enjoying sex comfortably for years, so they are baffled when they suddenly start experiencing painful sex.

Roughly four percent of all women with vaginismus are over the age of 51, so hundreds of women deal with this issue. Over half of all menopausal women report feeling at least some discomfort during sex.

The Link Between Menopause and Vaginismus

Vaginismus is an incredibly complex subject, so there can be more than one issue causing it to occur. It occurs right around the time a woman becomes premenopausal because hormonal changes affect the vagina. The vagina becomes drier, which makes sex more difficult in general.

Menopausal women are more likely to deal with vaginal tears, urinary tract infections and other vaginal health problems that can sometimes trigger vaginismus. It is important to remember that vaginismus also has a mental component. Women may begin to associate intercourse with pain, insecurity or discomfort, so they might begin to instinctively tense up before sex. This can just lead to further issues and continue to worsen the vaginismus.

What You Can Do to Address Menopausal Vaginismus

There is a range of treatments available for women dealing with menopausal vaginismus. You may want to talk to your doctor about one or more of the following options :

• Vaginal Dilation Training – This is a process that involves gradually stretching out the vaginal muscles and getting used to the sensation of dilation without pain. The process starts by your simply touching the area as close to the vagina as you can get without experiencing pain, and then you move on to penetration with a small device. Over time, you will gradually increase the size of the dilators and the time of insertion until you can comfortably build up to penetration without pain. Your gynecologist or a sex therapist will typically be the one to recommend this method, but you normally do it at home.
• Pelvic Floor Exercises – The muscles of the pelvic floor are the muscles that help to control contractions and movements in the vagina. Your doctor may recommend that you practice Kegel exercises to improve your control over the vaginal muscles. Even though they strengthen the muscles that cause the problem, these exercises are important for treating vaginismus because they help you to intentionally relax the muscles.
• Counseling – Getting used to your changing body takes a lot of time and effort, so it can be helpful to have someone who can counsel you through this tough time. Therapists can help you change the way you think about yourself, your body and sexual intercourse, and this can greatly help with working through some of the causes of vaginismus. It may be particularly useful to have couples counseling or sex therapy classes with your partner so that you can discuss the issue together.
• Hormone Replacement Therapy – Hormone replacement therapy works to provide you with artificial forms of the estrogen that you lose when you start menopause. This can be in the form of a pill you take daily, or it might be a cream that you apply every now and then. It helps to alleviate many menopausal symptoms, including the vaginal dryness that may be contributing to vaginismus. Talk to your doctor to see if this option may work for you.