An estimated 40% of women experience some type of sexual dysfunction, including pain and difficulty reaching orgasm. Three common types of sexual dysfunction are vaginismus, dyspareunia, and anorgasmia. Living with these issues may be frustrating and upsetting, and understanding their common causes and treatments is a vital step in finding sexual satisfaction.
Vaginismus
Vaginismus is a persistent involuntary tightening of vaginal muscles (pubococcygeus, or PC) that interferes with penetrative vaginal sex. For many people with vaginismus it can also be difficult to complete pelvic exams or to insert a tampon.
The cause of vaginismus is primarily psychological, but can also involve dysfunction with PC muscles. Many people develop vaginismus as a result of trauma or painful sexual experiences. Body image issues, feelings of shame or guilt regarding sex, and relationship problems can also lead to this type of dysfunction.
The good thing about vaginismus is that it is often easily and successfully treated. At home you can practice relaxation techniques such as calming breathing exercises. You can also purchase a set of dilators, which are smooth insertables that typically range from .5” to 1.25”. Practice using these in a comfortable environment, starting with the smallest size. Alternatively you could buy a few sex toys that you like in different sizes. Using lube is recommended as it can make penetration easier.
Some physical therapists are able to treat pelvic floor dysfunction including vaginismus. The therapy sessions include trigger point release, tissue manipulation, and biofeedback. The biofeedback helps you visualize the tightening and loosening of your PC muscles and helps you learn how to control and relax them. Some kegel exercisers like the Minna K-Goal utilize biofeedback too and are something you can use at home.
Dyspareunia
Dyspareunia is defined as recurrent genital pain associated with intercourse. Occasional genital pain is not unusual, but dyspareunia is pain that occurs consistently.
Dyspareunia has many causes, some of which can be difficult to identify. It is advisable to speak to your doctor if you're experiencing pain with intercourse, especially since it may be caused by infection or other medical conditions including endometriosis, ovarian cysts, and uterine fibroids. Sometimes dyspareunia is a result of vaginismus or weak PC muscles, of a lack of lubrication. Occasionally the cause is anatomical, such as an obstructed or thickened hymen, or constrictive clitoral hood.
Since there is a wide range of underlying causes, there are of course many different treatments. Alleviating genital pain can be as simple as using lubrication, or using lube that works better for your body. In cases when genital pain is related to vaginismus or weak PC muscles, kegel exercises and physical therapy can be beneficial. In the case of anatomical or medical causes, a doctor can assist you with addressing these issues using medication or other means.
Anorgasmia
Also known as female orgasmic disorder, anorgasmia is an inability to achieve orgasm during prolonged genital stimulation.
For some people, difficulty reaching orgasm can be a matter of inexperience -- particularly with self touch. A lack of familiarity with one's own body and preferences can make it difficult to provide the right kind of stimulation to achieve orgasm. If you don't know what feels pleasurable for yourself, partners will have a hard time knowing what makes you feel good too. Masturbating and getting to know your body, trying different things and maybe incorporating toys, can help you learn what feels most satisfying.
Sometimes the cause is related to misinformation or unrealistic expectations, especially ones related to orgasm with penetration. For example, many people believe it is easy for women to orgasm from vaginal penetration alone, but this isn't true for a majority of people. If you're not orgasming when you have penetrative sex, that's completely normal! Clitoral stimulation, whether with fingers or toys or using the coital alignment technique, is usually necessary. Again, trying different things and using sex toys can help reach orgasm during sex.
Anorgasmia can have psychological causes as well, including feelings of shame or guilt, depression, anxiety or stress, poor body image, past trauma, relationship problems, etc. Mental health or sex therapy to address these issues can be beneficial.
Medication, especially anti-depressants, may interfere with ability to orgasm. It is important to discuss potential side effects with your doctor. Use of alcohol or other drugs can effect this as well, and decreasing or stopping the use of these can lead to an ability to orgasm again.
By: April
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