Emergency Contraceptive Pill

Emergency contraceptive pill

An emergency contraceptive pill is a safe and easy way to prevent an unintended pregnancy from occurring after unprotected sex or contraceptive failure.

I-Pill

I-Pill is an emergency contraceptive pill manufactured by Cipla. A single dose of I-Pill provides a safe and easy way to prevent an unintended pregnancy after unprotected sex or contraceptive failure.

Appropriate time to use I-Pill

If you have had unprotected sex and want to prevent a pregnancy, you should take I-Pill as soon as possible, preferably within 12 hours and no later than 72 hours of unprotected intercourse.

I-Pill is useful as a backup birth control method under following circumstances:

  • Contraceptive failure
  • Unprotected sex
  • Improper use of your regular birth control method
  • Forced sex

Directions for using I-Pill

I-Pill is a single dose tablet to be taken orally. It should be swallowed with some water after a meal. I-Pill should be taken as early as possible and not later than 72 hours of unprotected sex or contraceptive failure.

Inappropriate time to use I-Pill

I-Pill will not work if you are already pregnant because it is only a backup or emergency method of contraception. It is not a substitute for regular contraceptive methods. I-Pill will not be effective if taken 72 hours after unprotected sex.

I-Pill is not recommended if you are allergic to levonorgestrel, which is the name of the medicine in I-Pill

I-Pill Users

I-Pill can be used by any woman of childbearing age and is facing the prospect of an unintended pregnancy due to absence or failure to use a contraceptive. It can also be used in the case of rape or forced sex

Premature Ejaculation

Doctor consultation before taking I-Pill

A medical check-up is not required for taking I-Pill. However, if you are suffering from any serious ailment or have a known allergy to levonorgestrel, it is advisable to consult your doctor.

I-Pill Action

I-Pill can work in any of three different ways depending on where you may be in your menstrual cycle.

  • It may stop an egg being released from the ovary.
  • If an egg has been released, I-Pill may prevent the sperm from fertilizing it.
  • If the egg is already fertilized, it may prevent it from attaching itself to the lining of the womb.

It is important to note that pregnancy is established only after the fertilized egg attaches itself to the womb.

I-Pill is ineffective if the pregnancy is established (i.e. the fertilized egg has attached itself to the womb). It is therefore not an abortion pill.

How is an emergency contraceptive pill' different from an 'abortion pill'?

In medical terms pregnancy begins once the fertilized egg gets attached to the lining of the womb.

Abortion pills contain drugs known as antiprogestins, which stop the development of a pregnancy after it has occurred.

On the other hand, emergency contraceptive pills like I-Pill, which contain common female hormones prevent pregnancy in the first place and so do not cause an abortion.

Am I Pregnant?

Best results from I-Pill

I-Pill works best when used as early as possible after unprotected sex or contraceptive failure, but not later than 72 hours.

I-Pill Effectiveness

The sooner you use I-Pill, the more effective it is. It is 95% effective within 24 hours of unprotected sex, 85% between 25 - 48 hours and 58% if taken between 49 - 72 hours. But if your periods are delayed by more than a week, you should go in for a pregnancy test and contact your doctor.

Side effects of I-Pill

I-Pill has no long-term or serious side effects, and is safe to use for almost every woman.

Nausea, vomiting and headache are some common side effects after taking I-Pill. You might also have some lower abdominal pain or find your breasts more tender than usual. All this should stop within a day or two. There are chances of unexpected vaginal bleeding, but this is not dangerous and should clear up by the time you have your next period. I-Pill might also cause your next period to come early or later than normal. But if your periods are delayed by more than a week, you should go in for a pregnancy test and contact your doctor. I-Pill will have no lasting effect that may complicate future (and wanted) pregnancies.

I-Pill is not recommended if you are allergic to levonorgestrel, which is the name of the medicine in I-Pill.

Warnings before use of I-Pill

You need to know the following things before taking I-Pill:

  • I-Pill works best when used as early as possible after unprotected sex or contraceptive failure, but not later than 72 hours.
  • I-Pill is ineffective if you are already pregnant.
  • It should also not be used as a regular birth control method.
  • I-Pill does not offer protection against HIV/AIDS or other Sexually Transmitted Diseases (STDs)

How will I know if I-Pill worked?

There is no concrete evidence or symptoms to know whether I-Pill worked or not. After taking I-Pill you need to wait and anticipate your next menstrual period at the expected time or within a week of the expected time. In case your menstrual period is delayed beyond one week, it is advisable to get a pregnancy test and consult your doctor.

I-Pill and regular birth control

No. I-Pill is not recommended for regular birth control. It is effective when used as a backup method after unprotected sex or contraceptive failure. Make sure you do not replace your regular birth control pill with I-Pill.

What is vaginismus?

I-Pill usage Frequency

I-Pill can be used more than once in a cycle but it is recommended only as an emergency contraceptive.

There are several reasons why I-Pill is not a logical choice for regular contraception:

  • Any method of regular contraception is more effective than repeated use of an EC
  • Long-term overuse can cause irregular menstrual cycles

It can cause annoying side effects like nausea and vomiting

Make sure you continue to use regular methods of contraception for preventing unintended pregnancies.

I am already pregnant

I-Pill does not work if you are already pregnant. If you take I-Pill while you are already pregnant, there will be no harm to you or your fetus.

If my menstrual period is delayed beyond one week

Under such circumstances it is essential you consult your doctor immediately since this may require immediate medical attention.

Periods after I-Pill

Your next period should come on time but it may be a few days early or a few days late. However, in case your period is delayed by more than a week, please go in for a pregnancy test and contact your doctor.

I-Pill and breast-feeding

I-Pill is safe during breast-feeding. Using I-Pill is unlikely to have any significant effect on milk quality that can affect the infant adversely.

Emergency contraception failur

If you wish to do so, you can continue with your pregnancy. The medicine used in I-Pill will not cause any harm to you or your baby. In case you do not wish to continue your pregnancy, please consult your doctor.

I-Pill availability

I-Pill is available over the counter at your local chemist outlet. You do not need a doctor's prescription to buy I-Pill.

Premature Ejaculation

Definition

Premature ejaculation occurs when a man orgasms during intercourse sooner than he or his partner wishes.

Causes

Premature ejaculation is a common complaint. It is only rarely caused by a physical or structural problem.

Premature ejaculation early in a relationship is most often caused by anxiety and overstimulation. Other psychological factors such as guilt may also be relevant. The condition usually improves without formal treatment.

Symptoms

Ejaculation happens before the individual or couple would like (prematurely). This may range from before penetration to a point just after penetration, and may leave the couple feeling unsatisfied.

Exams and Tests

Abnormal findings are unlikely to be associated with the condition. Useful information is more likely to be obtained from interviewing the person or the couple.

Treatment

In general, practice and relaxation will help you deal with the problem. Some men try to distract themselves by thinking non-sexual thoughts (such as naming baseball players and records) to avoid becoming excited too fast.

Some helpful techniques include the following:

The "stop and start" method:

  • This technique involves sexual stimulation until the man recognizes that he is about to ejaculate. The stimulation is then removed for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.

The "squeeze" method:

  • This technique involves sexual stimulation until the man recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds, withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.

Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because they have a common side effect of prolonging the time it takes to achieve ejaculation.

Local anesthetic creams may be applied to the penis to decrease stimulation. Decreased feeling in the penis may prolong the time before ejaculation. Condom use may also have this effect for some men.

Evaluation by a sex therapist, psychologist, or psychiatrist may be helpful for some couples.

Outlook (Prognosis)

In most cases, the man is able to learn ejaculatory control through education and practice of the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression, both of which could be helped by psychiatric intervention.

Possible Complications

  • Very early ejaculation, occurring prior to entry into the vagina, may prohibit a desired pregnancy.
  • A continued lack of ejaculatory control may lead to sexual dissatisfaction on the part of either or both partners and may be a factor in sexual tension or discord in the relationship.

When to Contact a Medical Professional

Call for an appointment with your health care provider if premature ejaculation is causing a problem and does not respond to techniques such as those described above.

Prevention

There is no prevention for this disorder, though relaxation can reduce the likelihood of its occurrence.

Vaginismus Diagnosis & Tests

Women often suspect they have vaginismus from their symptoms. Medical diagnosis is typically determined by gynecological exam to rule out the possibility of other conditions and patient history.

Quick diagnosis chart - common manifestations of vaginismus

Strong indicators of vaginismus include any of the following

Difficult penetration or impossible intercourse / unconsummated couples

Female penetration problems and unconsummated marriages are typically due to vaginismus. Entry tightness and pain are common symptoms of vaginismus.

Ongoing sexual pain after a pelvic problem, medical issue, or surgery

The experience of ongoing sexual pain or tightness after resolving or managing a pelvic medical or pain issue is typically due to vaginismus.

Ongoing sexual pain after childbirth

The experience of ongoing sexual pain or tightness following childbirth (after everything has healed) is typically due to secondary vaginismus.

Ongoing sexual pain and tightness with no discernible physical cause

Vaginismus often occurs only during sex attempts. Physicians may initially be unable to find any problem or cause for the sexual difficulties.

Avoidance of sex due to pain and/or failure

When a woman states that she avoids being intimate with her husband because sex does not feel good or has become very painful, vaginismus should be strongly considered.

Is there a simple medical test I can take that would tell me if I have vaginismus?

What is vaginismus?

There is no medical test that can be taken to confirm the vaginismus condition. Vaginismus is diagnosed through patient history and description of problem/pain, and gynecological examination to rule out the possibility of other conditions.

The medical diagnosis of vaginismus

Women often suspect they have vaginismus from their symptoms, but getting medical confirmation can be challenging. Confirming a formal diagnosis of vaginismus may take some planning and perseverance. No definitive medical test exists for the diagnosis of vaginismus so it may take a number of visits to several physicians or specialists before a medical diagnosis is obtained. When physicians are initially unable to find any specific medical problem (a common experience of vaginismus sufferers), no diagnosis or misdiagnosis is a common outcome of initial medical exams. Many physicians are unfamiliar with vaginismus, so part of the process is simply finding a physician that is knowledgeable about the condition. A successful medical diagnosis of vaginismus is typically determined through patient history and description of the problem, gynecological examination and the process of ruling out the possibility of other conditions.

Talking to physicians about sexual problems can be difficult. Embarrassment, shame and anxiety are often present, making it hard to communicate and obtain appropriate care. Women may need to strongly advocate for themselves, insisting on a full diagnosis from a knowledgeable professional to rule out any other medical condition and properly confirm the vaginismus diagnosis. A medical diagnosis is helpful in removing any doubts or anxiety related to identifying the condition and enables women to have more confidence in moving toward treatment solutions.

Could this be related to vaginismus?

Vaginismus may impede orgasm in some cases.

The inability to achieve orgasm may relate to vaginismus. In some cases, vaginismus impedes orgasm through blocking penetrative intercourse or by causing pain during thrusting. Although vaginal penetration is not necessary in order to achieve orgasm, if the body reacts to stimulation by triggering the vaginismus response, the tightened pelvic floor may abruptly end arousal and even impair the ability to achieve orgasm manually. Also, any emotional issues contributing to the vaginismus response could also be impairing relaxation and the ability of a woman to allow the arousal cycle buildup to orgasm. For example, some women have anxieties related to being naked or vulnerable, and this could impair their ability to become aroused to the point of orgasm. Note that this is not universal. Many women with vaginismus have no trouble at all achieving orgasm.

Finding solutions to achieve orgasm

A systematic approach to problems with orgasm are helpful, as there are many reasons why orgasm difficulty could be taking place. Women are encouraged to try to determine the nature of the difficulty with orgasm, if it is related to any emotions, anxiety, physical pain, or medication use. The self-help sexual history inventory in Step 2 of the vaginismus program may be helpful to identify any specific sexual fears or emotions that could be contributing to the problem.

Vaginismus Diagnosis & Tests

If the vaginismus response is preventing orgasm, women may wish to try eliminating anything that could potentially trigger the pelvic floor tightening response, especially any perceived potential of intercourse. Most women with vaginismus (whether or not penetration is possible) are still able to have manual or non-penetrative orgasms, while they continue working to overcome vaginismus. Later, when pain-free intercourse becomes a reality, transition time for practice and experimentation may be necessary to achieve intercourse accompanied with orgasm. After pain-free intercourse is proceeding, some women may continue to prefer to have orgasms separate from penetrative intercourse during other phases of lovemaking. Not all women are able to have orgasms during intercourse even when vaginismus is not present. Only approximately one-third of women experience orgasm routinely during intercourse.

Finally, if the problem is unrelated to vaginismus, couples may want to read up on the subject to learn better techniques at lovemaking. There are many books on sex and intimacy that discuss orgasm issues and techniques to help achieve orgasm.

What is dyspareunia? What is the connection between dyspareunia and vaginismus?


Any type of dyspareunia (general sex pain) may trigger vaginismus (ongoing sex pain or penetration problem from involuntary vaginal tightness).

Dyspareunia

Dyspareunia is a medical term that simply means ‘painful intercourse’. It is a general term used to describe all types of sexual pain. Sexual pain may occur upon penetration, during intercourse, and/or following intercourse. It can exist anywhere in the genital area - the clitoris, labia, or vagina, etc. The pain may be described as sharp, stinging, burning, bumping, cramping or may be described in other ways.

The connection between dyspareunia and vaginismus

There are many causes of sexual pain (dyspareunia) and vaginismus is one of these. Vaginismus is uniquely characterized by involuntary tightness of the vagina due to the pubococcygeus (PC) muscles. With attempts at intercourse, vaginal tightness may cause sexual discomfort, sensations of burning, tightness, pain or inability to penetrate.

I can't seem to have orgasms. Could this be related to vaginismus?

Vaginismus is also closely related to any of the other forms of dyspareunia in that any type of general sex pain may trigger vaginismus. In these cases, vaginismus becomes a complicating discomfort or pain condition in addition to the original pain problem and typically remains even after the original problem is resolved or managed. A woman may, in fact, confuse the ongoing problems of vaginismus with the original pain problem, believing that the original problem is still unresolved.

“With any kind of sexual pain that is ongoing and seems to have no physical cause, vaginismus should be considered as a possible contributor or perhaps the primary cause.”

Diagnosing and treating sexual pain can become quite difficult when there are overlapping complications from vaginismus. It can be frustrating for both physicians and patients. Take for example, a woman who experienced a temporary infection (one form of dyspareunia) that triggered vaginismus. Perhaps by the time a visit is made to a physician the infection had resolved itself but the vaginismus remains. When the physician attempts to discover the source of the pain, there may seem to be no physical cause evident, since the patient continues to experience pain from vaginismus and no longer from the original infection. Moreover, the woman’s description of the pain may seem confusing since there was really two separate pain-causing issues at different times.

Where there are two forms of sexual pain present at the same time, and the second one is vaginismus, most specialists recommend treating the original medical condition first, and then taking the steps necessary to treat the vaginismus.

Caution: Surgeries and medical procedures have been thought necessary by physicians and their patients when in fact a simple case of vaginismus was present which could have been resolved without any invasive procedures. Patients should be careful to seek second opinions with physicians who are experienced in treating female sexual pain disorders, especially if they are contemplating invasive surgical treatment options. Vaginismus treatment does not normally involve surgery.

Possible causes of painful sex (dyspareunia)

There are many causes of sex pain:

  • Vulvodynia / Vestibulodynia (Vulvar Vestibulitis or Vestibulitis)
  • Pelvic Inflammatory Disease (PID)
  • Genital or Pelvic Tumors
  • Ovarian Cysts
  • Urethritis
  • Urinary Tract Infection
  • Interstitial Cystitis
  • Vaginal Atrophy (atrophic vaginitis)
  • Vaginal Dryness
  • Insufficient vaginal lubrication
  • Childbirth Trauma (postpartum)
  • Vulvar Cancer
  • Radiation Therapy
  • Vaginal Infections / Irritants - Yeast or bacterial, some STDs, etc.
  • Skin Conditions - Lichen Sclerosus, Lichen Planus, Eczema, Psoriasis
  • Side-effects to certain medications
  • Injury to the pelvic/genital area
  • Age-related symptoms associated with menopause and/or aging
  • Allergic reactions to clothing, condoms, contraceptive foams, and/or spermicides
  • Painful pelvic examination
  • Trauma due to sexual assault
  • Female Genital Mutilation (FGM)
  • Bartholin’s Cyst
  • Endometriosis
It is important to note that vaginismus can co-exist with the above conditions or continue to be present even after they have been resolved or managed.

How does vaginismus affect husbands or partners of women with vaginismus?


Sexual problems due to vaginismus can negatively affect all aspects of a relationship. Overcoming vaginismus together can deepen and strengthen couple bonds and bring needed restoration.

Although women experience the consequences of having vaginismus most acutely and directly, it is important to acknowledge that their partners will also experience a wide range of impacts. As the ordeal of untreated vaginismus drags on into weeks, months or years before solutions are found, frustrations mount and the relationship can undergo severe strain. The impacts of vaginismus on men create unique burdens as they often feel helpless and at the mercy of a situation they can’t control. Some typical emotions the male partner may experience are:

  • Rejection - “I’m so tired of being rejected all the time. What’s wrong with me that keeps her from wanting to have any kind of sexual relationship with me? First, it was just being unable to have intercourse, but now she hardly wants me at all. This whole thing makes me feel unappreciated.”
  • Empathy - “My wife would be crushed if anyone found out about this. I feel so badly for her and I know she is going through so much pain. I believe that she means well and doesn’t intend to hurt me, but her problem is hurting both of us. I really feel sorry for her, and yet I have no idea what to do.”
  • Guilt - “I feel so guilty for wanting to have sex at all because I know how painful it is for her. I can’t even look at her when we attempt sex because it hurts her and she is just trying to endure the pain. I have normal guy ‘needs’ and I’m not sure what to do about all this frustration. Is it selfish to want to be with the woman I love? Did I do something that could have caused this?”
  • Anger - “I’ll admit I haven’t always been the most supportive of husbands. I’ve been so angry at the situation, angry at people who can actually have sex and just angry in general. It makes me mad when she pushes me away or ignores my advances. When I realize that it is not her fault, I’m not as directly angry with her, but I’m still angry inside.”
  • Frustration - “I am trying with all my heart and soul to try and see her side of the situation. But, what about me? I have feelings too! All I want is to feel the emotional connection that sex is supposed to provide. Is that too much to ask?”
  • Confusion - “I don’t get it! I always thought my wedding night would be the most wonderful night of my life and then … nothing. Now it is a year later and still no sex. The doctors say there is nothing wrong with my wife. What can we do?”
  • Fear - “I don’t know how long I can do this. I mean, I really love her but come on! I don’t want to live forever in a sexless relationship. We wanted kids and now I’m afraid that won’t happen either. What is my future going to be like if this continues?”
  • Distancing - “My home life is a mess and I don’t even want to see my wife right now. I might as well put my time into work or spend more time with the guys. At least my friends appreciate me and if I’m busy I won’t have to think about it.”

It is important for male partners to understand that vaginismus is not something the woman intentionally caused to avoid having sex. The tightening of the PC muscle that causes the vagina to ‘clamp shut’ is an unconscious reaction which is involuntary and happens without control or intention.

Even though a woman may very much want to engage in intercourse, there is a ‘disconnect’ between her mind and body which triggers the PC muscle to spasm. There are many emotional and physical factors which may contribute to the development of vaginismus. Emotional factors such as fear of penetration (not common to all types of vaginismus) will impact some women with vaginismus. In these cases it is important for a woman to understand and overcome her fear and negative thoughts about sex. The self-led emotional inventory included in the self-help program helps a woman to get to the root of these factors and override them with positive sexual feelings.

It is not uncommon for men to ‘bottle up’ their emotions and deny the anger, frustration and stress associated with living in an unconsummated relationship. Often men feel like they can’t tell anyone about their situation. They may also be worried about hurting their wife if they tell someone else about their “little secret” so they live with pent-up feelings of resentment and sadness - both for them and their mate.

Vaginismus and Dyspareunia

Sadly, many couples discontinue having times of intimacy because of the pain and the frustration of failure at attempted intercourse. Conflict is common and relationship issues may continue to escalate as the vaginismus remains untreated. Communication breakdown may occur as spouses retreat to their own side of the bed or even sleep in separate beds.

In addition to the vaginismus, a couple may also have to deal with the medical condition, surgery, or assault that possibly triggered the problem, potentially causing further relational strain.

There is a solution

Typically, once a diagnosis has been made and a treatment process initiated, there is a reduction in the overall level of stress the couple has been experiencing. Many couples, after working through vaginismus treatment do find that they are emotionally closer to one another, have improved communication skills, and do not take their sexual relationship or partner for granted

Can my problem still be vaginismus if I've had pleasurable intercourse before and now it hurts?

Vaginismus can occur later in life following years of pain-free or pleasurable intercourse.

Vaginismus can, and frequently does occur later in life following years of pain-free or pleasurable intercourse. This form of vaginismus is called secondary vagnismus Symptoms may vary widely from simple discomfort to intense burning sensations upon penetration to inability to penetrate altogether. Sometimes the cause may not be apparent, other times it may stem from a wide range of medical/physical conditions such as discomfort from inadequate lubrication to more painful experiences such as childbirth, surgery, hormonal changes, or other health issues (see Causes). It can also be triggered in response to a traumatic emotional situation, such as a spouse's infidelity.

How does Vaginismus affects the Husbands?

Many women initially keep on having intercourse even though it hurts. Eventually, due to the pain and discomfort they may avoid sex altogether. Sometimes thinking back to when the pain was first noticed helps to discover the cause. If the initial trigger was a medical problem that has not yet been addressed, medical treatment should be sought. It is often recommended to treat underlying medical issues and then focus on resolving the vaginismus problem

Could my hymen be causing my problem?


Hymen problems rarely cause penetration difficulty. Vaginismus is a much more common cause of penetration difficulties, and the symptoms are almost identical.

In very rare cases, women with unusually thick hymens could have penetration difficulties because of it. However, in practice, most women who believe their hymen is causing a penetration problem actually have vaginismus. Vaginismus is a much more common cause of penetration difficulties, and the symptoms can be almost identical to that of a hymen problem. Women frequently do not realize that their pelvic floor has tightened up the vaginal entrance when they attempt penetration, since with vaginismus this is happening involuntarily (the muscles are acting on their own without conscious direction). So they are confused as to why their partner is 'hitting a wall' with attempts at intercourse, and erroneously conclude that it is a hymen problem.

Can Vaginismus occur later in my Life?

Adding further confusion to the issue, many physicians are unfamiliar with both vaginismus and what a 'normal' hymen should look like. If pelvic tightness occurs during a pelvic exam, it may appear to a physician that the vagina is abnormally small or that there is a hymen problem requiring surgery. At the same time, if a pelvic spasm doesn't occur, the vagina may look completely normal and so the physician may be confused as to why there is any penetration problem. The physician may suggest surgery to open up the hymen or vaginal area, falsely believing that this will help with penetration. Note also that women in rare circumstances, could have both vaginismus AND a hymen problem. This is why a good diagnosis from a competent health specialist (who is well-versed on both vaginismus and hymen problems) can be helpful to determine the right course of action.

If there is a physical abnormality with the hymen, it may require a minor surgical procedure (usually called a hymenectomy or hymenotomy) to open or remove the hymen to correct the problem. However, again, this is rarely a necessity. We encourage women suspecting hymen problems to complete a gynecological exam with a knowledgeable specialist where issues like this can be discussed, and seek a second opinion when necessary.

Is it possible that my vagina is just too small? Could it be smaller from lack of use?


When a woman experiences penetration difficulties or tightness, it is rarely due to a small or abnormal vagina, and nearly always due to vaginismus.

A vagina that seems too small…

When penetration or sexual tightness problems first become apparent, it is very common for women to wonder if their vagina is too small for intercourse or has become smaller due to lack of use. Problems with penetration or sexual tightness may occur at any time in life, and are most commonly due to vaginismus, although age related issues may contribute.

Women with first-time Sex difficulties, difficulties inserting tampons, or difficulties allowing the insertion of a doctor's speculum during pelvic exams, often mistakenly believe their vagina is too small. In the vast majority of these cases, involuntary constrictions of the vaginal muscles due to vaginismus is the sole cause of the problem. The vagina may seem unusually small, even to physicians, but there is no physical abnormality. The constriction of the pubococcygeus (PC) muscles causes the unusual tightness and the appearance of an abnormality.

Young women are often misdiagnosed by health care providers who do not realize it is the underlying muscle constriction making the vagina appear small or unusually tight. Typically, no matter the woman's physical height, size, or age (see below), the vagina is physically able to accommodate a man's penis of any size. In principal, the vagina will widen much larger to accommodate the delivery of a baby during childbirth. It is vaginismus that disables the vagina and causes intercourse attempts to be either impossible, painful, or difficult (see below for Exceptions.)

Could my hymen be causing Vaginismus?

Similarly, later in life, women may begin to experience tightness or penetration problems. Some women may find that following menopause, surgery, or many years of sexual inactivity, sex is no longer possible due to tightness and pain. With age or disuse, the vagina may atrophy or shrink. In these cases, physicians frequently prescribe the use of dilators to gently stretch the vaginal tissues and help restore health. Often women do not realize that involuntary tightness relates also to vaginismus, and fail to address this problem. The vaginismus self-help program may be helpful for those needing help to improve pelvic floor health and control in the context of working toward restored intercourse (use in consultation with a physician).

Exceptions:

1। A short, small, inelastic or absent vagina is a rare condition experienced by a small group of women. It is a symptom of MRKH and vaginal agenesis। Dilators therapy is often prescribed to help enlarge the vaginal space.

2. Unusually thick or inelastic hymens are rare occurrences that may cause penetration difficulties.

Could vaginismus just be in my head?


Regardless of the potential causes, there is always a distinct, physical side to vaginismus.

With vaginismus, the pelvic floor tightening response is an involuntary physical occurrence, meaning that it is not under the immediate direction or control of the woman. Therefore, regardless of the causes of vaginismus, there is always a distinct, sexually crippling, physical side to the condition. It is a condition in which varying physical and/or emotional factors may play complementary contributory roles and so both should be examined as part of the treatment process.

Although emotions, past memories of experiences, or specific anxieties could be involved in causing vaginismus, the initial triggers of vaginismus may be the culmination of a variety of factors. In the treatment process, both physical and emotional aspects of vaginismus should be considered to identify all potential triggers and fully overcome vaginismus।

The physical components of treatment focus on exercises that teach how to control the pelvic floor muscles, retraining the body to eliminate involuntary tightness. The self-directed exploration and emotional inventory exercises draw out unhealthy emotions to help women take control over their pasts. By replacing negative messages and attitudes with positive solutions, women overcome any emotional hinderances or emotional components to their vaginismus. This 'whole woman' self-help approach has helped many to overcome what seemed like a hopeless situation

How many women have vaginismus?


Roughly 2 women in 1000 have vaginismus.

It is commonly accepted that roughly 2 women in 1000 will experience vaginismus. However, that number could be higher. Gathering reliable statistics for vaginismus occurrence is hindered by many factors such as:
  • Due to shame and embarrassment, many women do not seek help.
  • Some women are given an incorrect diagnosis and are never properly treated (or counted). Sadly, some resign themselves to a life devoid of a sexual relationship falsely thinking they can never be helped.
  • Healthcare providers do not normally keep statistics on the number of women specifically seeking help for vaginal penetration problems.

The following statistics are quoted to help in the understanding of the statistic gathering process for vaginismus.

Vaginismus Statistics

  • "Approximately 0.17 percent of women between fifteen and sixty-four (more than 27,200) in the United Kingdom alone are estimated to suffer from vaginismus."¹
  • "There is a higher incidence (0.49 percent) [of vaginismus] among women between fifteen and twenty-four, representing the usual period of a woman’s life when she first attempts intercourse."¹
  • "Approximately 20 percent of the women seeking help at the Masters & Johnson Institute … have a demonstrable degree of vaginismus."¹
  • "In my own research with my own clinic patients it [vaginismus] runs around two percent. However, if I were a gynecologist doing sex therapy I have no doubt it would be much higher, say four percent" - Dr. Harold I. Lief of the University of Pennsylvania¹
  • "Approximately forty percent of the women that we see here have vaginismus" - Dr. Marian E. Dunn, Ph.D., director of the Center for Human Sexuality, State University of New York Health Science Center, Brooklyn¹
  • Dr. Domeena Renshaw, M.D., director of the Sexual Dysfunction Clinic at Layola University in Chicago, states that their vaginismus incidence rate is 7 percent, of which about one-third have a remedial physical basis.¹
  • "One study reveals that women of all ages are statistically more at risk of developing vaginismus than they are of having to seek an abortion."¹
  • "One doctor specializing in sexual problems estimates that vaginismus occurs in approximately 5 out of 1000 marriages in Ireland."¹
  • "Another survey reveals that 16 out of every 100 women consulting one birth control clinic were suffering from vaginismus."¹
  • "Out of the total number of diagnoses made over a three year period in the sex therapy clinics of Relate Marriage Guidance (a national bureau which offers marriage therapy), approximately 7 percent of the diagnoses were vaginismus. In the same period about 300 cases of preorgasmic problems were seen, compared to about 150 to 200 cases of vaginismus."¹
  • "What is the family status of the vaginismus patient? [as seen at a private clinic in the U.S.A.]
    • 47% are either single or dating
    • 53% are married, anywhere from a few months to over 30 years."²
  • "What is the age of the typical vaginismus patient? [as seen at a private clinic in the U.S.A.]
    • 18% are under the age of 25. This figure could be much higher if the condition were to be better understood and properly diagnosed at an earlier age.
    • 53% are between the ages of 26 to 35
    • 26% are between the ages of 36 to 50, mostly including women who married late in life or those who have been in unconsummated marriages for many years, suffering in silence before seeking help.
    • 9% are over the age of 51"²

References

  1. Valins, L. (1992). When a woman's body says no to sex: Understanding and overcoming vaginismus. New York, NY: Penguin Books. P.23,24
  2. 2. Katz, D., & Tabisel, R. (2002). Private pain: It's about life, not just sex. Plainview, NY: Katz-Tabi Publications. P.70,71