Md. Süleyman ESERDAĞKadın Hastalıkları ve Doğum UzmanıCinsel Tedaviler & Kozmetik Jinekoloji

CONTRACTION IN SEXUAL INTERCOURSE

There may be a pain due to contractions, or sometimes contractions may occur because of real pain. In the problem of vaginismus, contractions occur due to ‘fear of pain in sexual intercourse’.
Contraction in Sexual Intercourse

The contraction  in sexual intercourse causes problems of having no sexual penetration or feeling pain and ache during sexual penetration. Contraction might occur in sexual intercourse with psychological and organic (physical) reasons.

Why contraction occurs in sexual intercourse?

The contraction in sexual intercourse is the most important symptom of the vaginismus problem. Because of the fear of pain or other subconscious sexual concerns, lower vaginal muscles involuntarily contract during penetration. The reason is that woman takes herself under control with a ‘reflex’ instinct depending on her subconscious fears, which come from the past. These contractions are never under the woman’s control.

The vicious cycle of pain-contraction-pain

Pain and ache expectation leads to contraction of PC muscles in the outer 1/3 of the vagina. In addition, it makes it difficult for the penis to penetrate and causes unnecessary pain. Contraction increases the pain and ache, and the increasing pain causes contractions, which is a vicious cycle.

The pain-dependent contraction in sexual intercourse

Pain in sexual intercourse can occur in such situations as vulvar vestibulitis, vulvodynia, hymen problems (hard and high-edged hymen or intermediate division). All these situations are called as ‘dyspareunia’ (sexual intercourse pain). In the case of dyspareunia, contraction occurs in sexual intercourse depending on the pain. It may have a psychological and physical origin.

Contraction with real pain and contraction with the fear of pain

There may be a pain due to contractions, or sometimes contractions may occur because of  real pain. In the problem of vaginismus, contractions occur due to ‘fear of pain in sexual intercourse’. Woman contracts herself with fear during sexual intercourse and feels pain because of contraction. The situations turn into a vicious cycle.

In the dyspareunia problem, pelvic contractions occur depending on a ‘real pain’.

So there is no real pain in the vaginismus, there is a fear of pain. In dyspareunia, a woman feels real pain and she tightens her. A simple gynecological assessment is sufficient for the differential diagnosis of he reason.

Which muscles contract during sexual intercourse? Pelvic floor muscles

The most known of the pelvic muscles that control vagina is "Pubococcygeus muscle (PC muscle)". In scientific studies, sudden contractions occur in another levator, bulbospongiosus, ischiocavernosus and transverse perineal muscles besides PC muscles.

Apart from pelvic muscles, common contractions can be seen until abdomen, waist, hips and even toes and chin muscles. On the other hand, those who have this problem can raise their hips by contraction during the penetration and prevent their partners to approach them by closing their legs or pushing their partners back with hands and feet.

In vaginismus problem, the woman often says ‘I love my husband and I want to have intercourse with him’ but male partner ‘hits on the wall’ since the woman contracts her vaginal entrance. It seems like that this area is narrow and closed. In addition, any kind of painful attempt causes to strengthen the ‘pain memory’ in the brain.

Treatment for contraction in sexual intercourse

Experienced physicians can overcome the contraction problems in sexual intercourse. In general, cognitive behavioral methods can be used to treat uncontrolled contractions of these muscles at the entrance of the vagina. The woman is given control over her own muscles.

In vaginismus treatment, Cognitive Behavioral Therapy (CBT) approaches are applied among the most effective methods in the treatment of sexual intercourse contractions. The problem of contractions in sexual intercourse can be treated in a very short time and permanently with pelvic floor rehabilitation and relaxation exercises performed by specialist doctors.

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