Is vaginal lock a real medical condition?

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DOCTOR'S CORNER

Welcome to Doctor's Corner, where medical experts from Makati Medical Center will answer health questions from readers! Got a question? Send them over to comment@gmanews.tv.

Q: Is vaginal lock a real medical condition? What's the 411? 

First, let’s define what it is. Vaginal lock is the informal term for vaginismus, a type of female sexual dysfunction that belongs to genito-penetrative disorder, where vaginal muscles are tense with persistent involuntary contractions.

It is "characterized by the persistent involuntary closure of the vagina upon attempts at penetration of any sort whether by a penis, tampons, fingers, or speculum," according to a 2023 study, and makes sexual intercourse painful and penetration difficult and near to impossible. In addition, even doing a pelvic exam like inserting a speculum is not possible. 

Based on various prevalence studies, vaginismus affects between 1% and 17% of women worldwide, though I suspect these are underreported figures. Women may be embarrassed to admit and seek treatment for this condition, while others may be misdiagnosed.

A study says age "particularly being over 45 years old, was a significant predictor of vaginismus complaints."

In my experience in the clinic, I’ve been seeing a minimum of 3 cases a week. Patients together with their partners usually consult in the clinic and their usual concern is that they never had penetrative intercourse because of the said condition.

This has caused them a lot of trauma and anxiety in their relationship. This can be addressed by gynecologic treatment, physiotherapy and also psychotherapy. There are a lot of psychological concerns that aggravate the condition.

What causes it?

Various situations when penetration to the vagina is anticipated or attempted. A woman could experience a tightening of her vaginal opening during vaginal penetration with a penis, finger, or sex toy.

Inserting a tampon could also prompt vaginal lock, as an appointment with a gynecologist, who uses a speculum to look inside the vagina and check the cervix.

This can be aggravated by symptoms of urogenital atrophy or vaginal dryness, urinary tract infection, vaginal infection or any inflammation that causes a lot of irritation in the vagina.

Moreover, a negative experience with a pelvic exam or vaginal delivery, a painful sexual experience, anxiety or fears in having sex, fear of getting pregnant, negative beliefs or feelings about sex, pelvic pain from yeast infection or surgery, sexual assault or abuse., religion and beliefs are emotional triggers of the condition. This can affect mental health too leading to increased stress, anxiety or depression.

Should a woman worry about it?

No. From my experience with patients, vaginismus is treatable. If properly diagnosed, it can be addressed with multimodal treatments under the supervision of a healthcare professional.

1. Pelvic physical therapy involves exercises, stretching, and massage to help you relax and control your pelvic floor muscles.

2. Varying sizes of cone-shaped vaginal dilators or a pelvic wand that is temperature sensitive or a vibrating pelvic can be gently inserted into the vagina to gradually stretch the tissues, making penetration less uncomfortable and painful.

3. A shot of botulinum toxin in the levator muscles can relax tight pelvic muscles.

4. Talk therapy allows you to express your anxiety and fears about your body and sex.

Women shouldn't be ashamed to seek treatment for vaginismus, or even tolerate the pain and discomfort felt during sexual intercourse.

If you think you have this condition, get a proper diagnosis from a doctor you trust and take steps to overcome it. A healthy and satisfying sex life is only one aspect of a relationship but it certainly contributes to a couple’s deep love and affection for each other.

Jennifer Marie M. Jose, MD, Obstetrics and Gynecology Specialist is the Section Chief of Makati Medical Center’s Urogynecology & Pelvic Reconstructive Surgery. She also serves as the Chair of the Philippine Board of Gynecologic Robotic Surgery, the President of the Aesthetic Gynecology Society of the Philippines, and Vice President of the Society of Gynecologic Robotic Surgery of the Philippines.

— LA, GMA Integrated News