What is vaginismus?
Vaginismus is the involuntary contraction of the vaginal muscles, making penetration very painful and often impossible. It can interfere with a person’s ability to have penetrative sex and can even happen anytime anything comes near the vaginal entrance, including tampons and fingers.
It can lead to feelings of hopelessness, as it is not a voluntary condition. There is a global impression that everyone is having sex, so it is also a very isolating condition. Symptoms include pain that usually goes away with withdrawal but not always. This can lead to a loss of sexual desire. In order to diagnose it, the symptoms must be experienced without anatomical or physical abnormalities, and the person must have a desire for penetration.
I’ve never heard of it!
Vaginismus doesn’t get as much attention as erectile dysfunction, and historically this condition has often been dismissed, or people get poor advice. People are often told just to calm down, have a glass of wine, or that nothing is wrong with them since a physical abnormality doesn’t accompany this condition. This type of advice deters women from seeking treatment.
Interestingly, part of the reason erectile dysfunction gets more media attention is due to the pharmaceutical push for ED medications. Vaginismus or other female sexual dysfunctions don’t get the same attention, nor do they have the same pharmaceutical treatments. The lack of public visibility also deters women from seeking treatment, as they assume that painful sex is normal or that they have a shameful condition with no possible solution.
This condition is common, but it’s hard to say exactly how prevalent it is because so few women seek treatment. It’s reported that 5-17% of people who go to sexual dysfunction clinics are diagnosed with vaginismus (Harish et al., 2011). However, it is so difficult to know the actual prevalence because so many women never seek treatment.
Primary vs Secondary Vaginismus
Some people experience symptoms of vaginismus their whole life, usually appearing in adolescence when they are first trying to put in a tampon or exploring their sexuality. This is called primary vaginismus. Risk factors for this include:
- Chronic pain
- Negative emotional reaction toward sexual stimulus
- Strict conservative moral education.
However, there is no known cause for vaginismus, and these are only mildly associated with the condition in research.
Others can have penetrative sex their whole life without issues, but a traumatic event can lead to pain, which can trigger vaginismus. This is called secondary vaginismus. Events can include:
- Hormonal changes, such as can happen in menopause, pregnancy and childbirth
- Sexual assault
- Yeast infections
These events are not causes of vaginismus, but experiencing them can put you at a slightly higher risk of developing it.
Vaginismus is treated most effectively in a two-pronged approach. First, psychotherapy can help ease anxiety and feelings of shame and mentally prepare you to work on vaginismus using behavioral therapy. Next occupational therapy or physical therapy can help you introduce penetration gradually, usually starting with non-penetrative kegels to help you regain control of your vaginal muscles, building up to penetration with fingers, and finally increasing the size of the penetrating object with dilators.
Using these two treatment methods at the same time leads to positive outcomes in most patients, so there is hope if you are experiencing symptoms of vaginismus! Don’t be afraid to seek medical attention, as there is a lot of evidence that it is very effective in easing symptoms of vaginismus and can give you back your sexual autonomy.
In a Relationship
It’s essential that you talk with your partner about vaginismus, your symptoms, and how they make you feel. A therapist can help mediate those conversations, especially if you are having a hard time broaching this topic with your partner. Vaginismus can negatively affect your relationship, but with communication, creativity, and patience, these challenges can be overcome.
In a relationship, it may be important to explore other types of sex and intimacy that don’t involve penetration. These can include:
- Participating in oral sex or using interesting add-ons and toys.
- Touch and massage – of all parts of the body can provide a real sense of connection. In fact, not having the pressure to perform (need for penetration) can lead to a relaxed exploration of your and your partner’s entire body – which is very erotic.
Being single is a great time to work on vaginismus alone if you want to! Exploring things such as your turn-ons, external stimulation, and where you are at with your sexuality without the pressure for penetration from a partner can be liberating.
When you are dating, disclosing this early on as something you are working on can help you discern if this new person is the right partner. After all, if they decide that they don’t want to work on vaginismus or its symptoms with you, you may have dodged a bullet.
Remember, vaginismus or any other sexual dysfunction doesn’t make you unlovable. If you are looking for support with this condition and don’t know where to start, Insight’s sex therapists are here to help. Simply book an appointment with one of them on our website to start your healing journey!
Harish, T., Muliyala, K., & Murthy, P. (2011). Successful management of vaginismus: An eclectic approach. Indian journal of psychiatry, 53(2), 154–155. https://doi.org/10.4103/0019-5545.82548