WHAT IS VAGINISMUS?
Chances are, if you have been diagnosed with Vaginismus, then you have been experiencing very painful sex (or attempts at sexual penetration) for quite some time. Some females notice it from when they first try to use tampons or have sex, while others may find it develops at a later stage in their sex life, or after childbirth, or a gynaecological exam/smear.
Vaginismus is frequently described as a sense of a partner’s penis hitting a wall, a searing or stabbing pain, and a feeling that vaginal sex is too painful or impossible. Many people struggle with years of suffering or avoiding intimacy and sex before discussing their pain with a doctor, gynaecologist, psychosexual therapist or pelvic health physiotherapist. Many females eventually get diagnosed when going for a smear/sexual health test and experiencing similar symptoms in the medical room.
HOW COMMON IS VAGINISMUS OR PAIN ON PENETRATION?
Statistics, on how common Vaginismus and Sexual Pain are, vary greatly, and it is likely that they do not fully represent the incidence due to many people not seeking help for the condition. In psychosexual (sex) therapy it is a very common presentation that people seek help with and the most common that I see in females after sexual desire issues.
WHAT IS HAPPENING AND WHY?
Vaginismus is caused by the involuntary contracting of the pelvic floor muscles which obstruct the vagina by making it tighter. The pelvic floor muscles are positioned in order to control bladder and bowel continence, sexual function and childbirth. While it is encouraged to keep these strong so that they are working as we wish them to, we need them to relax when attempting sexual penetration. If the muscles are clenched, tensed or contracted then the vagina tightens and it makes it hard or impossible for a penis or sex toy to pass through, and it is the attempt to push through the muscle that causes the pain that can be excruciating and distressing.
IF IT IS CAUSING PAIN, HOW CAN IT BE PSYCHOLOGICAL?
I feel it is important to understand this – both for the person experiencing Vaginismus and their partner. The pain is most certainly real and often incredibly painful. Vaginismus is caused by the mind-controlling the muscles (albeit involuntarily) so while the physical impact of it is very much present, the origins stem in the mind which is controlling it.
IS IT POSSIBLE TO OVERCOME IT?
Yes, absolutely. This is something that many of my clients have been able to overcome in order to experience comfortable and enjoyable sexual intercourse.
HOW IS VAGINISMUS TREATED?
When working through Vaginismus or any difficulties around sex, it is important to understand what is likely to be causing them. This can vary from person to person and common issues can include anxiety and fear around sex, negative perceptions of sex or self, gaps in sex education, fear of STI’s/pregnancy, previous trauma, relationship issues, injury, and an inability to fully relax and immerse self in the sexual experience. Once the cause is established therapy can help to work through those issues. Additionally, treatment involves practical steps to help the person gain a better understanding of their body and sexual function, improve self-perception, work on relaxation and arousal techniques, and introduce exercises to enable and support this. The use of dilators and small vibrators are very helpful, but a key consideration when using these is to ensure that they are used only once the body is ready and aroused (this is where lubricants are also advised).
Understanding the anatomy and what helps to aid comfortable and pleasurable penetration is key. Many will benefit from breathing and relaxation exercises and self/couples sensate, in addition to understanding what enables and increases their arousal.
HOW LONG DOES TREATMENT TAKE?
This is very variable and can be linked to someone’s motivations and desire to overcome their Vaginismus or sexual pain. The treatment process is likely to be quicker and more successful if someone is keen to overcome their difficulty for themselves and because they want to have enjoyable, pain-free sex with a partner (rather than at a partner’s request). It is likely to take a minimum of 8-10 sessions with a psychosexual therapist while for some can take longer. This will likely depend on the cause, what is holding the problem in place, as well as the desire to proactively work through the difficulties. Some people also benefit from seeing a pelvic health physiotherapist.
IF I AM READING THIS AND THINK I HAVE VAGINISMUS WHAT SHOULD I DO?
If you believe you have Vaginismus then a consultation with your GP, gynaecologist or sexual health clinic is recommended to confirm if this is likely the case and rule out anything else. If Vaginismus is the cause of your pain and difficulty with penetration, they will suggest you see a Psychosexual Therapist (sex therapist) to work on overcoming it.