What is vaginismus and why is nobody talking about it?

What is vaginismus and why is nobody talking about it?

vaginismus

When I look back on my sex life, I see a blur of tears, pain and anxiety. For years, I didn’t know why I couldn’t have sex like what I deemed to be ‘normal’. For me, sex involved searing pain; the kind where I felt like there were a thousand tiny cuts on the inside of my vagina and someone was rubbing chilli into them. Least to say, there was a lot of stinging and burning.

Accompanying this was also a stream of stress and anxiety and the feeling like I wasn’t the woman I ought to be. I couldn’t have sex, and so therefore, I was flawed. I would be in physical pain but be nursing much worse mental and emotional stress.

I thought my boyfriend would get frustrated and leave; that there could be something wrong with me that would later affect my chances of conceiving; that everyone else was having sex except me, because I was broken.  

I experienced this pain ever since my teenage years, but it wasn’t until I was twenty-two – and had seen a multitude of doctors and specialists – that I found out why. I had a condition called vaginismus.

Vaginismus is the involuntary contractions and/or spasms of muscles around the vaginal opening making penetration painful or impossible. This happens as a response to physical contact or pressure, or in anticipation to that touching. It can be primary – women who’ve always experienced the pain – or secondary – brought on by an underlying condition or traumatic event.

Dr Elizabeth Farrell, gynaecologist and Medical Director of Jean Hailes for Women’s Health explains, “What we find is that the muscles are overactive, so when you touch the muscle on the vaginal examination, the muscles are tight and very tender to touch.”

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In one of my vaginal examinations, my doctor placed two fingers inside me, told me to relax as much as I could, and that even then, I was as hard as rock. My muscles were so overactive they couldn’t switch off.

What caused this contracting and spasming was deeply rooted in my anxiety. My body was trying to protect me from what it deemed to be dangerous: penetration. However, the reasons for vaginismus range from woman to woman and case to case.

As Dr Farrell says, “From the doctor’s point of view, the most important aspect is that a good history needs to be taken”.

This is because the causation could be past trauma, including sexual abuse, being in a forced relationship, fear, instilled stigma from a conservative upbringing, religious reasons, negative attitudes towards sex, traumatic birth or fear and anxiety.

However, one common thread among many with the condition is psychological distress and the questioning of sense of self. Although physically painful, the condition can take a huge toll of mental wellbeing.

When I asked my friend who also has vaginismus about this, she told me, “It used to make me quite upset all the time – a lot of my sexual encounters would end up in a lot of tears and I’d be inconsolable. And yeah it would impact me quite a bit. Also, it was a bit isolating as well because none of my friends had it and no one knew anything about it.”

Like her, I too felt isolated by the pain. And I still struggle today with feeling flawed and to not blame myself. It’s hard when it feels like everyone around you is having carefree, fun sex and yours is intertwined with deep, calming belly breaths and compromise. It’s frustrating too. It’s not that I don’t want to have the pleasurable penetrative sex. 

Dr Farrell explains that these feelings are normal for someone with a condition like mine, “I think vaginismus has enormous consequences on one’s sense of sexual being – and the sense of sadness and loss and grief and all of those things – but particularly that you’re not functioning ‘normally’.”

She says a lot of this comes down to how society talks about sex too, “When you look at the media and you look at movies and all that, it’s about having penetrative sex. The fact that you can have a lovely sex life that doesn’t necessarily include penetrative sex is not something that is really discussed.”

Yet it’s a condition many women in Australia face. Dr Rosie King, sex therapist and author, says, “It’s very common. I see new patients with vaginismus almost every day I go to work.”

Yet despite this, many women with vaginismus go misdiagnosed or undiagnosed, sometimes for twenty or three years, and sometimes their lifetimes.

When I told Dr King it took me years of going to doctors and having ultrasounds to be diagnosed, said, “That’s a very typical situation – it’s not something that’s widely known. And it’s not widely known by a lot of doctors either.”

Even now, the reason many of my family and friends know about it is because I’ve spoken about it. And even then, it’s often confused for endometriosis or other reproductive conditions.

The other main reason many women go undiagnosed is because they’re embarrassed or ashamed of their condition. “The woman feels shameful that she’s not able to have intercourse, therefore she may be embarrassed to come and talk to a doctor about it,” Dr Farrell explains.  

But they aren’t the ones to blame, society’s treatment of sex, and in particular female pleasure, is. Until we can speak openly about our bodies – the good, the bad and the painful – without fear of shame, embarrassment or taboo, many will be left in the dark. And to me, that’s just not good enough. As my friend said, “Why is it not taught in schools?” and I would like to second that.

The good news is however that with a good doctor, pelvic floor physiotherapist and psychologist, it’s a treatable condition. (Expensive, but treatable). And regardless, it’s still very possible to have a healthy, pleasurable and enjoyable sex life without penetration. 

“The important thing to realise is you are absolutely not alone,” Dr King tells me.  

I wish I could go back to my teenage self and tell her the same thing.

What is vaginismus and why is nobody talking about it?

When I look back on my sex life, I see a blur of tears, pain and anxiety. For years, I didn’t know why I couldn’t have sex like what I deemed to be ‘normal’. For me, sex involved searing pain; the kind where I felt like there were a thousand tiny cuts on the inside of my vagina and someone was rubbing chilli into them. Least to say, there was a lot of stinging and burning.

Accompanying this was also a stream of stress and anxiety and the feeling like I wasn’t the woman I ought to be. I couldn’t have sex, and so therefore, I was flawed. I would be in physical pain but be nursing much worse mental and emotional stress.

I thought my boyfriend would get frustrated and leave; that there could be something wrong with me that would later affect my chances of conceiving; that everyone else was having sex except me, because I was broken.  

I experienced this pain ever since my teenage years, but it wasn’t until I was twenty-two – and had seen a multitude of doctors and specialists – that I found out why. I had a condition called vaginismus.

Vaginismus is the involuntary contractions and/or spasms of muscles around the vaginal opening making penetration painful or impossible. This happens as a response to physical contact or pressure, or in anticipation to that touching. It can be primary – women who’ve always experienced the pain – or secondary – brought on by an underlying condition or traumatic event.

Dr Elizabeth Farrell, gynaecologist and Medical Director of Jean Hailes for Women’s Health explains, “What we find is that the muscles are overactive, so when you touch the muscle on the vaginal examination, the muscles are tight and very tender to touch.”

In one of my vaginal examinations, my doctor placed two fingers inside me, told me to relax as much as I could, and that even then, I was as hard as rock. My muscles were so overactive they couldn’t switch off.

What caused this contracting and spasming was deeply rooted in my anxiety. My body was trying to protect me from what it deemed to be dangerous: penetration. However, the reasons for vaginismus range from woman to woman and case to case.

As Dr Farrell says, “From the doctor’s point of view, the most important aspect is that a good history needs to be taken”.

This is because the causation could be past trauma, including sexual abuse, being in a forced relationship, fear, instilled stigma from a conservative upbringing, religious reasons, negative attitudes towards sex, traumatic birth or fear and anxiety.

However, one common thread among many with the condition is psychological distress and the questioning of sense of self. Although physically painful, the condition can take a huge toll of mental wellbeing.

When I asked my friend who also has vaginismus about this, she told me, “It used to make me quite upset all the time – a lot of my sexual encounters would end up in a lot of tears and I’d be inconsolable. And yeah it would impact me quite a bit. Also, it was a bit isolating as well because none of my friends had it and no one knew anything about it.”

Like her, I too felt isolated by the pain. And I still struggle today with feeling flawed and to not blame myself. It’s hard when it feels like everyone around you is having carefree, fun sex and yours is intertwined with deep, calming belly breaths and compromise. It’s frustrating too. It’s not that I don’t want to have the pleasurable penetrative sex. 

Dr Farrell explains that these feelings are normal for someone with a condition like mine, “I think vaginismus has enormous consequences on one’s sense of sexual being – and the sense of sadness and loss and grief and all of those things – but particularly that you’re not functioning ‘normally’.”

She says a lot of this comes down to how society talks about sex too, “When you look at the media and you look at movies and all that, it’s about having penetrative sex. The fact that you can have a lovely sex life that doesn’t necessarily include penetrative sex is not something that is really discussed.”

Yet it’s a condition many women in Australia face. Dr Rosie King, sex therapist and author, says, “It’s very common. I see new patients with vaginismus almost every day I go to work.”

Yet despite this, many women with vaginismus go misdiagnosed or undiagnosed, sometimes for twenty or three years, and sometimes their lifetimes.

When I told Dr King it took me years of going to doctors and having ultrasounds to be diagnosed, said, “That’s a very typical situation – it’s not something that’s widely known. And it’s not widely known by a lot of doctors either.”

Even now, the reason many of my family and friends know about it is because I’ve spoken about it. And even then, it’s often confused for endometriosis or other reproductive conditions.

The other main reason many women go undiagnosed is because they’re embarrassed or ashamed of their condition. “The woman feels shameful that she’s not able to have intercourse, therefore she may be embarrassed to come and talk to a doctor about it,” Dr Farrell explains.  

But they aren’t the ones to blame, society’s treatment of sex, and in particular female pleasure, is. Until we can speak openly about our bodies – the good, the bad and the painful – without fear of shame, embarrassment or taboo, many will be left in the dark. And to me, that’s just not good enough. As my friend said, “Why is it not taught in schools?” and I would like to second that.

The good news is however that with a good doctor, pelvic floor physiotherapist and psychologist, it’s a treatable condition. (Expensive, but treatable). And regardless, it’s still very possible to have a healthy, pleasurable and enjoyable sex life without penetration. 

“The important thing to realise is you are absolutely not alone,” Dr King tells me.  

I wish I could go back to my teenage self and tell her the same thing.

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