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Sexual Wellness

What Is Vaginismus and What Can I Do About It?

| 04/25/2022

vulnerability Illustration by Sophi Gullbrants

If you’re frequently tensing up at the thought of penetrative sex, you may have vaginismus.

Sex is and should be something that’s always pleasurable, whether you’re with a partner or going solo.

However, there are times when even though your mind wants sex, your body isn’t willing to play ball.

Not heard of vaginismus? It’s not really talked about as many people feel it’s shameful. However, vaginismus can be experienced by anyone with a vagina, and it’s nothing to be embarrassed about.

It’s estimated that vaginismus affects up to 6% of people over the course of their lifetime, but it could be more, as many people may be embarrassed to talk about it.

What is Vaginismus?

Vaginismus is when your vaginal muscles involuntary contract at the thought of penetration, causing pain. While the level of pain can vary, some have likened the feeling to being scraped with razors or stabbed with a needle.

Many people find they have vaginismus when they try and use a tampon, have a pap smear or have penetrative sex for the first time.

The jury’s out on what causes vaginismus, and it can vary from person to person. It’s been linked to past experiences of painful intercourse as well as abuse and trauma. Anything from growing up in a religious household to worrying about getting pregnant can play a role.

However, previous surgeries, infections, radiotherapy and childbirth can all contribute too.

However, sometimes it just happens for no reason at all. Some people have an active and healthy sex life only to find one day; they start to tense up.

It’s estimated that vaginismus affects up to 6% of people over the course of their lifetime, but it could be more, as many people may be embarrassed to talk about it.

Vaginismus and Anxiety – Partners in Crime

Vaginismus and anxiety can come together in a catch-22 situation. You’re anxious about tensing up, which makes you even more nervous!

People with vaginismus view themselves in a more negative light than people that don’t have it. This can lead to a lack of confidence that not only affects your sex life, but life in general too.

What Can I Do If I Have Vaginismus?

If you think you have vaginismus, the first thing to do is to see your doctor – don’t be afraid to ask for a female doctor if it makes you feel more comfortable.

They’ll ask you a few questions about when you experience pain. They’ll then examine you to check if your symptoms don’t correspond to any other conditions like a urinary tract infection (UTI). The examination may be a little painful, but your doctor will be as gentle as they can and talk you through what they are doing.

The good news is that over four out of five people can enjoy pain-free intercourse after vaginismus treatment. If you do have vaginismus, there are a range of treatments available, and it may take a little time to find the one (or the combination) that’s right for you.

The options include:

Vaginal Dilators

A vaginal dilator is a plastic or silicone rod used to relax your pelvic floor muscles and reduce pain. Think of it as a medical dildo!

You gently insert the dilator (using lube) for a few minutes each week. You can go at your own pace and move on to a larger dilator when you’re ready to do so. Involving a partner can be a great way to build intimacy but remember – you need to call the shots.

Exercises

As vaginismus means you lose control over your muscles, exercise can help you take the power back. Pelvic floor stretches are very similar to yoga and can help you strengthen the muscles around your vagina.

Mindfulness exercises can help too. By focusing on your breathing and blocking out unwanted thoughts, you can lower your anxiety levels and take control of your vaginismus. Meditation, journaling and adult colouring books can be great ways to do this – whatever works best for you.

Pelvic Floor Physical Therapy

Your doctor may recommend pelvic floor physical therapy to you. This is a therapy designed to help people with a range of pelvic floor issues, including vaginismus.

A physical therapist will see how strong your pelvic floor muscles are and put together a plan to help strengthen your muscles, including exercise, the use of dilators and even electrical stimulation.

The advantage of physical therapy is because treatment is bespoke to your needs, it’s more likely to be successful. Studies have shown patients rate it as highly successful.

Therapy and Counseling

If you believe your vaginismus is related to a psychological issue, counseling can help you talk through your problems and work to relieve any anxiety you may have.

As we mentioned earlier, vaginismus can be linked to both physical and psychological trigger points. Many who have experienced trauma or abuse in the past, especially surrounding sex, are likely to have the condition.

A 2011 study has shown people with vaginismus are twice as likely to have experienced sexual abuse in childhood. With others, a traumatic sexual experience or anxiety around intercourse can play a part.

The therapy and counseling used will differ from person to person. Cognitive behavioral therapy looks at how your thoughts and actions affect your vaginismus and teaches you coping skills. Sex therapy looks at approaches you can take to improve communication and intimacy with your partner. By talking through your worries and concerns, you can both build up your confidence in the bedroom.

Surgery and Botox

Many people ask if surgery is an option for vaginismus, but we wouldn’t recommend it. Surgery can make vaginismus worse as it can reduce sensation and make intercourse even more painful.

Some clinics offer Botox to cure vaginismus as it relaxes the vagina muscles. While studies have shown it may improve symptoms, it’s worth bearing in mind that while Botox may relieve the physical issues vaginismus causes, it doesn’t help if there are any underlying psychological problems.

Remember, You’re Not Alone

Vaginismus can be frustrating, especially if you want sex but know you are having a difficult time with it. The important thing to remember is that your condition doesn’t define you. Many people with vaginismus think they’re ‘broken’, but this just isn’t the case.

Most people who experience vaginismus can still get aroused, meaning you can enjoy oral sex, foreplay, and gentle masturbation. Take your time, and if you’re with a partner, don’t be afraid to tell them to stop or slow down.

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