What is Vaginismus?

Sexual relationships in the modern world are complicated. On the surface, it seems like we’re hooking up more than ever. Everyone is swiping right and captivated by Love Islandesque romance. But statistics show that British adults are having less sex now than in previous years.

As our stress levels rise and our libidos lower, connecting physically with your partner can sometimes feel like an obligation instead of an act of love. For some people though, sex is a scary prospect because it’s a source of physical discomfort. In fact, one in 10 women in the UK experience pain during sex, and many others are suspected to have a condition called vaginismus, which regularly goes undiagnosed.

What is Vaginismus?

It occurs when muscles in the vagina contract in anticipation of pain. Those affected by vaginismus describe it as a burning or stinging sensation. Some people first become aware of it when they try to use a tampon, and say it feels like ‘hitting a wall’ inside their vagina. For others, it may be during penetrative sex, or while having a pelvic examination. Either way, it makes entry painful, and often impossible.

Living with the condition can cause embarrassment and relationship problems, due to avoidance or lack of sexual intimacy. Sweeping the problem under the carpet can have a ripple effect, and lead to feelings of shame, isolation, and low self-esteem.

Who is Affected?

The true number of vaginismus sufferers is immeasurable because there is so much stigma around the condition. Ignoring the problem can put pressure on your romantic relationships, and you may avoid sexual intercourse altogether. Even for those who choose not to have penetrative sex, it can be a barrier to important medical examinations.

Experienced sexologist and psychotherapist Penelope Bould says that the condition is an unconscious reaction and is no one’s fault. “It involves involuntary muscular spasm, so your vagina is a no-entry zone sometimes, or all the time.”

What Causes It?

The cause of vaginismus is often psychological, and is commonly linked to trauma, depression, anxiety, and post-traumatic stress disorder. According to Penelope: “Fear is often at the heart of vaginismus.”

This could be a result of childhood abuse, harmful sexual acts, or a coercive relationship. Traumatic childbirth or apprehension around pregnancy can also be to blame, as can genital surgery or radiotherapy. You may be unable to remember exactly what triggered the fear itself, yet your body still has a physical reaction to penetration.

It can also come and go, meaning that you may only have a physical reaction in some situations, or with particular people. At other times, penetration is achieved painlessly.

Can It Be Treated?

Before vaginismus can be diagnosed, medical tests and an examination are recommended in order to rule out any physical conditions which could be responsible for the pain. Understandably, the mere thought of this can cause more anxiety than the condition itself.

Penelope suggests enlisting the help of a trusted friend or support worker to have in the room to ease any emotional distress. You could also ask to record your visit to your GP or gynaecologist if you’re worried that your heightened anxiety might mean that you miss important information. That way, all you have to do is focus on staying calm, as you can return to the recording later on.

Once diagnosed, a fully trained psychotherapist will explore your history in a constructive and supportive way, and provide a range of techniques to suit your needs. Many of these can be used at home and may involve physical exercises, medication, positive statements, mindfulness, and relaxation techniques.

Sweeping the problem under the carpet can have a ripple effect, and lead to feelings of shame, isolation, and low self-esteem

• Primary vaginismus is when putting anything inside your vagina has never been possible.

• Secondary vaginismus is when it occurs at any time later in life.

• Vaginismus can also be an issue for someone who was born intersex, or who has experienced Gender reassignment surgery. For people who have had a vagionplasty, it is very important to have a physical maintenance regimen, in addition to any therapy.

Penelope Bould

If you feel anxious about intercourse, then the thought of psychosexual therapy may terrify you even more, but it’s helpful to remember that there is nothing physically intimate about the treatment.

“Later in the treatment, clients are instructed how to gently use some small devices at home, starting with a really small one, at your own pace,” says Penelope, “to be used in conjunction with the therapy and special exercises and statements.”

Many therapists recommend couple psychosexual therapy if you’re in a relationship, as this can give your partner space to talk. It may also flag up any abusive behaviour that may be contributing to your condition. The good news is that clinical trials have found that 80% of people receiving treatment for vaginismus see the benefits. Recovery time can vary, and while some people needed up to six months of treatment, others achieved pain-free intercourse in as little as five weeks.