Often described as a vaginal panic attack Harley Street Fertility Clinic Director and gynaecologist Dr Venkat explains everything you need to know about vaginismus.

Sex on Female First

Sex on Female First

What is vaginismus for those who don’t know?                                                        

“Vaginismus is a condition that affects a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons and gynaecological examinations. This is a result of an involuntary reflex contraction of the pubococcygeus muscle, which supports the vagina. This reflex causes the muscles and tissues in the vagina to tense up suddenly, which makes any kind of vaginal penetration, including sexual intercourse extremely painful and sometimes it is impossible.  It is estimated that approximately 0.17 percent of women between fifteen and sixty-four in the United Kingdom (over 27,200) suffer from vaginismus. Due to shame and embarrassment, many women do not seek help.

What causes it?                                                                                                   

Usually the root cause of vaginismus is a combination of physical or non-physical triggers that cause the body to anticipate pain explains Dr Venkat. Reacting to the anticipation of pain, the body automatically tightens the vaginal muscles, bracing to protect itself from harm. Sex becomes uncomfortable or painful, and entry may be more difficult or impossible depending upon the severity of this tightened state. With attempts at sex, any resulting discomfort further reinforces the reflex response so that it intensifies more.  Dr Venkat goes on to add that many of her clients who suffer from the condition were raised in rigid, conservative environments, in which female virginity is prized and sex is considered dirty. These “life lessons” are hard to unlearn and can deeply impact on your psyche.    

What are the treatments?                        

It is highly recommended that you seek help from a sex therapist or a cognitive behavioural therapist to find the triggers behind this problem. Spending more time getting to know your body and being intimate with yourself is imperative.  Using a vaginal dilator set is also an effective treatment to try out in the privacy of your home. Dr Venkat also says that seeking treatment is imperative if you want to start a family, as gynaecological examinations are a part of life and should not cause distress.

How can a lubricant help?                                                                                                   

Using a natural lubricant (such Sylk, a plant based intimate moisturiser) mimics your bodily fluids, which can help you to relax and “adapt” gradually to sexual activity. (www.sylk.co.uk)

Why is it rarely discussed?                                                                                                   

Sadly a lot of women don’t discuss this condition due to feeling ashamed, says Dr Venkat. It’s such a personal issue and for many women it impacts on their confidence and makes them feel like a failure. Statistics show that vaginismus is not rare and is highly treatable with the right care and support.  

Why do you feel there needs to be more positive information around this subject?           

Many women who suffer from vaginismus unfortunately avoid the situation and hope that it would go away on its own accord. Dr Venkat urges women to seek treatment immediately, as the sooner you confront these issues the quicker you can move on with your life.

Can it reoccur after a woman has received treatment?

It can never be cured completely. With treatment, the condition improves. There have been some recent developments in the treatment of this condition, including the use of botox injections, which are commonly used for decreasing wrinkles on the face. Unfortunately, once the effect of the injection wears off, the injection needs to be repeated.

How long does it take to treat?

Vaginismus can be dealt with in a reasonable time frame. Motivated women without significant complications usually find that six weeks is adequate to resolve their sexual pain or penetration problems. Research has shown that even two-week time frames are potentially realistic where there is an intense 'full-time' effort, professional assistance, and no significant complications."

Vaginismus Case Study:

‘My issue arose out of multiple issues. I had thrush that seemingly wouldn't go away and I tried all medications under the sun and had examination after examination. This went on for quite a few months. Turns out I never actually had thrush. Then I had a bladder infection that wasn't actually diagnosed - just thought it was a symptom of what doctors were calling vulvodynia or vaginismus. The bladder infection went away in about 6 months. I'd never actually had one before - I only realised that's what it was when I was diagnosed with a bladder infection (unrelated) a few years later. Apparently too much thrush medication and/or trauma and exams down there can actually cause this problem in the first place...

How did it impact your confidence?

I was crushed that no one could help me. Doctors always said that there was no cause and no cure. They gave me numbing creams that didn't help and I went through countless sessions of attempting very painful sex. I feared that this is what my life would be like forever. Constant pain and torture - even using tampons was excruciating.

How can vaginismus affect a relationship as well as the individual?

Obviously sex is a big issue. Despite meeting my now-husband just before my issue started, he was 100% supportive throughout. He was very patient and didn't put any pressure on me at all. I guess in some relationships this could be a big stress factor but obviously with this condition - the more you can't have sex, the more psychologically stressed you get and the worse the pain gets and so on and so forth. 

What action did you take to help?

I just gave it time. Lots and lots of time. And so did my husband. I think going through this together strengthened our bond more as well - as we had to find other ways to be intimate at a point in a relationship when all you want to do is have sex! Eventually it became less and less of an issue and I would say I've been completely cured for a good few years. There have been no signs of it returning either. I still had quite a big problem with thrush after I felt I was 'better', but stopping the contraceptive pill cleared that up as well. I can happily say my vagina has been 100% problem free since stopping the pill - so take from that what you will! Also I'm having more sex than ever - maybe that is to do with not filling my body with unnecessary hormones as well! 

What advice do you have for other women who suspect that they may have vagninsmus?

The more pressure you put on yourself the worse it will get. It can be a painful time both mentally and physically but the more you relax and the more you feel comfortable with your partner, the easier and less painful it will get. Trust you will get over it and enjoy spending time exploring other intimacy options along the way. I know I sound optimistic about this and that's probably what people don't want to hear in this situation - but the only cure for this horrible affliction is time, patience and love.' 


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