How Common Is Vaginismus And What Toll Does It Take On Women?

Did you know that many women find it next to impossible to have sex? As taboos around the topic of sex are slowly breaking down in our society, we’re coming to acknowledge sex as a natural part of life, especially women’s lives, and as something that is equally fun and pleasurable for them as it is for men. But a dark shadow lurks behind this newfound acceptance, something that is easier ignored than brought into the light of day to complicate matters. This is the fact that 3 out of 4 women experience vaginal pain during sex, ranging from temporary to long-term.1 1-7% of these women suffer from a condition called vaginismus, which makes vaginal penetration extremely painful for them.2 What exactly is this condition, is it physical or psychological, can it be cured, and what toll does it take on women’s physical, mental, and sexual health, their self-worth, and their relationships? It’s high time we tackle the matter.

What Is Vaginismus And How Common Is It In India? 

Vaginismus is a psychophysical disorder that causes involuntary vaginal muscle spasms either during or in anticipation of vaginal penetration, leading to painful sex or fear. This isn’t just limited to sex and masturbation but can also happen during the insertion of a tampon, menstrual cup, or a contraceptive device, and even during a gynaecological exam. It is a form of dyspareunia, the medical term for painful intercourse, and it often stems from a deep-rooted fear of penetration, which itself is often a result of some past trauma. So there are multiple ways in which it impairs the lives of these women, from affecting their physical health to bringing their sex life to a deadening pause, which in turn has a negative impact on their sense of identity, self-worth, and romantic or sexual relationships.

This is not something which only a minority of women experience. On the contrary, the prevalence of vaginismus in women residing only in urban areas of India has been found to be 10%.3 One can easily conclude that the actual number of women in India with this disorder would be even higher given the fact that it probably remains undiagnosed in rural areas. It is worth exploring what causes this condition in such a large number of women.   

Getting To The Bottom Of It: Is Vaginismus Psychological?

If it wasn’t enough that women have had to deal with pain during something that is supposed to be pleasurable, the way that medicine has treated vaginismus in the past has been dreadful to say the least. In the 19th century, vaginismus was attributed to women’s moral or psychological failings and they had to undergo marital counselling, or much worse, procedures such as clitoridectomy, or the surgical removal of the clitoris. Once Freudian psychoanalysis came into the picture in the early 20th century, the condition started being seen as a symptom of sexual repression or anxiety. For all its misogynistic failings, the one thing that Freudian psychoanalysis got right was the fact that vaginismus might be stemming from psychological factors.

Over time studies have found that vaginismus is either experienced by women who have faced some sort of sexual abuse in their childhoods, or those who live in cultures that lead to sexual repression in women or in which women are not afforded any sexual knowledge.4 This is particularly true in India where sexual repression and the lack of sex ed is quite prevalent. Because sex itself is still such a taboo subject, most women do not even acknowledge this condition or seek help for it, or to be more fair, they do not even know that it is something for which help can be sought. Add to this the fact that sex is often thought of as a marital responsibility that women have to fulfil, especially in India. Thus most cases of vaginismus go undiagnosed and untreated. 

But the fact of the matter is that vaginismus is a psychosexual disorder listed by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and as such, is something for which help now exists. It’s time that we spread awareness about this, so that women whose sexual and emotional lives are being ruined due to this condition, can seek out treatment and lead more fulfilling lives in the future. However, it’s important to note that vaginismus treatment isn’t just limited to psychological therapy because there can be some physical causes of vaginismus too, such as previous surgeries, some sort of infection, childbirth-related injuries, such as vaginal tears, or medical issues like bacterial vaginosis, endometriosis, or pelvic cancer. Additionally, vaginismus treatment involves physical exercises as well. Let’s learn more about vaginismus diagnosis and treatment below.

You Don’t Have To Suffer: Vaginismus Diagnosis And Treatment

The first thing you should know is that if you experience painful intercourse, you’re not broken and you don’t have to suffer forever. Vaginismus is very much a treatable condition. The first step involves seeing a medical professional, such as a gynaecologist or a sexual health therapist, who can diagnose vaginismus based on your symptoms, both physical and psychological, and medical history. These are the symptoms they would be looking out for:

• Pain in the vulva or pelvic region during sexual intercourse
• Tightened pelvic floor in anticipation of vaginal penetration 
• Fear or anxiety at the thought of vaginal penetration

Treating vaginismus also requires all aspects of the condition to be addressed. So, if you’ve been diagnosed with it, your best bet is a combination of vaginismus exercises or pelvic floor physical therapy and sex therapy or talk therapy. 

Physical therapy involves: 

• Desensitisation therapy with vaginal dilators or your own fingers to slowly make you more accustomed to and relax during vaginal penetration.
• Pelvic floor exercises such as Kegel exercises, along with practising mindfulness and deep breathing, to help you regain control over your vaginal muscles. If you feel vary about visiting a pelvic floor therapist and are wondering ‘how to treat vaginismus at home,’ these exercises are something that you can try on your own to begin with. 

Sex therapy or talk therapy such as Cognitive Behavioural Therapy (CBT), on the other hand, would involve getting to the bottom of your fears and anxiety around sex or penetration. It also involves learning more about vaginismus and your own anatomy, unlearning negative beliefs about sex, and discussing any relationship or communication issues that might be contributing to your condition. 

Your Vagina, Your Rules

If you’ve been diagnosed with vaginismus or are considering visiting a medical professional to get a diagnosis, know that you are not alone. Many women experience what you are experiencing, and many of them have also been cured. It’s not something to be ashamed of, either because you feel you are not fulfilling a duty (which is an untrue assumption to begin with because sex is NOT women’s duty) or because you feel left out of conversations about sexual pleasure. It’s time for you to take charge of your own physical and sexual health and seek out help that would help you leave behind all pain and negative feelings around sex and begin a healthier, pleasurable relationship with sex and your own body.    

FAQs

Q. Can vaginismus be cured?

Ans: Yes, vaginismus can be cured with the help of pelvic floor physical therapy or vaginismus exercises, which help your vagina get more accustomed to penetration, and sex therapy or talk therapy, which helps you understand where your fears of penetration stem from and unlearn negative beliefs about sex.

Q. How do I know if I have vaginismus?

Ans: You might have vaginismus if you have any of these symptoms:

• Pain in the vulva or pelvic region during sexual intercourse
• Involuntary tightening of pelvic floor in anticipation of vaginal penetration 
• Fear or anxiety at the thought of vaginal penetration 

Q. Why am I experiencing pain with penetration?

Ans: There can be multiple reasons why you might experience painful sex, including 

• Dyspareunia, such as vaginismus
• Sexual trauma from the past
• Physical causes such as previous surgeries, some sort of infection, or childbirth-related injuries, such as vaginal tears
• Medical issues like bacterial vaginosis, endometriosis, or pelvic cancer