Anonymous, a 22-year-old straight female asks: “Vaginismus: let’s talk about it! It’s a really hard issue, especially when your bf REALLY wants to have sex with you…”
Dear Anonymous, thank you for your request! Admittedly, I had not been very well-informed about vaginismus and its treatments until I took the time to look into it at your behest. Now, I agree that this information is vital for sexually-active college students to have.
Vaginismus, according to most peer-reviewed medical sources, is a condition when the muscles of the vagina involuntarily contract upon penetration. This response, which is not something the individual can control, can lead to pain during penetrative sexual intercourse. Vaginismus causes dyspareunia, the medical term for painful intercourse. Vaginismus differs from other types of sexual dysfunction in that there is no physical sign of why the person is experiencing contractions.
Sometimes this pain can make it difficult to insert tampons and receive gynecological exams. For many people with vaginismus, not being able to have sex without experiencing pain causes a lot of distress. It can be a burden, especially if they already feel pressure to perform sexually.
The cause of vaginismus is unknown, and variable from each individual’s narrative. Medical journals say vaginismus could be caused by a trauma via assault or unwanted sexual contact, an injury caused during childbirth, social stigma surrounding women’s sexuality, or even anxiety. Vaginismus is typically considered to be more of a psychological dysfunction than a somatic dysfunction, meaning the person’s body is likely reacting automatically to stimuli it perceives as a threat.
The most likely reason we don’t have more definitive answers of what vaginismus is, how it starts, and why it happens is that there is very little published, vetted research on the subject. A comprehensive study by the National Institute of Health concluded that it is difficult to pinpoint the best treatment for vaginismus because no existing study has enough reliable data extracted from a satisfactory sample size due to the “heterogeneity of comparisons within the studies” and an “inadequate reporting of data.”
While the formal diagnosis rate of vaginismus is low, medical professionals believe more women, who are not comfortable bringing up the subject with their doctors, could struggle with the condition. Sexual topics are taboo, especially for women who have grown up in environments where sex, particularly before marriage, is seen as a moral failing.
If you, like Anonymous, suspect that you have vaginismus, the first best step would be to mention your concerns to your gynecologist. They might perform a physical examination to ensure that there aren’t any noticeable injuries or alternative reasons for involuntary pelvic muscle contractions. From there, your provider may have a few suggestions for treatment.
Common forms of treatment for vaginismus are sex therapy (either solo or with your partner), pelvic floor physical therapy, education, and systematic desensitization. The last form, systematic desensitization, is a very scary looking phrase that means getting your vaginal canal used to the stimulus of penetration in a controlled environment. This can be done with a finger or with a tool called a dilator. These long, silicon tools look similar to dildos, but come in progressive widths and lengths to allow the user to work up to penetration for larger objects, like a penis.
While I wouldn’t recommend this for more sensitive issues, I found that the subreddit r/vaginismus is full of various experiences from people who have dealt with the condition themselves.
Anoymous, the only concern I have with your submission is that you mentioned vaginismus is really hard to deal with, “especially when your bf REALLY wants to have sex with you.” It’s all fine and dandy that your boyfriend wants to have sex — but do you? Do you feel pressured to have sex even when it is painful or uncomfortable? Because that will not help alleviate the symptoms of vaginismus.
When it comes to overcoming a challenge in sexual intercourse such as vaginismus, it is really important that the person with the condition is supported and does not feel pressured to do anything that is painful. Sex should be fun and pleasurable, not something that you dread because it hurts.
This is not to say women who have vaginismus do not feel desire — it’s actually quite the opposite. Vaginismus does not hinder a woman’s sexual desire unless she feels extremely nervous about the pain she expects to experience during sex. Women who have vaginismus often do want to have sex, but can’t due to their condition making it painful.
Overcoming vaginismus is likely going to be a time commitment for the person who has it. Treating vaginismus requires a lot of patience and grace with yourself; it won’t go away overnight, and being hard on yourself will likely only make your symptoms more persistent. And if your partner can’t handle going without penetrative sex, the onus is on them to communicate that and collaborate with you to find a way to meet their needs.
Vaginismus can be incredibly difficult to deal with, but treatment is available. The most important thing is that we have open dialogues about vaginismus. Hopefully, this can lead to more comprehensive studies and more avenues of treatment to become available. Ultimately, this can reduce the stigma surrounding dyspareunia and painful intercourse, in turn making it easier for women to get help for this issue.
