What is Vaginismus?
Vaginismus involves recurrent or persistent involuntary spasms of the vagina’s outer muscles, preventing the penetration of any object (penis, finger, tampon, menstrual cup, gynaecologist’s speculum etc.), despite the person's definite desire to do so. It is understood as the body’s protective response that causes an involuntary contraction of the pelvic floor muscles, causing the entrance of the vagina to close. Vaginismus is an uncontrollable response generally rooted in fear. It does not necessarily affect one’s ability to get aroused or enjoy other types of sexual contact.
Vaginismus is classified as primary or secondary. It is primary vaginismus if it’s a lifelong condition i.e. if the individual has never been able to have penetration of any kind, despite desiring so. This is often discovered during one’s first attempt at penetrative sex, inserting a tampon, or the first time a pelvic examination is attempted by a doctor. It is secondary vaginismus if painless intercourse has been experienced in the past but the individual is no longer able to have it. This can be triggered by particularly stressful life events, emotional distance created by marital conflicts, childbirth trauma and injuries, or health conditions such as pelvic inflammatory diseases, infections, endometriosis etc.
It has been associated with high levels of disturbance for those affected and can have a profound impact on how a woman feels about herself, on her partner, and on their relationship.
What Makes Vaginismus a Psychological Concern and Not Only a Physical Concern?
Vaginismus is neither a purely physical nor a psychological concern. Vaginismus is a psychosomatic condition, which means that it is borne out of an interaction between the mind and the body. Traditionally, vaginismus was understood as a physical concern characterised by the vaginal spasm. However, a multi diagnostic framework was needed to understand it beyond the physical diagnostic markers to focus on deeper cognitive and emotional meanings behind the physical symptoms. The factors that contribute to vaginismus are understood to lie on a spectrum and are understood as a combination of physical to psychological, influenced by relationships and one’s cultural context. Different blends of these factors will contribute to it in unique ways to each set of partners experiencing vaginismus. Some of these factors include:
- Beliefs around penetrative sex being painful or underlying fears about tissue damage or the hymen being torn, due to misinformation about the body and acts of sex
- Beliefs around sex and masturbation being shameful or wrong including overly restrictive upbringing (in which sexuality was considered a taboo subject), repressive religious teaching resulting in unhealthy or sex negative messages, and inadequate sex education,
- Negative beliefs around sexual organs including the vagina being too small or having a penis aversion
- Excessive fears around negative consequences of sex including painful childbirth, unwanted pregnancy, sexually transmitted diseases etc.
- Experiences of pain around genitals including painful periods, vaginal injuries or surgeries
- Painful first sexual experiences
- Traumatic events including past emotional, physical and sexual abuse or being a witness of violence or abuse, or exposure to unsafe touch experiences, or excessive exposure to stories of sexual assault
- Having a general anxiety disorder that is characterised by hyper-vigilance, catastrophic thinking and an excessive need for control as well as development of perfectionism
- Relationship dynamics, particularly a lack of emotional safety with one’s partner (due to mistrust, lack of commitment or emotional detachment) which could create anxiety about being vulnerable.
As the aforementioned factors underlying vaginismus are primarily psychological, emotional, relational, and cultural in nature, it makes vaginismus a psychological and mental health concern as well.
Overcome Vaginismus with Confidence
Vaginismus is curable with a multidisciplinary, holistic, and customised approach to healing. Given below are the important components needed to heal vaginismus:
- Psycho-sexual therapy to address the underlying psychological and mental health factors of vaginismus. In the presence of a trauma-informed mental health expert, one must gain insight into the negative beliefs and stressors that may be contributing to vaginismus as well as heal their related past trauma.
- Mind and body relaxation done through mindfulness, breathing, and exercises as advised by a trained yoga professional.
- Pelvic floor exercises as advised by a trained pelvic health physiotherapist to target the pelvic floor muscles to gain better control of them and general movement. This also aids with vaginal training or dilation wherein the movement and stretching would decrease the pain and allow the muscles to relax.
- Vaginal training using vaginal dilators can be extremely helpful for the mental, visual, and physical adaptation to penetration and to refute negative beliefs around penetration being painful. Dilators are cylindrical shaped devices which come in various sizes. They are used to help open and stretch the tissues in the vaginal canal and release pain points, along with building the mental and emotional threshold to accept penetration. Oftentimes, women are just given a set of dilators to practise with on their own and it can be an overwhelming experience to go through alone. It’s important for a trained pelvic health physiotherapist or professional to guide you as you get started with dilation.
- Partner relationship and intimacy to build better communication and understanding between partners, provide a space for them to vent and feel supported, along with initiating partnered physical exercises aimed at improving emotional and physical connection. In some cases, couples counselling may be needed to address some deeper running issues.
- Support network with other women with vaginismus to address feelings of isolation that come with the condition, experience empathy and support.
As written above, vaginismus healing has elements of psychological healing and support and physical exercises to be done consistently. It does not necessarily need physical/in-person examination or presence of a professional to execute all of the steps. As of April 2024, more than 350 women have healed from Proactive For Her’s award-winning vaginismus healing program. This is testament to the fact that vaginismus is curable and an online program can facilitate the healing of women battling this condition.
Treat Vaginismus at Home
Proactive For Her’s addresses the multi-disciplinary components of healing vaginismus through the following support structures, all available online:
- Dedicated coach and therapist who anchors the program for the participants and addresses the underlying psychological and mental factors, and tracks physical and vaginal training.
- Support and educational groups conducted by mental health professionals, gynaecologists, a yoga professional, and a pleasure and intimacy coach.
- Dedicated WhatsApp group for the women of the cohort to interact with each other and for the program professionals to address their concerns.
- Support and educational group for the partners of the participants of the program to facilitate better understanding and support between the couple.
- Focused and detailed educational and guidance content in the form of recorded videos, infographics, etc.
The programme essentially offers an ecosystem of individual, group, and informational support that sets one up for success to heal from the comforting environment of their homes. It also allows for women from all over the globe to access painless and pleasurable penetration, free from vaginismus.
Real Stories, Real Solutions
Radha* (name changed), a 30 year old woman hailing from Bengaluru joined the program as the last resort to address her vaginismus. Even though she had a satisfying sex life with her partner, she was worried about the one act of penetrative sex that was available to many other couples, but not them. She also dreamt of being a mother through natural conception. Battling significant anxiety and a sex-negative beliefs she carried, she committed to deep emotional healing with her coach to move towards sex-positivity, was disciplined in her physical exercise and vaginal training using dilators, all while working a full-time job. In a course of eight weeks, she was able to achieve painless and pleasurable penetrative sex with her partner. There are many other women just like Radha with different versions of the same story, all healed through the online program and leading fulfilling sexual, emotional, and relational lives.
Conclusion
Vaginismus is a lot more common than we all think. Proactive For Her’s award winning, multi-faceted, online Vaginismus Healing Program has a multidisciplinary team to treat vaginismus holistically and supportively. If you suspect someone you know might be dealing with vaginismus, reach out to us to schedule an initial screening call and gain more information.