Do I have Vaginismus?
Neither your vulva nor your vagina should hurt, nor should sex be painful. Inserting tampons or menstrual cups, and getting a routine gynecological check up shouldn’t hurt either.
Vaginismus is a condition in which the muscles around the vaginal entrance contract involuntarily, closing the entrance of the vaginal opening and making penetration uncomfortable or impossible. Here are some symptoms to watch for if you feel you have vaginismus:
- Feeling like there’s a “wall” down there, blocking anything from penetrating.
- Pain with vaginal penetration, including sexual intercourse, tampon insertion, or a medical examination.
- Fear or anxiety around penetration, which might make you want to avoid sexual activity or push your partner away in anticipation of sexual activity.
- Feeling like the vaginal opening is too small for anything to penetrate.
How common is Vaginismus in India?
Unfortunately, vaginismus is still considered a taboo and shameful topic in India. Fortunately, things are steadily improving, with recent programmes like ours at Proactive for Her. Vaginal discomfort has long been disregarded and normalized, and many people simply view it as a normal part of life.
Vaginismus affects around 1-7% of the female population worldwide. The frequency of vaginismus varies among people and areas, and statistics particular to India are difficult to come by. According to a 2020 research performed by AIIMS, New Delhi, India, 82% of women in India face some form of sexual difficulty. Cultural factors, shame, and a lack of information about sexual health concerns contribute to underreporting, and we suspect that the percentage of people suffering from vaginismus is much higher.
I get anxious at the thought of penetration
Often, if you’ve had a history of trauma to an area (like your vagina), or we don’t have knowledge around sexual health and your female organs, the thought of penetration can be scary and anxiety provoking.
Our bodies can sometimes perceive penetration as a “threat or warning”, making us anxious and want to hold our guards up. What you perceive as a threat or warning can become planted not just in the mind but also in the body.
If your anxiety around penetration and sexual intercourse is affecting your relationship or giving you significant distress, it’s a sign to see a mental health professional who has experience helping people who have fear around penetration.
“I am unable to have sex because of a ‘brick wall’ sensation which makes penetration impossible”.
The muscles in your pelvic floor consist of 3 layers. The “wall” you’re feeling is most likely the muscles tightening, making the vaginal opening smaller and difficult to penetrate.
Physically, tension in the pelvic floor muscles can reduce the size of the vaginal opening, causing discomfort during entry. Majority of women are unaware that this tension occurs within their bodies. Most women who experience pain with sex aren’t able to relax their pelvic floor muscles, especially because their minds are disconnected from the muscles.
Women who lack this connection with their pelvic floor muscles may experience discomfort during intercourse.
There are two important aspects of dealing with this “block”. First is to address your mental health because it will play a role in your pelvic tension. Secondly, pelvic floor relaxation will help increase the flexibility in the pelvic floor muscles and create more space in the vaginal opening. The Vaginismus Program at Proactive for Her includes one-on-one coaching, pelvic floor relaxation sessions, a women’s support group, pleasure coaching workshops, and partner support sessions, giving you a holistic approach to care.
“I have a sense that there isn't enough space in my vagina to have sex or put in a tampon”.
Biologically the vagina is made to accommodate insertion of various sizes. Fear of penetration can cause the opening to close up, making you feel like you don’t have space
Women who have Vaginismus may have intense dread and avoidance of genital contact or hindering genital touch, whether sexual or not. This anxiety might result in excessive pelvic floor muscular tension, which in turn, makes the vaginal opening and vaginal canal feel small.
“I get spasms in my pelvic floor muscles”
During an examination, most doctors encourage their patients to "just relax." For some women this is simple, but for others, they’re not able to find ways to “just relax”, especially if they have pelvic floor muscle tension. But how do they 'just relax' when they don't realize they're tensed in the first place?
Pelvic floor muscle spasms are a reflexive muscle contraction, that occur as a response to a reaction in a person’s mind. It’s a way the body tries to protect itself from pain or suffering, which in turn blocks penetration.
When a person is experiencing spasms in reaction to insertion, it’s typically because insertion is viewed as an invasion of the body, and the spasm indicates an urge to defend oneself, set limits, and guard against this violation.
When spasms occur at the vaginal opening in anticipation of fear of pain, the muscles tend to shorten and tighten from all sides. Subsequent experiences can make the muscles tighten and form knots or bands. This can cause greater pain sensations when one tries to insert a penis, toys or tampons into their vagina.
Spasms at the pelvic floor may occur due to a history of sexual trauma or assault, pelvic injury, pelvic surgery, childbirth, recurrent vulvar infections, and vulvar skin conditions. Research published in the Journal of Sexual Medicine discovered that the condition was more frequent in participants who were prone to anxiety.
Mental health counselling, pelvic floor physiotherapy, sex therapy, dilator therapy, mind-body relaxation techniques, and among the most successful treatment options for vaginismus and addressing this spasms.
If you have Vaginismus, you don't have to live with discomfort for the rest of your life. The Vaginismus program at Proactive For Her offers a well rounded and holistic approach for healing.
The right way to treat Vaginismus
If the notion of penetrative intercourse makes you nervous, it's crucial to identify and handle these sentiments. Here are some tips for navigating and managing your symptoms:
Communication
It is critical to maintain open and honest communication with your partner. Share your thoughts and worries, and ensure that your partner understands your point of view. Anxiety may be reduced by creating a supportive and understanding atmosphere.
Educate yourself
Learn more about your body and sexual health by educating yourself. Understanding the anatomy and physiology of the female reproductive system can help to debunk myths and alleviate worry.
Relaxation Techniques
Deep breathing, and meditation while connecting to your pelvic floor help you relax and minimize anxiety.
Take Things Slowly
It's critical not to hurry into anything that makes you feel uneasy. Take things slowly and make sure you and your partner are on the same page when it comes to the timing and progression of your sexual activities.
Foreplay and Non-Penetrative Activities
Concentrate on non-penetrative types of intimacy and sexual activities. This can assist you and your partner develop trust, connection, and comfort.
Professional help
Obtain professional treatment if anxiety persists or becomes a substantial obstacle. A therapist, particularly one who specializes in intercourse and trauma , can offer advice and assistance in dealing with sexual anxiety.
Pelvic Floor Physiotherapy
Pelvic floor physiotherapy is therapeutic for people experiencing physical discomfort during intercourse. A physical therapist can help you treat any muscle tension or soreness.
Dilators: Healthcare practitioners may advocate the use of graded dilators in some circumstances to assist progressively stretch and relax the vaginal muscles. This is usually done under the supervision of a healthcare practitioner.
Takeaway
Vaginismus is thought to be a psycho-physiological condition, signifying that it is a psychological condition with physical manifestations.
According to a research published in Sexual Medicine, 71% of vaginismus patients reported pain-free intercourse after just five weeks of therapy.
Although Vaginismus can be a painful condition both mentally and physically, it’s important to know that there is hope for healing. Mental health counselling, along with pelvic floor relaxation, dilation therapy, and pleasure coaching all help people overcome vaginismus.