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. It 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.
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 are the Types of Vaginismus?
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.
What are the Factors that Contribute to Vaginismus?
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, being a witness of violence or abuse, 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.
For those with vaginismus, it is often a combination of multiple factors that contributes to their condition and in maintaining vaginismus. Often, these excessive fears or negative beliefs originate from a lack of information or misinformation about the body, genitals and acts of sex. Beliefs around sex, sexuality, sexual organs, relationships etc. are often shaped by the societal and cultural contexts one is raised in, and which are often different from one's biological sexual needs. With a trained professional and through specific interventions and education, one can learn to identify which of these causes are contributing to their experience of vaginismus, and gain insight into changing them and/or healing from traumatic past experiences.
Is Age a Factor in Vaginismus?
With primary vaginismus, symptoms may be noticed first during the late teens or early adulthood when one attempts to insert a tampon or a menstrual cup, goes to a gynecologist for a pelvic examination, or attempts to have penetrative sex for the first time. Age is a factor involved in vaginismus because the earlier someone has been exposed to the factors mentioned above, the higher the chance a person develops primary vaginismus. It also affects the depth of psychological impact a person may experience.
Secondary vaginismus may develop anytime later in life and age is not a factor in this case. It can set in for someone after years of comfortable and painless penetration.
The time between a woman’s onset of vaginismus and her being diagnosed with the condition can be long and varied due to the lack of information and awareness around it. There’s also a high stigma attached to conversations around sex and relationships, guilt around vaginismus symptoms,and lack of access to sensitive professionals who can diagnose the condition.
How Can You Diagnose Vaginismus at Any Age?
The diagnosis of vaginismus and the assessment conducted in order to diagnose someone with vaginismus remains similar across age groups. Diagnosing vaginismus requires a detailed medical, psycho-social, sexual, menstrual, and pelvic health history, including any episodes of traumatic sexual experiences. A medical provider might ask questions related to sexual knowledge and family culture due to the role that cultural influences have in the development of vaginismus. The clinician would take a clear description of the pain, fear, and the avoidance responses to penetration.
A genital examination may be necessary sometimes to exclude any physiological reasons such as challenges with skin, hormonal changes, infections, and scarring that could contribute to vaginismus. This may be anxiety-inducing for some women as they may anticipate pain or may be fearful. It is important to meet with a non-judgemental and trauma-informed gynecologist and to be able to communicate with them freely about one’s fears and concerns.
If you and anyone you know suspect experiencing vaginismus, reach out to the vaginismus-informed gynaecologists at Proactive For Her for a vaginismus screening consultation, no matter what the age, to learn more about your body and the next steps to address vaginismus.
Conclusion
Vaginismus is a lot more common than we all think and women of different age groups are able to access the treatment for it or exercise their choice to take the treatment at different times. Proactive For Her’s award winning, multi-faceted Vaginismus Healing Program has a multidisciplinary team to treat primary 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.