This article is compiled by Saloni Taneja, a Product Manager at Proactive For Her.
What is Vaginismus?
Vaginismus is defined as the inability of a woman to allow vaginal penetration of a penis, finger, tampon or a menstrual cup due to an involuntary spasm of the vaginal muscles, despite the person’s definite wish to do so.
Vaginismus often leads to lots of interpersonal conflict and frustration between partners due the inability to have smooth penetrative sexual intercourse. More often than not, women have been blamed for ‘not trying hard enough or ‘not wanting sex enough’. However, the fact is that women with Vaginismus often have a high level of desire, but are unable to control the involuntary closure of the vaginal opening. This leads to extreme distress, frustration and disappointment. Vaginismus doesn’t prevent sexual arousal, but it does prevent penetration.
Awareness about vaginismus in India:
Many women experience painful intercourse in their lives, however, the root cause of this painful intercourse often goes unreported or undiagnosed. Vaginismus, as a condition, is not common knowledge in Indian society. In fact, a simple google search reveals that the first blogs about this issue started getting published only in 2019. Since there is so much shame and stigma associated about sexual activity in the Indian society, a majority of cases often go unreported both in urban and rural settings. Women often suffer in silence and isolation or wait for the issue to resolve itself spontaneously. The lack of awareness and statistics around treatment of vaginismus leads to women struggling to find reliable sources that can guide them in the right direction.
Inadequate support from the health care system in India:
Given the very niche nature of this diagnosis, most gynaecologists that are trained in the Indian healthcare system lack the training for vaginismus diagnosis and management. Hence, this lack of training leads to diagnosis through methods which may aggravate this condition like vaginal examinations. This ends up being extremely traumatic for women an can set off stronger vaginal spasms next time penetration is attempted. For better management and diagnosis of this condition women or couple should opt for a consultation with a psychiatrist or sexologist. However, given the tremendous amount of taboo around this, many women or couples hesitate to proceed with consultations with these specialists.
Women or couples are often offered suggestions that are incomplete ("practice putting fingers inside"), generic and not useful ("just relax", "have some wine"), unscientific (like Botox or Hymenectomy) or induce shame and blame ("it's your partner's fault that he allowed this to go on for so long", "you need to learn to bear some pain"). After such experiences, many women or couples give up hope of healing.
What is the impact of vaginismus on an individual or couple:
- On the individual: Unhealed Vaginismsus can lead to feelings of sadness, depression, and a sense of hopelessness. Women often report feeling inadequate about not being able to ‘do the most basic thing which everyone else can do’. When they see their friends enjoying sex or even getting pregnant, they start to lose their self-confidence and self-esteem. They start to believe something is essentially amd intrinsically wrong and broken about them. Many start to wonder if they are ‘asexual’ or their vaginal hole was too small. Because of the lack of a healthy conversation around sex and puritanical nature of society, sex is often seen by women as a ‘duty’ after marriage and being unable to fulfil that ‘duty’ brings a lot of guilt and shame.
- On the relationship: While a majority of urban partners are supportive and understanding of their partners condition, lack of awareness and treatment options often lead to a lot of frustration, conflict, intimacy issues and even loss of desire and separation.
Types of Vaginismus and its causes:
Vaginismus can be of two types:
Primary vaginismus: This is when painless penetration has never been achieved. Vaginal muscles go into an involuntary spasm due to some memories and beliefs, stored in the subconscious mind. Themes of "Pain and Shame" are most commonly discovered during therapy.
Causes of primary vaginismus:
- Fear of Pain: The belief that penetration is going to be painful & difficult.
Hearing stories of the first night being painful for some women, detailed news anddiscussions in social media about rape cases or even an experience of a painful and rough gynaecological examination can trigger the cycle of pain in minds of women.
- Shame: The belief that sex is an immoral, dirty act.
The huge taboo around pre-marital sex in our society creates an environment of sexual suppression. Any attempt at exploration of one’s sexuality is shamed & rejected.
- Past sexual trauma: Past experience of sexual abuse, bad touch or violation can create a relationship of pain and trauma with the sexual areas of the body.
- Painful experiences around the genitals: Painful periods, genital surgery during growing up years can create a relationship of pain with the genitals.
- Lack of sex education: Lack of understanding about one’s genital organs and sexual activity.
- Fear of pregnancy: Lack of knowledge of contraceptives causing fear of pregnancy during attempted penetration.
Secondary vaginismus: This is when a woman has had painless penetrative intercourse in the past but for some reason is not able to do that now.
Causes: Emotional distance created by marital conflicts, past experience of traumatic childbirth, painful episiotomy scar, endometriosis, pelvic inflammatory disease, infections etc.
Proactive For Her’s Vaginismus Healing Program led by Dr Taru Jindal
To address this huge unmet need in India, Proactive For Her along with Gynaecologist Dr Taru Jindal launched a 6-week online Vaginismus Healing Program to help women with Vaginismus heal their conditions while also accepting and exploring their sexual selves.
It is a wholesome program with multiple components like individual patient therapy, participant support groups, partner support groups, pelvic floor relaxation coaching and also Art & Movement therapy.
It is based on the ‘Four-Step Process’ of healing, which Dr Taru has designed based on current evidence-based approaches. She has also drawn from her own experience of healing Vaginismus of 7 years to create an impactful and effective program structure. This program has completed 1 year in September and is now running its seventh batch. In this one year, oue healing program has assisted 56 Indian women with vaginismus from across the globe. These women had been suffering from Vaginismus sicne anywhere between 6 months to 10 years.
We have had the pleasure of seeing very encouraging results. 84% of women completed Vaginal Dilation (Vaginal dilators are used to help the woman practice relaxing her mind and body during vaginal penetration with dilators in her own safe space. Fingers can also be used for this purpose). Women of our program who feared even looking at their vulva completed this stage of healing in an average duration of 6 weeks.
64% of those who completed dilation achieved painless penetration. The average time taken to complete the last step of painless penetration was 8 weeks. Women whose goal was to conceive naturally have also managed to get pregnant!
The experience of running this program has been immensely satisfying for the entire team. After witnessing the transformation that Vaginismus healing can bring to a woman's life, and to her relationships, we are inspired to break the silence around this extremely painful and distressing issue.
Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.
Proactive For Her is a digital clinic for women, offering accessible, personalized, and confidential healthcare solutions. We offer products and services for out-patient health concerns of Indian women, across their lifetime - from puberty to pregnancy to menopause. To know more on the sexual and reproductive health of women, visit https://www.proactiveforher.com/
If you, or anyone with you, has Vaginismus, kindly fill this form about our 6 week program & we will get back to you
https://proactiveforher.typeform.com/to/yS91AzKo
Youtube playlist by Dr Taru Jindal with explanatory videos on Vaginismus:
https://youtube.com/playlist?list=PLRYFn0Jc3KfXu_QhgU_LYoKWqm7Jweo2g