What is Vaginismus?

Sex. It’s supposed to feel great. It provides us with toe-curling orgasms and gives us that deep, intimate connection with another person (or other people depending on what you’re into). One thing consensual sex is not meant to do, is hurt. However, for some vagina owners, (I use this term to be inclusive of transgender men and assigned female at birth non-binary folx) toe-curling orgasms and the pleasurable sensations that are supposed to come with sex seem fictitious because all sex does is hurt. Experiencing pain during sex can be incredibly isolating and frustrating to deal with and is often caused by a condition called vaginismus.

This is a condition I have lived with for my whole life and first learnt about in 2019. Before I knew I had vaginismus I thought I was destined for failed relationships because I couldn’t have sex or it hurt too much. I hated my vagina and convinced myself that I was broken, unworthy and would never have a fulfilling sex life. It wasn’t until I fainted at work and went to A&E as a friend thought I must have appendicitis due to the pain I was experiencing in my lower abdomen, that I realised I had vaginismus. All this pain was brought on by attempts at penetrative sex with a long term partner I was seeing during the summer of 2019. 

Even getting a diagnosis of vaginismus was painful. I got told by GPs I was probably sleeping with the wrong people or that the only possible reason sex was painful was because I had an STI. I got tested, went back to the GP with negative results and was told to get tested again. Some people with vaginismus have opened up about their GP telling them to have a glass of wine during sex. It took about a year and one emotional breakdown in front of a trainee nurse to finally have the pain I was experiencing during sex taken seriously. This goes to show how unaware people are of vaginismus and both the emotional and physical turmoil it can cause, which extends into our healthcare systems too. So, I’m writing this article to hopefully raise awareness around vaginismus and to answer the question: what is vaginismus? 

You’ve probably gathered from what you’ve read so far that vaginismus is a health condition that makes sex painful. However, people with vaginismus often can’t use tampons or aren’t able to get pap smears or certain medical examinations done. Any form of vaginal penetration, vaginismus majorly dislikes. Vaginismus is also so personal to an individual. You could have penetrative sex without a problem but not be able to use tampons, or be able to use tampons and not be able to have penetrative sex. This is known as situational vaginismus. On the other side of things, there is global vaginismus which means the condition is always present and any object penetrating the vagina is a solid no. These terms are used to see what triggers vaginismus for someone. You also have primary and secondary vaginismus, which focuses on the type of the condition that someone has. Primary vaginismus is when you’ve struggled with penetration, regardless of it being global or situational, for your whole life. It’s something that has always been there. Secondary vaginismus is when you’ve been able to have pain free penetration but then an event happens that brings on vaginismus. This could range from surgery to childbirth to a drop in oestrogen levels. All these factors are what make vaginismus such a personal and individual experience. 

It is also important to make it clear that despite how many times I’ve mentioned the word vagina and the connotations the word ‘vaginismus’ might have, that vaginismus is not a health condition directly linked to the vagina. Yes, it does impact people being able to have things enter their vagina, but this impact is caused by the muscles around the vagina. Vaginismus is a muscular problem, not a vagina problem. The vaginal muscles involuntarily contract or go into spasm when penetration is about to happen or during penetration. The contractions then make your vagina tense up and sometimes completely close up. This tension and tightness of the muscles then leads to painful sensations and if the muscles get extremely tight, at times people with vaginismus can’t achieve any kind of penetration. If something tries to get on up there, it’s like hitting a brick wall.

Usually, if people can sense their muscles tensing up, maybe in a massage or a dental check-up, we’re told to relax. Opening up to certain people about vaginismus in my life has also led to me hearing the phrase ‘just relax’ so much. Unfortunately, telling someone with vaginismus to relax isn’t going to solve anything, trust me we’ve probably told ourselves to chill out and take a deep breath most of the time. You can be as relaxed and as turned on as possible and vaginismus can still get in the way. Your vaginal muscles have this automatic response to penetration, almost like a built-in fight-flight or freeze response. For whatever reason penetration activates this response and our muscles go into freeze mode and tighten up, causing pain. Your mind and body begin to unconsciously anticipate pain in scenarios that involve penetration, kind of like how if something gets too near to our eyes we blink. It’s the body automatically trying to protect itself. This is one of the hardest things to deal with when it comes to vaginismus, especially if penetrative sex is a situation that triggers it. You’re aroused and excited to have sex with a partner, then your body and mind anticipate this pain, you become anxious, sad and frustrated with yourself and start to associate sex with these negative emotions to the point you just end up avoiding sex, whether it is penetrative or not. This cycle repeats and it knocks your self-esteem completely. Escaping what is known as the cycle of pain is one of the biggest challenges for those of us with vaginismus. 

Another thing about vaginismus, is that there is no specific, root cause. One person with vaginismus could’ve grown up in an environment that viewed sex as shameful and something a vagina owner should only have after marriage, therefore the shame they link to sex goes onto further impact their sex life by creating a physical anxiety that manifests as vaginismus. One person could’ve grown up in an environment promoted the myth that the first time someone with a vagina experiences sex, it will hurt, which then creates an anxiety around sex. But no one knows which came first, the vaginismus or the anxiety. I grew up in a very sex positive environment, I never had the sex talk and my friends and family were never intrusive or judgemental of my sex life but I still have vaginismus. At times vaginismus can be a symptom of another health condition, like endometriosis. Understanding what could be causing  vaginismus is so important in terms of treatment or seeing if it is to do with a whole other health condition. 

The most effective vaginismus treatment is of-course going to be dependent on the individual as no two experiences of the condition are going to be the same. Some might find psycho-sexual therapy more effective, as they may have grown up in a sex-shaming environment and need to unpack and change their views around sex in order to heal. Others might find that a more physical treatment such as using vaginal dilators to help slowly stretch their vaginal muscles more impactful, as for them vaginismus could be more of a physical issue, rather than an emotional one. For me, vaginal dilators have been really effective. Also getting out of the mindset that penetrative sex is the ‘only way’ to have sex has transformed my sex life and given me a better understanding of my sexuality as well as encouraging me to continue to work on treating my vaginsmus because I’d love to experience a g-spot orgasm one day.

Regardless of the route those with vaginismus go down, there is a 95% success rate when it comes to treatment. Realising I didn’t deserve painful sex and pain is not something I should have to deal with, to constantly going to my GP until they took me seriously were the first two steps in my own vaginismus recovery journey. It’s not a simplistic recovery and it is frustrating at times but I am looking forward to a pain free sex life – and the day I can actually go swimming on my period. 

Words by Emmie Cosgrove

Photo by Dainis Graveris

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