Vaginismus

By Tanya Koens

This is a story I have longed to tell, about a problem that is much more prevalent than people believe.  Research shows us that approximately 8% of women suffer from it.  It’s something that is couched in shame and despair and it is an issue that people do not know how to address.  To make matters worse, it is often unacknowledged by professionals when sufferers seek help.

In my work as a Sexologist, I have so many lovely young women come to see me about an inability to have intercourse or experiencing large amounts of pain and/or discomfort during intercourse and other sexual activities.  Older women have this complaint as well, but this seems particularly prevalent amongst younger women.

What is particularly distressing for many of these women is that they have often been to numerous practitioners and been told:

-       There is nothing wrong with you!

-       Stop being so silly! Just get on with it.

-       You will get used to it in time.

-       Just relax.

-       Stop being so up tight!

And many other dismissive things.

In fact, a colleague of mine has done a PhD dissertation on Female Genital Pain and she presented that women who experience Vaginismus have often been to upward of 18 practitioners and can have spent in excess of $20,000 seeking treatment for their problem.  This breaks my heart.

When I speak to these girls I immediately validate and normalize their pain/discomfort.  I give them permission to be experiencing it and sit with their frustration and fear at the situation they find themselves in.  I can see their bodies immediately relax when they realize that they are speaking to someone who finally gets what they have been experiencing.  They just want to be “normal” and can’t understand why they are having these problems.

It’s the relaxing of the body that proves potent.  Vaginismus is a dysfunction that starts in the head but has very real pain and physical repercussions.  It is an involuntary clamping or tensing of the vaginal and pelvic floor muscles that can – at its most extreme – prevent entry by a penis, a digit or even a doctor’s examining tool.  Sometimes penetration is possible but it can cause pain and discomfort which can result in the sufferer being fearful of and wanting to avoid sex.  This, of course, can have detrimental effects on the sufferer’s relationship(s) with sexual partner(s).

It is possible that after suffering Vaginismus for some time without resolution, the muscles can remain in hypertonic spasm.  Often women are not in touch with the pelvic region of their body and will be unable to tell if there is any stress or discomfort there unless an extreme event – such as intercourse – is attempted.  Often they are unable to tell if they are sexually aroused as they are not in touch with how their body works.

When I see the young women relax as we are speaking, I notice it to them.  It’s a great opportunity to then ask them if they tense up during sex … and by the time I get to meet them, they invariably are.  Given that the client now knows that I understand what is going on and that I have empathy for the frustration and fear that they are experiencing, we have set a good foundation to start working on the cause of the Vaginismus.

There are many causes for Vaginismus ranging from a fear of the mechanics of sex; lack of knowledge about foreplay and arousal; feeling pressured into sex; feeling hurried or a lack of privacy; feeling guilt or shame; picking up on a partner’s anxiety or fears.  So many different reasons!

The work I do with these young women is to explore their narratives about sex; discover stories that may not be useful to them; help them listen to their body and what their body is telling them; and give them permission to have their experience as it is.  We then start to re-write their narrative around sex to something that will serve them better and often work in conjunction with specialist physiotherapists to help unlock any muscles that are in spasm.

Sounds very straight-forward and it is!  But the pressure these girls experience to be “normal” and “perform” is immense.  It’s a journey that can take from one visit to six months of regular appointments … but it’s a journey that can be well worth it for these girls … one of self discovery, knowledge and permission granting and one that finds their voice around their own sexuality. 

This is the kind of work I love to do; addressing self doubts; tackling their pain and fears and re-writing their sexual narrative to reflect who they are and to give them permission to embrace their own sexuality (without feeling shame, obligation or fear).

In other words, I get to meet fabulous people and help them be more fabulous … its not a bad gig is it? 

I really am grateful everyday for that experience.